You can (and should) train yourself to sleep on your back

American adults are in pain. A 2015 study from the National Institutes of Health showed that 25 million U.S. adults cope with chronic pain every day. While everyone's suffering is different—there are as many sources of pain as people—for many, how you sleep plays a crucial role.

Members of my own family are a part of this statistic: My grandma has purchased every pillow on the market to find one that supports her ever-aching neck, and my father relies on physical therapy exercises to keep his shoulder pain in check. I myself have tried purchasing a supportive mattress and pliable pillow, and I eat healthy and exercise regularly, but I still feel sore and stiff in the morning. According to the experts, it might be time to change my sleeping position.

Advice for side-sleepers

Most Americans sleep on their sides, according to the National Sleep Foundation. While many of them presumably do it without pain, this is not the best way to sleep. It can cause shoulder and hip pain, for one.

On top of that, several studies have shown that sleeping on your right side can aggravate heartburn. Scientists think that's because lying in this position loosens your lower esophageal sphincter, the involuntary muscles that keep acid from rising up out of your stomach and into your throat. Sleeping on the left side, however, seems to keep the trap door between the throat and stomach shut, so leftie sleepers are less likely to feel the burn.

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Shelby Harris, a sleep medicine expert and a professor at Albert Einstein College of Medicine, says that there's no need to change your sleep position if it's working for you. But if you're waking up in pain, you can take steps to improve your situation.

She says side sleepers should buy pillows that are thick enough to support their heads, taking some of the pressure off their shoulders. If you experience acid reflux or heartburn, try to sleep on your left side. And, Harris says, tuck a pillow under your knees to better support your lower back.

101 on stomach sleeping

Side sleeping is hardly the worst of it. Though they're rare, the seven percent of stomach sleepers are likely doing themselves a world of hurt. Because this position puts pressure on the entirety of their body, they're at risk of numbness and tingling. If they turn their head to one side or another to breathe, that further increases the possibility of muscle and joint pain.

If you're a stomach sleeper, Harris recommends using a flatter pillow to reduce strain on your neck. Other doctors suggest putting a pillow underneath your forehead to elevate your mouth and nose. This lets you sleep with your face straight down, eliminating that crick in the neck altogether.

Back sleeping is best

Only eight percent of people sleep on their backs. If you're naturally one of them, count your lucky sheep. Back sleeping is the best option for pain management, as it allows your body to rest in a neutral position, which is great for reducing aches. It also cuts down on heartburn, as it keeps your head elevated above your chest.

For a back sleeper, Harris recommends resting your head on a pillow that's thick—or thin—enough to keep your skull exactly level with your body. But, she warns, even with a perfect pillow, this position is not great for snorers. Back sleeping can cause sleep apnea or exacerbate existing cases of the disorder. So if you're prone to this problem, or find yourself suddenly suffering from new symptoms while lying on your back, then this isn't the pose for you.

Switch your sleep position

Even after taking this advice, side- and stomach-sleepers may still wake up sore. As a last resort, Harris says you can actually train yourself to sleep on your back.

When you're ready for bed, put pillows on both sides of your body, and one under your knees. This should hold you in place and keep you from flipping to one side.

If that doesn't cut it, Harris has an advanced method: Sew a tennis ball into the lining of your shirt on whatever side you need to avoid. When you flop onto your side or stomach, the discomfort will ensure you flip back over, even if you're dead asleep.

The proposition of changing the way you sleep seems preposterous. After all, you're asleep. How much can you really control? As an achy side-sleeper, I took the challenge myself, using a knee pillow and side pillows in an attempt to train myself to sleep on my back. I found it took longer to fall asleep, but that when I did, I stayed in place, and when I woke up later in the night, I found my eyes staring at the ceiling.

Related: Your body's response to no sleep

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27 horrible things that happen if you don't get enough sleep
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27 horrible things that happen if you don't get enough sleep

1. Short term memory and learning problems

Sleepiness has long been a problem for students. One study of middle school kids found that "delaying school start times by one hour, from roughly 7:30 to 8:30, increases standardized test scores by at least 2 percentile points in math and 1 percentile point in reading." Sleep researchers say that teens, who naturally tend to become night owls, suffer even more from early start times. But it's not just kids. Sleep deprivation also wrecks adults' short-term memory, according to one study that found cutting sleep short significantly impaired the ability of adult volunteers to remember words they'd been shown the day before. In another study, researchers found that while people tend to improve on a task when they do it more than once, this isn't true if they are kept awake after they try it the first time — even if they sleep again before doing it again.

