Steve and I were reflecting recently on the patient conversations we find ourselves repeating over and over again like a broken record. One such conversation pertains to sleeping position, and in particular stomach sleeping.

As a reformed stomach sleeper, I can appreciate how unpleasant of a conversation it is to have with your healthcare provider when you're told that your problem is not going to improve much or beyond a certain recovery point without changing sleeping position. But it's a necessary conversation because of what you do for 8 hours a day, or about 1/3 of your life, can have a profound impact in unraveling what we do in the office for 15 minutes much less what a patient may be doing with home exercises at home for 20 minutes a day.

In this brief video Steve and I demonstrate 3 areas of major mechanical stress associated with stomach sleeping, namely the mid to lower next, the lumbosacral spine, and the shoulder. The 4th slightly less common area of stress as the jaw, which is going to be asymmetrically chronically pushed to one side with the pressure of the mattress and pillow on the chin.

Some patients have tried to mitigate the impact of their stomach sleeping position with a few retrofits such as chest pillows with a forward face slot, and other retrofit pillows that take the rotation out of the neck, but ultimately the only long-term sustainable solution is to switch to side or back sleeping. It's a transition that will take anywhere from 3 to 4 weeks and requires some sleep interruptions. My recommendation has been for the patient to secure a fairly long pillows such as a king size pillow or a site sleeper pillow to wrap the upper arm and leg into three-quarter prone position, with a good site sleeper pillow, so that the patient may not roll all the way onto the stomach in their sleep. The patient will often wake up as they attempt to do so, and have the opportunity to reposition themselves. Over time, the body will break the automatic reflex to roll over during your sleep. It's an uncomfortable process but worthwhile in the long term.

https://www.youtube.com/watch?v=yC0Piw8vwf0