The No. 1 Best Side to Sleep on For Heart Health, According to Cardiologists
Sleep is often mentioned when discussing keeping your heart healthy, and for good reason. "Adequate sleep allows the body to rest and repair itself, regulating hormones that influence blood pressure, inflammation and blood sugar levels—all of which are critically important for heart health," says Dr. Rigved Tadwalkar, MD, a board-certified consultant cardiologist at Providence Saint John’s Health Center.
A March 2020 study published in Circulation suggested that the American Heart Association add "sleep" to Life's Simple 7 measures for good cardiovascular health, along with other measures like diet and exercise. The AHA did (and changed the name to Life's Essential 8 in the process).
However, if you're hyper-focused on heart health—not a bad focus to have, by the way—which sleep position should you get into? Cardiologists discuss the best side to sleep on for heart health, a few to try to avoid and tips for actually getting to sleep.
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Sleep on Your Side to Breathe Better
Sleeping on your side—period—is often recommended for heart health because it can help manage the potentially dangerous effects of sleep apnea. People with sleep apnea start and stop breathing while they sleep, and snoring is a common side effect.
"Sleep apnea is one of the most under-recognized cardiac risk factors in cardiology," says Dr. Renato Apolito, MD, the medical director at the Cardiac Catheterization Laboratory with Hackensack Meridian Jersey Shore University Medical Center. It is associated with hypertension, atrial fibrillation, palpitations, fatigue and lack of restful sleep as it interferes significantly with the REM phase of sleep."
And who wants that? "Sleeping on the side is felt to better keep the airway more open and may improve blood flow from the lower body to the heart," Dr. Tadwalkar says.
If you have sleep apnea, you'll want to attempt to steer clear of a few other sleep positions.
"In people with untreated sleep apnea, sleeping on the back as opposed to side sleeping can worsen snoring and breath pause episodes because the pull of gravity on the throat tissues can block the airway," explains Dr. Robert Salazar, MD, a cardiologist with Memorial Hermann in Houston. "These breath pause episodes lower blood oxygen levels and are associated with higher daytime blood pressure and rates of atrial fibrillation."
You'll also definitely want to stay off your stomach. "Stomach sleeping is universally considered the least healthy way to sleep as it will obstruct your airway or windpipe leading to apnea, and it is not a healthy position for the...neck [and] spine," Dr. Apolito says.
Speaking of your back...
Sleep on Your Back for Back Pain
Back pain is super-common, and your chances of experiencing it go up with age, according to CDC data. That pain can make it challenging to sleep—which doesn't do your back (or heart) any good.
"Ultimately, comfort and quality of sleep are more important," says Dr. Rohit Vuppuluri, DO, FACC, a cardiologist. "It is important to find a position that allows for restful sleep throughout the night rather than trying to sleep in a position that is not conducive to a full night's rest."
Now, there's a caveat. "If you have sleep apnea or chronic heartburn, prioritizing side sleeping is generally recommended," Dr. Tadwalkar explains.
Sleeping on your side with a pillow tucked between your knees can reduce the pressure on the back. Regardless, if back pain affects your sleep and waking life, speak with a doctor about other ways to manage it.
"Beyond sleeping position, professional medical pain management is important to getting comfortable above all," Dr. Apolito says.
Sleep on Your Side to Boost Brain Power
Since the brain and the heart work together to boost your health, keeping both in the best shape possible is important. So, here's another reason cardiologists recommend side sleeping: it keeps the organ in your noggin healthy and, as a result, helps the heart.
"Research suggests that adopting a side-sleeping position may generally enhance the brain's glymphatic system, a vital waste removal system that is important for neurological health," Dr. Tadwalkar says. "The debate over whether the left or right side is superior for the brain remains inconclusive; some studies propose left-sided sleeping as more efficient, while others find no significant differences."
A 2015 study conducted by researchers at Stony Brook University in New York also found that side-sleeping instead of back or stomach sleeping helped remove brain waste and could lower the risk of developing neurological diseases like Alzheimer's.
Sleeping in the lateral, or side position, as compared to sleeping on one’s back or stomach, may more effectively remove brain waste and prove to be an important practice to help reduce the chances of developing Alzheimer’s, Parkinson’s and other neurological diseases, according to researchers at Stony Brook University.
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Sleep on Your Right Side to Protect Your Heart
Side sleeping can be super helpful in reducing heart issues stemming from sleep apnea or brain function. However, there may be something extra-protective about right-side sleeping.
"Sleeping on the right side can be beneficial for people with heart failure or certain cardiac arrhythmias," Dr. Salazar says. "Studies have found that lying on the left side alters the heart's position in the chest due to the pull of gravity, resulting in lower heart pressure and electrocardiogram changes. When lying on the right side, the heart is held in place by the lungs and the mediastinum."
Sleep on Your Left Side for Better Digestion
If your biggest concern about your heart is the burn you feel at 3 a.m., flip over to the left side and drift back to sleep.
"Sleeping on the left side often helps with acid reflux," Dr. Vuppuluri says. "When sleeping on the left side, the lower esophageal sphincter is higher than the stomach. Therefore, it is less likely stomach acid will flow into the esophagus."
3 Tips for Getting Better Sleep
1. Exercise daily (physically and mentally)
Bedtime habits are important. However, what you do during the day also matters.
"Exercise daily and do something to stimulate your mind as well, like reading or crossword puzzles," Dr. Apolito says. "This will make your body and mind invite sleep, help you fall asleep faster and stay asleep longer."
2. Stay consistent with bedtimes
Bedtimes aren't just for little ones.
"Going to bed and waking up at the same times daily, including on the weekends, contributes to regulating your internal clock, resulting in enhanced sleep quality," Dr. Tadwalkar says. "If necessary, resist the temptation to oversleep by more than an hour beyond your regular waking time, as this practice supports the stability of your sleep patterns."
3. Create a Relaxing Bedtime Routine
Dr. Tadwalkar also recommends embracing a routine. "Rethink your pre-sleep activities," he says. "Steer clear of stimulating pursuits like screen time before bedtime. Instead, embrace calming rituals such as reading a book, or practicing relaxation techniques to signal to your body that it's time to wind down."
Also? Ditch the boozy nightcap. "While alcohol can relax you and make you sleepy, it will interfere with deeper sleep stages and REM and often cause you to awaken unrested in the middle of the night with the inability to return to restful sleep," Dr. Apolito says.
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Sources
Dr. Rigved Tadwalkar, MD, a board-certified consultant cardiologist at Providence Saint John’s Health Center
The Role of Sleep as a Cardiovascular Health Metric: Does It Improve Cardiovascular Disease Risk Prediction? Results From The Multi-Ethnic Study of Atherosclerosis. Circulation.
Life's Essential 8. AHA.
Dr. Renato Apolito, MD, the medical director at Cardiac Catheterization Laboratory with Hackensack Meridian Jersey Shore University Medical Center
Dr. Robert Salazar, MD, a cardiologist with Memorial Hermann in Houston
Back, Lower Limb, and Upper Limb Pain Among U.S. Adults, 2019. CDC.
The Effect of Body Posture on Brain Glymphatic Transport. The Journal of Neuroscience
Lying position classification based on ECG waveform and random forest during sleep in healthy people. BioMedical Engineering OnLine
Dr. Rohit Vuppuluri, DO, FACC, a cardiologist