Source: Nature, 1999; Nature Neuroscience, 2000; Education Next, 2012

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2. Irritability

"Complaints of irritability and [emotional] volatility following sleepless nights" are common, a team of Israeli researchers observed. They put those complaints to the test by following a group of sleep-deprived medical residents. The study found that the negative emotional effects of disruptive events — things like being interrupted while in the middle of doing something — were amplified by sleep loss.

Source: Sleep, 2005

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3. Skin aging

Poor sleep quality is strongly correlated to chronic skin problems, according to some research out of the University of Wisconsin. Other research has shown that people who don't sleep well or sleep five hours a night or less have a harder time recovering from skin damage caused by ultraviolet light exposure and by having tape taken off of their skin. When researchers compared those participants to people who slept well, they found more signs of skin aging in poor sleepers.

Source: Clinical and Experimental Dermatology, 2015; Cutis, 2008

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4. Weight gain and impulse control problems

People who don't get enough sleep have a harder time resisting high-calorie foods, more cravings for unhealthy meals, and a hard time controlling their impulses. Researchers think going without sleep causes hormonal imbalances that are responsible for this, imbalances they link to a high body mass index and obesity.

Source: Journal of Clinical Endocrinology & Metabolism, 2012; PLOS Medicine, 2004; Nature Communications, 2013; PNAS, 2013

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5. Alzheimer's-linked toxin build-up in the brain

One 2015 study found that sleep helps cleanse the brain of the beta-amyloid protein that can build up while you are awake. That protein is strongly associated with Alzheimer's disease, and researchers say that this process can lead to a vicious cycle, since the more beta-amyloid there is in the brain, the harder it is to get to a cleansing deep sleep state.

Source: Nature Neuroscience, 2015

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6. Vision problems

Sleep deprivation is associated with tunnel vision, double vision, and dimness. The longer you are awake, the more visual errors you'll encounter, and the more likely you are to experience outright hallucinations.

Source: International Journal of Occupational Medicine and Environmental Health, 2010

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7. Heart disease risk

When researchers kept people awake for 88 hours, their blood pressure went up — no big surprise there. But even subjects who were allowed to sleep for 4 hours a night had an elevated heart rate when compared to those getting 8 hours. Concentrations of C-reactive protein, a marker of heart disease risk, increased in those fully and partially deprived of sleep.

Source: Journal of the American College of Cardiology, 2004; PLOS ONE, 2009; Sleep Medicine Reviews, 2012

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8. Slowed reactions

Your reaction time is severely impeded when you don't get enough sleep. When researchers gave West Point cadets two tests that require quick decision-making, some were allowed to sleep between the tests, while others were not. Those who had slept did better the second time — those who had not did worse, and their reactions slowed down. A study in college athletes found similar results.

Source: Sleep, 2009; Asian Journal of Sports Medicine, 2012

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9. Immune system issues

You know that great thing your immune system does, where when you get an open wound of some kind it doesn't always get infected immediately? Prolonged sleep deprivation and even one night of sleeplessness can impede your body's natural defenses against infection.

In another small study that showed sleep deprivation can make vaccines less effective, 19 people were vaccinated against Hepatitis A. Ten of them got 8 hours of sleep the following night, while the rest pulled an all-nighter. Four weeks later, those who had slept normally had levels of Hepatitis A antibodies almost twice as high as those who'd been kept awake.

Source: American Journal of Physiology, 1993; The FASEB Journal, 1996; Journal of Immunology, 2011

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10. Bad decision-making in ways that put lives and finances in danger

Planning to make some changes to your portfolio? You might want to make sure you're well-rested. "A single night of sleep deprivation evoked a strategy shift during risky decision making such that healthy human volunteers moved from defending against losses to seeking increased gains," researchers concluded.

Other researchers have found that severe sleep deprivation impairs people's ability to follow pre-established procedures for making a "go" or "no-go" decision, something that researchers say contributed to the space shuttle Challenger explosion, the Chernobyl meltdown, and the Exxon Valdez disaster.

