Although stomach sleeping may feel comfortable in the moment, it could cause pain and stiffness when you wake up. That's because stomach sleeping, also known as the prone position, can strain the joints and muscles in your neck, shoulders, and back, says Gbolohan Okubadejo, MD, a New York City–area spinal and orthopedic surgeon at the Institute for Comprehensive Spine Care.
“Ideally, you should sleep on your back,” Dr. Okubadejo says. “This position enables your spine to remain neutral, which decreases tension.” Sleeping on your side could also work, but he recommends a supportive pillow if you sleep in this position often. “The pillow will help preserve spinal alignment and avoid discomfort,” Okubadejo says.
Over time, sleeping in the wrong position can lead to spinal misalignment and chronic pain. While changing sleeping habits often requires some patience and practice, it's in the best interest for stomach sleepers to do so to maintain optimal health.
Not all effects of sleeping on your stomach are negative. It can reduce the risk of snoring, and some studies suggest that the prone position may alleviate sleep apnea. But experts say the risks outweigh the potential benefits.
Neck Pain
When you sleep on your stomach, you must turn your head to one side to breathe. This twisting can strain the neck muscles and contribute to spinal misalignment, leading to pain, Okubadejo says.
“Prolonged twisting can also irritate the cervical spine and surrounding tissues, increasing the risk of chronic neck pain over time,” he says.
Back Pain
Stomach sleeping also flattens the natural curve of your spine, putting stress on the back, says Raj Dasgupta, MD, a quadruple board-certified physician specializing in internal medicine, pulmonology, critical care, and sleep medicine and chief medical advisor for Sleepopolis, a sleep health education platform that offers independent mattress and sleep product reviews.
“This can cause spinal misalignment, leading to muscle strain and discomfort, especially in the lower back,” he says. “People that already have spinal issues or those who are overweight may experience more pain from stomach sleeping because of the increased pressure on their spine and joints.”
Shoulder Pain
Whether you raise your arms up near your pillow or stretch them out to the sides, stomach sleeping forces your shoulders into an awkward position, Okubadejo says.
This strange alignment during sleep can cause muscle strain or uncomfortable pressure on the shoulder joints, leading to pain, he says. “Over time, the pressure placed on the shoulders can cause inflammation or irritation, especially in people who sleep on their stomachs consistently,” Okubadejo says.
Facial Wrinkles
Pressing your face into your pillow creates friction and compression in the skin, which can lead to sleep wrinkles, says Asmi Berry, DO, a dermatologist at BHSkin Dermatology in Los Angeles.
“These are lines on the forehead, cheeks, and around the eyes caused by external pressure rather than facial expressions,” she says. These lines can become more permanent over time as collagen and elastin (the proteins responsible for your skin's structure and elasticity) naturally break down with age.
Sleeping on your back is the best way to prevent these wrinkles, since it eliminates direct pressure on the skin, Dr. Berry adds.
The risks of sleeping on your stomach are even greater during pregnancy, Dr. Dasgupta says.
During the first trimester, when the uterus is still small, pregnant women typically only face the same chance of pain and stiffness as everyone else from stomach sleeping, Dasgupta says. But the sleep position can become more uncomfortable and problematic as you get further into your pregnancy.
“As the uterus grows, stomach sleeping puts pressure on your internal organs and can restrict blood flow which can be unhealthy for the baby,” Dasgupta says, adding that it's best for pregnant women to sleep on their sides, particularly in the second and third trimesters. Sleeping on your back during this time isn't recommended either, as the weight of the uterus can put pressure on a major blood vessel, restricting blood flow to your heart and uterus.
If you're sleeping on your stomach because of problems like acid reflux, snoring, or back pain, you'll want to address these underlying issues first, says Rebecca Gonzalez, a senior specialist physical therapist at Northwell Staten Island University Hospital in New York City. The following techniques may also help.
1. Use Pillows to Your Advantage
Gonzalez recommends placing pillows around your body to reinforce a healthier sleep position. “Essentially, you are using the pillows as a ‘bumper' to prevent you from rolling onto your stomach,” she says.
Placing a body pillow in front of you while side sleeping can have a similar effect, says Joseph Hribick, DPT, an orthopedic manual therapist and a clinical assistant professor of physical therapy at Lebanon Valley College in Annville, Pennsylvania. “It can also provide the comfort and pressure that stomach sleepers are accustomed to without putting the spine in a vulnerable position,” he adds.
2. Choose a Supportive Mattress and Pillow
A moderately firm mattress and supportive pillow can make back and side sleeping more comfortable, which may reduce your tendency to shift into the prone position, Hribick says.
“Aim for a pillow that isn't too thick or too thin and keeps your head in a neutral position,” he says. “When resting on the pillow, your head and neck should be in line with the rest of your body, not tilted to the side or flexed or extended.”
3. Be Patient and Consistent
It won't be easy to break the stomach sleeping habit, so be patient with yourself, Hribick says. “This change doesn't happen overnight (no pun intended) — it does take time and some patience,” Hribick says. If you wake up on your stomach, Hribick suggests slowly repositioning yourself to avoid stressing your back by moving too quickly.
While working toward a different sleep position, Hribick recommends the following to reduce the adverse effects of sleeping on your stomach.
Place a thin pillow under your pelvis to reduce lower back stress and support your spine's natural curvature.
Use a thin pillow under your head to keep your spine in a more neutral position. Thick pillows can force the neck, midback, and lower back into excessive extension, increasing stress and strain.
Gently stretch your neck and back before bed and in the morning to help counteract muscle tightness, improve mobility, and alleviate discomfort.
The risks of sleeping on your stomach — including neck, back, and shoulder pain — outweigh any potential benefits.
The best sleeping positions for health include lying on your back or side.
Breaking the stomach-sleeping habit isn't easy but using pillows to your advantage and a medium-firm mattress may help.
If underlying issues are prompting you to sleep on your stomach, talk to your doctor to address these.
