Although sleep may seem like a harmless necessity of life, it is important to respect that it still poses a risk for injury like any other activities we perform. Some risk factors for musculoskeletal injuries include: awkward postures, prolonged static positions, and contact stress. We encounter all of these factors as we sleep, and because we spend a third of our life sleeping it is crucial that we reduce the risk. Ensuring we have the ideal sleep ergonomics in place can limit our risk of injury, helping us wake feeling refreshed and ready to take on our day!
Believe it or not, Goldilocks was onto something! Not too hard, not too soft, you need to look for something that is just right! Picking the right firmness and material that will provide support to your body during the night is important to ensuring a comfortable night’s sleep.
Too Soft: While soft mattresses give you the sensation of sleeping on a cloud, they can leave you feeling stiff and sore in the morning. This is because the soft material doesn’t provide enough resistance to support your body weight throughout the night. This means that your lower back/hips sink deep into the mattress, which pulls your spine out of its neutral alignment. Spending all-night in this awkward position puts you at risk for lower back pain and discomfort.
Too Hard: Remember that one time you were out camping and woke up on the ground because your air mattress had deflated. You probably woke up with a few sore spots on your hips, back and shoulders. This happens with a mattress that is too hard as well. The mattress material is too stiff to conform to the contours of your body creating unequal weight distribution which leads to pressure points, typically on the hips and shoulders. Contact stress is a risk factor for injury as it reduces blood flow to the areas of increased pressure (which is how bedridden individuals develop bedsores). The uneven weight distribution also puts the spine in an awkward position, allowing gravity to pull your unsupported torso towards the mattress.
Just Right: When picking a mattress you want to find one that suits your body best. If you are on the heavier side of the spectrum, selecting a stiffer mattress will benefit you best. Petite individuals can often select a softer mattress. When you are testing a bed, we recommend that you lie down however you would when you sleep and have someone hold a straight object along your body to see if your hips, shoulders, and head can all stay in a straight line.
Credit: Real Mattress Reviews
What Mattress Material is Best?
Picking between memory foam, innerspring, latex, or hybrid mattress will depend on you personally, and what you find most comfortable. But generally hybrid mattresses; inner springs or coils with a pillow top made of latex or memory foam, are best. Latex and memory foam mattress are also good options but latex would just edge out memory foam as the memory nature of the foam can make it difficult to move around at night as the mattress needs time to re-conform to your body’s shape. Additionally, we recommend shying away from a water bed as they often don’t provide enough resistance to support your total body area and your heavier torso/hips typically sink into the bed.
What About When You Have A Partner?
This is when picking a mattress can become a little tricky. Say one of you is 6’5 and 250lbs and the other is 5’4 130lbs; you are both going to require a different type of mattress resistance to suit your unique body types. This is when air beds can be very helpful, and I don’t mean that old air mattress you keep tucked away in the garage! Air beds contain 2 separate air chambers that a user can inflate or deflate depending on their body size to provide appropriate support. They are typically quite costly, but can be worth the investment for a comfortable night’s sleep.
Alternatively, you can select two different twin XL sized beds of differing material and push them together, allowing each person to have individualized support. There are bed bridges/connectors on the market designed to smooth out the divot between the two mattresses. When these beds are connected they equate to the same size as a king bed!
Pillows need to be chosen based on your sleeping position. Choose a flatter pillow if you sleep on your back or stomach, and a thicker pillow with more support if you sleep on your side. But just like with the mattresses, you want to ensure that your pillow provides the appropriate amount of support and allows you to keep your head inline with your body.
When picking a pillow for sleeping on your back you want your chin to stay level. You don’t want the pillow so soft that your head falls back and your chin points up, nor do you want one that is so firm that your head is pushed up with your chin tucked into your chest.
For stomach sleepers it’s all about the height of the pillow, not so much firmness; the flatter the pillow the better. Sometimes even no pillow may be best.
Side sleepers need the pillow to be the same thickness as the distance between the tip of your shoulder and your ear. You then need the pillow to have adequate firmness so your head stays in line with your body. A pillow that is too soft and lets your head sink in too far will lead to awkward neck postures.