Source: The Journal of Neuroscience, 2011; Sleep, 2015

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11. Overproduction of urine

When people sleep, the body slows down its normal urine production. This is why most people don't have to pee in the night as much as they do during the day. But when someone is sleep deprived, this normal slowdown doesn't happen, leading to what researchers call "excess nocturnal urine production." This condition may be linked to bed wetting in children and, in adults, it's tied to what's called nocturia — the need to use the bathroom many times during the night.

Source: American Journal of Physiology, 2010; American Journal of Physiology, 2012

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12. Distractedness

Having trouble paying attention to what you're reading or listening to? Struggling with anything that requires you to truly focus? "Attention tasks appear to be particularly sensitive to sleep loss," researchers have noted. If you want to stay alert and attentive, sleep is a requirement. Otherwise, you enter "an unstable state that fluctuates within seconds and that cannot be characterized as either fully awake or asleep," and your ability to pay attention is variable at best.

Source: Archives of Italian Biology, 2001; Seminars in Neurology, 2009

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13. Trouble speaking normally

Severe sleep deprivation seems to affect your ability to carry on a conversation — much like having way too much to drink. "Volunteers kept awake for 36 hours showed a tendency to use word repetitions and clichés; they spoke monotonously, slowly, [and] indistinctly," one study noted. "They were not able to properly express and verbalize their thoughts."

Source: Sleep, 1997; International Journal of Occupational Medicine and Environmental Health, 2010

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14. Colds

If you're wondering why you're sick all the time and seem to pick up every bug that travels around the office, it's probably because you're not getting enough sleep. When a group of 153 people were exposed to a common cold, those who had gotten less than 7 hours of sleep in the two weeks prior were almost 3 times more likely to get sick than those who'd had 8 or more hours of sleep. How well you sleep is also a factor – those who had spent 92% of their time in bed actually asleep were 5.5 times more likely to catch a cold than those who had been peacefully slumbering 98-100% of the time they were in bed.

Source: Archives of Internal Medicine, 2009

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15. Muscle atrophy

Lack of sleep causes hormonal changes that make it harder for your body to build muscle and heal. This makes it harder to recover from the muscle damage caused by exercise and worsens conditions related to muscle atrophy. Other research has also shown the reverse — your body releases growth hormone and heals damage during sleep, which is why fitness advocates will always point out that sleep is an essential for getting into shape.

Source: Medical Hypotheses, 2011; International Journal of Endocrinology, 2010

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16. Car accidents

Drowsy driving is often compared to drunk driving: You really shouldn't do either. "Motor vehicle accidents related to fatigue, drowsy driving, and falling asleep at the wheel are particularly common, but often underestimated," one review concluded. Pilots, truck drivers, medical residents, and others required to stay awake for long periods of time "show an increased risk of crashes or near misses due to sleep deprivation."

Source: Seminars in Neurology, 2009

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17. Depleted sex drive and function

Testosterone is an important component of sexual drive and desire in both women and men. Sleeping increases testosterone levels, while being awake decreases them. Sleep deprivation and disturbed sleep, consequently, are associated with reduced libido and sexual dysfunction, and people suffering from sleep apnea are at particular risk.

Source: American Journal of Obstetrics and Gynecology, 2007; Behavioral Brain Research, 2009; Journal of Sexual Medicine, 2009; Sleep Medicine, 2010; Brain Research, 2011

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18. Pain

People in pain — especially those suffering from chronic pain — tend not to get enough sleep. This makes sense: Pain can wake you up in the night and make it hard to fall asleep in the first place. But recently, researchers have begun to suspect that sleep deprivation may actually cause pain or at least increase people's sensitivity to pain. One study found that after research subjects were kept awake all night, their pain threshold — the amount of painful stimulus they were able to endure — was lower.

Source: Journal of Sleep Research, 2001; Sleep Medicine Reviews, 2006

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19. Type-2 diabetes risk — even for non-overweight people

Being awake when your body wants you to be asleep messes with your metabolism, which in turn increases your risk for insulin resistance (often called "pre-diabetes") and type 2 diabetes. "Interventions to extend sleep duration may reduce diabetes risk," one study in adolescents concluded. And four large studies in adults found a strong association — though not a cause-effect relationship — between regular sleep loss and the risk of developing diabetes, even after controlling for other habits that might be relevant.

