Best Sleeping Position

will the real Randy Gardner please stand up in 1964 high school student Randy Gardner successfully stayed awake for 11 days and 24 minutes setting the world record for the longest human has gone without sleep over the several days awake Gardner experienced everything from mood changes memory lapses random hallucinations to temporarily losing the ability to identify objects and recall words but you don’t have to stay away from multiple days to experience detriments from lack of sleep as neuroscientist Matthew Walker will tell you I would like to stop with testicles men who sleep five hours a night have significantly smaller testicles than those who sleep seven hours or more in his book.

 why we sleep Walker explains the ins and outs of just how bad too little sleep is not only for your reproductive cardiovascular and immune health but learning and cognition as well interestingly lacking sleep even affects you socially so we just published asleep a study demonstrating that’s the gospel trick of viral loneliness as Walker is explaining here in this interview with Rhonda Patrick this paper he authored demonstrated that people are much less comfortable with people standing close to them after they’ve been sleep deprived they even put people in an MRI scanner and found that the brain is lighting up in a way that makes you more suspicious of people and less able to understand their intentions now one of the things that was striking to me that Matthew Walker said was that you cannot recover a sleep debt you can’t just catch up on sleep by sleeping for 12 hours on a Saturday after three nights of sleeping poorly so if we only have one chance at sleep then sleep quality where the efficiency of sleep must be very important even if you’re getting the recommended eight hours a night there are many things you can do to improve sleep quality and I’ve discussed this in another blog but what I’ve been curious about lately is sleeping posture.

 what is the best position to sleep in and what is the best kind of pillow or should we even use a pillow this question has bugged me for a while because I’ve tried all kinds of pillows including this thing that’s supposed to keep your head from rolling to one side but I’ve never been 100% satisfied the first thing I thought might be worth looking at is how other primates sleep a quick google image search of sleeping primates shows a lot of them sleeping on their side as Charles nunn explains what the great apes have in common with humans is that they all build some sort of comfortable nest or sleeping platform each night humans have different bone structures from apes of course but I still thought it would be interesting to consider the position that they sleep in most often this 2015 study monitored the sleeping patterns of five orangutans for two years they found that orangutans spent three times more of their sleeping time on their sides than they did on their backs now while digging into human research.

 I had trouble finding many papers specifically looking at how sleep position affected sleep quality and I couldn’t find any papers comparing sleep quality when people used a pillow versus when they didn’t use a pillow but we can of course use a bit of logic and make some inferences based on the data that we do have so I figure a sleep posture that promotes sleep good quality would have to one prevent snoring and to at least not impede the glymphatic system for now let’s look at snoring what’s happening during snoring is that airflow is being partially blocked by tissues in the airway as evidenced by a snoring sound I think more often than not people would assume that snoring is mostly a nuisance to one’s sleeping partner and the effects on sleep quality is not enough to cause alarm however a study from 2003 you looking at 1140 for schoolchildren separated the kids into either always frequently occasionally and never snoring what they found was that in the kids snoring always was significantly associated with poor academic performance in mathematics science and spelling and snoring frequently was also significantly associated with poor academic performance in mathematics and spelling another study from 2001 found that children with lower academic performance in middle school are more likely to have snored during early childhood another study from 1994 showed that between age 4 and 7 daytime sleepiness hyperactivity and restless sleep.

 were all significantly more common in the habitual snores than in those who never snored and yet another study from 2005 titled snoring predicts hyperactivity four years later shows that snoring and other symptoms of sleep disordered breathing are strong risk factors for future emergencies a survey ssin of hyperactive behavior I could go on with several more studies showing children who snore secrete less growth hormone how snoring is associated with headache and daytime sleepiness as well as high blood pressure heart attack and stroke but we can get into the full details in another video for now here’s two recent nights from just the other week tracking my sleep with the app snore lab here’s the night where I snort a lot and slept about seven hours and here’s a night where I slept less about six and a half hours and barely snored at all most of what the app picked up was me rustling around and my air conditioner turning on and off as indicated by the orange frowny face I distinctly remember being very groggy this particular morning when I snored a lot but quite refreshed on this morning when I didn’t snore that much one pretty clear example of snoring being disruptive to sleep quality is the fact that it seems to wake me up on the nights that I do snore the recording will show that the snoring sometimes wakes me up enough to rustle around or change positions.

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 2013 review on positional therapy and position-dependent snoring explains that it’s often observed the snoring is usually worse when sleeping on the back and better when people are sleeping on their side and several papers have shown that sleep apnea gets worse when people sleep on their backs during the American War of Independence and later during World War one soldiers were advised to wear the rucksacks on their backs while sleeping to keep them on their side and avoid sleeping on their backs this would prevent snoring and making their position known to the enemy papers from 1984 and 1996 found that people snore worse on their back and this one 2013 study found that snores snoreless on their side so far it looks like sleeping on one side or at least avoiding sleeping on your back would be good for sleep quality this study from 1983 you found that consistently poor sleepers spent more time on their backs with their heads straight now what about pillows there are several types of pillows and most of the ones that advertise to improve sleep quality aim to support the neck there’s a natural curvature in the neck a lordosis and you can lose that and develop something called flat neck syndrome this is developed presumably from looking down all the time probably at your smartphone or using a pillow that is too high but if we want to sleep on our sides we shouldn’t need to worry too much about having the perfectly shaped pillow you can just get one that keeps your neck from bending too much while you sleep on your side moving on to further evaluate sleep positions that promote good sleep quality the position should be good for glymphatic transport in the body we have something called the lymphatic system that helps with each organs problem of waste clearance this network of vessels extends through the body and collects cellular debris proteins and other wastes from the spaces between the cells so that it can be disposed of the brain however does not have lymphatic vessels that it can use for waste clearance as neuroscientist Jeff Iliff explains in his TED talk this doesn’t make much sense considering the adult brain uses about 25% of the body’s energy budget and generates a considerable amount of metabolic waste so how then does the brain solve its waste clearance problem the brain solution to the problem of waste clearance it was really unexpected it was it was ingenious.