Different Pillow Materials
Down/Feather Pillows: These pillows are best for back or stomach sleepers. Down is highly compressible and the pillow will flatten out with the weight of your head. However, down can aggravate allergies in some people.
Synthetic/Down Alternative Pillows: This type of pillow usually comes with varying degrees of firmness, very soft to very firm, meaning they are a good choice for any type of sleeper; more firm for side sleepers and softer for back or stomach sleepers.
Memory Foam/Latex Pillow: These pillows can come as either solid or shredded. The solid option works well for side sleepers, but just like the mattresses, memory foam can make it more difficult to change positions throughout the night. The shredded option allows for more adjustability, which can make it a good option for any sleeper.
Water Pillow: As previously mentioned, we advise against water beds, however a water pillow is a different story. Water pillows can provide the optimal amount of support when the water level is filled just right, similar to the memory foam pillow. However, unlike the memory foam, the water pillow adjusts immediately to a new position. The one drawback can be the sound of the water moving as you sleep!
How Many Pillows Is Too Many?
We all know those people who have a million pillows on their bed! When it comes time to sleep it is usually best to sleep with just one pillow under your head that suits you best. However, if you are a person who switches between different sleeping positions, it is a good idea to have pillow options that suit each position. Maybe you have a soft down pillow for when you sleep on your stomach and keep a firmer shredded memory foam pillow beside the bed for when you switch to sleep on your side.
Best Sleeping Position
The position that you decide to sleep in needs to be whatever is more comfortable for you. However, because we are ideally sleeping for 8 hours every night it is important to note that certain positions pose risk for injury.
Stomach: This position poses the greatest risk for injury.
- When on your stomach you have to turn your head to one side in order to breathe. Add in your pillow and you have to extend your neck back. This awkward position puts stress on the small joints and muscles in your neck, which can lead to pain and stiffness in the morning.
- Many people who sleep on their stomach will have either both or one of their arms up by their face. This actually puts them into a ‘chicken wing’ position, which is hard on the shoulder and the rest of the arm because it limits blood flow and nerve conduction due to the position of the arm bone in the shoulder joint. You may notice that your hands start to feel cold, or may even experience numbness or tingling if you sleep like this.
Back: This position is usually a good option for most of your body, but it does pose a risk to your neck.
- It is typical to end up with a forward flexed neck throughout the night due to the height of the pillow underneath your head. This position is particularly bad for people who snore or have sleep apnea as it interferes with our airways.
Side: Typically the safest position to sleep in as you are able to achieve ideal body alignment if you create a pillow fortress around you!
- When you are sleeping on your side make sure that your head pillow supports the weight of your head so you can maintain neutral spine alignment
- A pillow in between your knees helps to prevent rotation in your lower back and reduce contact stress between your knees.
- If you sleep with one leg straight and the other bent up towards your chest, it is a good idea to place a pillow underneath the bent knee to limit rotation through the hips and lower back.
- Sleeping with your bottom arm up by your face is usually most comfortable. Instead of wedging your arm underneath the pillow, place it on top to reduce the rotation in your shoulder.
- Sleeping with a pillow hugged against your chest as a place to rest your top arm can reduce rotation through your mid back keeping you aligned.
The MoveSafe Approach to Sleep Ergonomics
MoveSafe approaches sleep ergonomics with the same principles we use when facing office or industrial ergonomic risks. Recognizing the potential for musculoskeletal injuries and following injury prevention principles can help keep you healthy and feeling your best. MoveSafe sums injury prevention into 3 principles and when each principle is followed you put yourself at the greatest advantage of maintaining a healthy and active body throughout your life.
Prepare & Maintain the Body: Be aware of when your body is telling you that something is uncomfortable. If you are uncomfortable, make a change. Either change your position or think about changing your equipment.
Use Healthy Postures & Movements: Pick a sleeping position that is most comfortable for you and puts you at the least risk for injury.
Prepare Your Equipment: Choose a mattress and pillow that suits your body best, providing appropriate support that allows you to maintain neutral spine alignment. Replace mattresses and pillows when they are no longer able to support you.
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