Source: Journal of Applied Physiology, 2005; Annals of Internal Medicine, 2012

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20. Clumsiness

Most people notice that when they're sleepy, they're not at the top of their game. One study found that one sleepless night contributed to a 20-32% increase in the number of errors made by surgeons. People playing sports that require precision — shooting, sailing, cycling, etc. — also make more mistakes when they've been awake for extended periods of time.

Source: The Lancet, 1998; Physiology & Behavior, 2007

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21. Cancer risk

Scientists are just beginning to investigate the relationship between sleep and cancer, and different kinds of cancer behave differently. But since disrupted circadian rhythm and reduced immunity are direct results of sleep deprivation, it's no surprise that preliminary research seems to indicate that people who don't get enough sleep are at increased risk for developing certain kinds of cancer, most notably colon and breast cancers.

Source: Journal of the National Cancer Institute, 2003; Pathologie-biologie, 2003; Cancer, 2011; AAOHN Journal, 2011

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22. Memory problems

Sleep disruptions in the elderly can lead to structural changes in the brain that are associated with impaired long-term memory — and sleep-related memory deficits have been observed in the general adult population as well. As early as 1924, researchers noticed that people who slept more forgot less.

Source: Cell Signal, 2012; Nature Neuroscience, 2013; JAMA Neurology, 2013

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23. Genetic disruption

A 2013 study shed some light on why sleep is tied to so many different aspects of our health and wellness. Poor sleep actually disrupts normal genetic activity. After one week of sleeping less than 6 hours per night, researchers found that more than 700 genes were not behaving normally, including some that help govern immune and stress responses.

Some genes that typically cycle according to a daily (circadian) pattern stopped doing so, while others that don't normally follow a daily pattern began doing so. What does this mean? Just one week of less-than-ideal sleep is enough to make some of your genetic activity go haywire.

Source: Proceedings of the National Academy of Sciences, 2013

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24. Unhappiness and depression

In a classic study led by Nobel Prize-winning psychologist Daniel Kahneman, a group of 909 working women kept detailed logs of their moods and day-to-day activities. While differences in income up to $60,000 had little effect on happiness, a poor night's sleep was one of two factors that could ruin the following day's mood. (The other was tight deadlines at work.)

Another study reported higher marital happiness among women with more peaceful sleep, although it's hard to say whether happy people sleep better, better sleep makes people happier, or — most likely — some combination of the two. Insomniacs are also twice as likely to develop depression, and preliminary research suggests that treating sleep problems may successfully treat depressive symptoms.

Source: Science, 2004; Behavioral Sleep Medicine, 2009; Journal of Affective Disorders, 2011

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25. Gastrointestinal Problems

One in 250 Americans suffer from Inflammatory Bowel Disease (IBD), and sleep deficiencies make its symptoms much worse. Regular sleep loss also makes you more likely to develop both IBD and inflammatory bowel syndrome, which affects an estimated 10-15% of people in the U.S. And patients with Crohn's disease were twice as likely to experience a relapse when they weren't getting enough sleep.

Source: World Journal of Gastroenterology, 2013

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27. Death

Many health problems are associated with sleep deprivation and poor sleep, but here's the big one: People who consistently do not get 7-8 hours of sleep are more likely to die during a given time period. Put more simply: We all die eventually, but sleeping too little — or even too much — is associated with a higher risk of dying sooner than you otherwise might.

Source: Sleep, 2010; Sleep Medicine Reviews, 2010

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Back-sleeping significantly improved my neck and shoulder pain—but it was also nearly impossible to commit to. Sleeping on my back didn't feel natural; I craved curling up in the fetal position. And that, Harris says, is where the rubber meets the repose.

"Although it is commonly recommended that sleeping on your back is the best position to sleep in, comfort is key," she says. "If you're in pain or uncomfortable from your sleep position, it can definitely impact your sleep quality." In other words, if changing your sleep position makes you feel better, that's great. But Harris stresses you still need to sleep soundly to stay healthy. "Sleep quality is extremely important in your overall health, memory, mood, and energy," she says. When trying to sleep differently starts disrupting your circadian rhythms, then you know it's not worth it.

Personally, I'm still trying to start my night sleeping on my back, but I don't get upset if I wake to find I turned over in the night. My hope is that, along with other alterations to my nighttime habits, I'll have more days when I wake up rested—and maybe even ready to jump out of bed.

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