How do Sleep Position Affect Six Common Diagnosis

Most of your best healing occurs while you are healing. Improper sleep positions can slow down the healing by compressing tissue, decreasing blood flow, stretching injured structures, all which affect the inflammatory process. All healing processes require an inflammatory process to build new tissue while simultaneously removing unwanted debris. Unfortunately, some sleep positions can delay healing and prolong symptoms.

The following are a list of six common diagnoses and how improper sleep positions can cause and impede their healing.

1. Rotator Cuff Syndrome: A lot of people sleep with their arm over their head which over time can cause shoulder impingement. Over time this sleep position can even lead to more severe rotator cuff issues. The solution is to avoid sleeping on the affected side. Also, consider sleeping on your back or with the affected side up. Place a pillow between the arm and body for support to minimize the effects of traction ischemia.

2. Neck Pain: Sleeping on your stomach with your head turned to one side is a common stressor to the neck. Pillow height can also force compression to the neck structures, resulting in pain. Thin pillows can aggravate degenerative conditions by allowing excessive extension or lateral flexion of the spine. Thicker pillows can cause excessive neck flexion which can negatively affect disc lesions. Avoid sleeping on an excessively thick or thin pillow. Choose a pillow that also allows your neck to remain in more neutral position. Also, avoid sleeping on your stomach with your head torqued to one side.

3. Tennis Elbow: Tennis elbow, also known as lateral epicondylitis, can be aggravated by sleeping with affected elbow beneath a pillow which results in sustained compression to the wrist extensors. The solution is to try to keep the arm at the side.

4. Carpal Tunnel Syndrome: Sleeping in a fetal position with sustained wrist flexion can result in compressive ischemia to the median nerve. A night splint can help prevent hyper-flexion of the wrist by reducing nerve compression. 

5. Cubital Tunnel Syndrome: Also sleeping in a fetal position with sustained elbow flexion can result in traction ischemia to the ulnar nerve. Try using a brace that prevents elbow flexion beyond 45 degrees that will limit stretch to the ulnar nerve.

6. Gluteal Tendinopathy: Gluteal tendon pain can get aggravated with positions, activities, and exercises that involve sustained or repetitive compressive loading. Sleeping on your side compresses the lateral hip resulting in ischemia and a decreased ability to heal. Try sleeping on your back. If it is unavoidable to sleep on your side, try placing a pillow between the knees to reduce torque on the upper hip. 

References: 

Gorski, J. (2018). Letter to the Editor. Journal of the American Academy of Orthopaedic Surgeons, 1.

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