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Advantages and disadvantages to prone, supine, and recumbent sleeping postures

This is an excerpt from Dynamic Human Anatomy 3rd Edition With HKPropel Access by William C. Whiting.

Lying Posture When resting or sleeping, we normally assume a recumbent, or lying, posture because it is the least physiologically demanding. This posture rotates the action of gravity from its longitudinal orientation in standing (figure 7.4a) and sitting to a transverse direction relative to the long axis of the body. Basic lying postures include lying face down (prone), lying face up (supine), and lying on one side or the other (figure 7.4b). Each of these lying postures has advantages and disadvantages.Figure 7.4 Line of gravity standing versus lying: (a) standing; (b) prone, supine, and side postures.

Surface characteristics play an important role in spinal alignment and how forces are applied to the body. On a very hard surface, only specific body areas (e.g., hip, shoulder) come in contact with the surface (figure 7.5a). This creates localized pressure points that can be uncomfortable or even injurious. Sleeping on too soft a surface can also cause problems, including excessive lumbar flexion when in a supine position, exaggerated lumbar extension in a prone posture, and lateral spinal curvatures when side lying (figure 7.5b). The surface and head support (e.g., pillow) should be consistent with maintaining proper spinal alignment (figure 7.5c). In a review of mattress-type choice to avoid back pain, Caggiari et al. (2021, p. 1) concluded that “a medium-firm mattress promotes comfort, sleep quality and rachis (spinal) alignment.” Consistent with this conclusion, Verhaert et al. (2011, p. 169) noted that “a sagging sleep system negatively affects sleep quality for people sleeping in a prone or lateral posture.”

In clinical settings, “smart” medical beds have been found to reduce the occurrence of lesions (e.g., pressure ulcers) for patients who are bedridden for prolonged periods (Ghersi et al., 2018; Shi, Dumville, Cullum, Rhodes, Jammali-Blasi, et al., 2021; Shi, Dumville, Cullum, Rhodes, McInnes, et al., 2021).

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