 so the brain has this large pool of clean clear fluid called cerebral spinal fluid we call it the CSF the CSF fills a space that surrounds the brain and wastes from the inside of the brain make their way out to the CSF which gets dumped along with a waste into the blood in the brain there is a specialized network of plumbing that organize and facilitates this cleanup process you can see that in these videos the frame on your left shows what’s happening at the brains surface and the frame on your right shows what’s happening down below the surface of the brain within the tissue itself the blood vessels are labeled in red and the cerebrospinal fluid that’s surrounding the brain in green and as it flushed down into the brain along the outsides of these vessels it was actually helping to clear a way to clean the waste from the spaces between the brain cells what’s interesting is that all this is happening when you’re asleep the video on the Left shows how much of the cerebrospinal fluid is moving through the brain of a mouse while it’s awake barely anything but when the animal goes to sleep the CSF rushes into the brain to rinse and clean it out Alzheimer’s disease is an example of how important is sleeping brain cleanup procedure is a hallmark of Alzheimer’s disease is a buildup of a peptide called amyloid beta and the glymphatic system helps clear this stuff out of the brain the research on sleeping position affecting lymphatic transport is very limited but this 2015 study had rodents sleep on either their side back or stomach and were monitored via magnetic resonance imaging they found that glymphatic transport was most efficient in the lateral position on their side dr. Mike and nedra guard said it is interesting.

 that the lateral sleep position is already the most popular in humans and most animals even in the wild and it here’s that we have adapted the lateral sleep position to most efficiently clear out the brain of the metabolic waste products that built up while we are awake one interesting thing about this study is that it specifically looked at the clearance of Alzheimer’s protein amyloid beta and found that the removal of it was most efficient in the side sleeping position now this is just in rodents but this study was looking at how sleep position could affect neurodegenerative disease in humans this study strapped a small device with an accelerometer to the patient’s heads to monitor what sleeping positions they were in and for how long they found this spending more than two hours sleeping on the back at night was significantly more frequent in those with neurodegenerative disease those with neurodegenerative disease spent nearly twice as much time on their backs while sleeping controls spend about 30% of their sleep on their backs and those with ndd spend about 50% of their sleep on their backs the hodza of tanzania are often interesting to look at as their lifestyle is thought to be similar to that of prehistoric humans.

 I couldn’t find studies specifically on their sleeping position but this brief video talking about a study on the HUD’s of sleep patterns shows most of them sleeping on their side so the data is limited but it’s enough at least for me to want to try and sleep on my side more however the problem is you can’t just say okay time to sleep on my side because Ulysses McGill said so people unconsciously change their sleeping position multiple times throughout the night one study found that over the course of one night subjects change their position as many as twenty to forty times per night so how can we get ourselves to stay on our sides or at least bias ourselves to select that position more often as we rustle around at night in 1984 the Journal chest published a letter written by a patient’s wife she had cured her husband’s snoring problem by inserting a plastic ball into a pocket sewn on the back of a t-shirt to prevent her husband from sleeping on his back in fact there’s a type of therapy called positional therapy designed to keep patients off of their back they use all kinds of things from a back with a softball inside to a ball and a sock on the back to a shark fin type thing two alarms that ring when you roll onto your back so what if pillows are making sleeping on our backs artificially too comfortable that is let’s say you lay down to sleep but you simply don’t use a pillow laying on your back might become a little less comfortable now that your neck and head aren’t cradled in a cushy comfortable cushion what’s going to be the more comfortable position probably sleeping on your side because you can support your neck with your shoulder or a pillow made out of your arm and hands surprisingly there was one paper that addresses this directly in this paper by Michael Tetley titled instinctive sleeping and resting postures and anthropological and zoological approach to treatment of low back and joint pain he argues at forest dwellers nomads and tribal peoples suffer from few Musco skeletal problems because they sleep in a natural posture without a pillow and night according to Tetley he has organized over 14 expeditions all over the world to meet native peoples and study their sleeping and resting postures they all adopted similar postures and exhibited few Musco skeletal problems he says tribes people often do not like having their photographs taken so he demonstrates most of the postures himself what was interesting about this paper is that none of the positions he’s presented show people sleeping on their backs so the data on this topic is limited but based on what I did find so far it seems that the side position is the better position for cleaning out your brain and preventing snoring from impeding your sleep and ditching the pillow might be the way to get yourself to spend more time in that side position.

 that’s the idea anyway it’ll probably take some time to adjust to sleeping without a pillow and I’m not saying this is realistic for everyone if you don’t snore and you wake up feeling refreshed and are without back or neck pain in the morning there’s probably no need to change your routine also maybe you could figure out some other way to keep yourself on your side during the night without ditching your pillow actually I’ve been sleeping without a pillow for about a week now and I can’t say I’m waking up drastically more refreshed but I haven’t woken up with a stiff neck or back yet something that would usually happen every other day but I don’t really know if this way of sleeping is keeping me on my side like I was thinking so I’m planning to track a couple of weeks of sleeping like this with a wearable device and hopefully one of those baby monitor type is seeing the dark cameras.