An Osteopathic Approach to Sleep and Bedding
Many people attribute back pain to injury, weight issues, poor posture and lack of, or strains from exercise.
However, we can be contributing to back pain when we least expect: that is, when we are asleep.
A third of our lives are, on average, spent sleeping and the choice of bedding and sleep posture will influence the quality of our sleep and overall health.
When looking to buy a bed, it is a very personal choice, but there are a few key factors to consider:
Ideally, the top layer should have enough ‘give’ to absorb pressure from your body and the layer underneath should be firmer to maintain good support.
What is the best mattress?
Be wary of so-called ‘orthopaedic’ beds as that term does not actually refer to anything specific and they can often just be too firm. The modern mattresses have come a long way from the too soft open sprung or too hard foam models we may have purchased in the past.
The key types are:
Pocket Sprung or ViSpring – usually made of good quality natural wool and organic cotton and some luxury brands with added cashmere and horsehair fillings. Very breathable materials, which allow for easy evaporation of perspiration, comfortable and supportive, but not appropriate if you are allergic to animal fibres.
Natural Latex (rubber tree sap) – can be very good to mould to your body, while still very supportive and mostly hypo-allergenic.
Memory Foam or Tempur – moulds to your body more than the Latex and can retain too much heat and moisture for some people.
Testing a mattress:
It can be useful to go with someone so that they can check that when you lay on your side, all the side-line contours of your body are in contact with the mattress, not just the side of your pelvis and side of your shoulders. It is when the waist isn’t supported in this position, that ligamentous strain, a type of ‘lumbar sag’, can occur. Ideally, the shoulders and pelvis should sink into the upper layer of the mattress, whilst the waist and sides are supported and the spine remains suspended and straight between them. If there are two of you, choose with your partner. If your weights are quite different, it might be that the zip and link approach for two mattresses is the best for you both. Either way, it is important to lay on the mattress for at least 15-20 minutes to test and not try and compare by sitting on the edge or just pressing into the upper layer to really get a true impression.
How much to spend?
On balance, it is advisable to invest in the best quality mattress you can afford. Typically, this can be anything between £500 – £1500 for a large double mattress. The high end mattresses are pricey, but when you think about your usage across the lifetime of the mattress, the cost can be calculated over 8-10 years.
A MATTRESS TOPPER is an economical alternative, but only as long as the mattress beneath is in good condition.
Choosing the Bed Base:
The base that the mattress rests on may be slatted, sprung or rigid. Again, it is a matter of personal taste, but important factors to consider are good ventilation and height of the bed base. A slatted base will allow air to circulate around it, a higher base will make it easier to get in and out of the bed and a sprung base may be best to buy together with the bed if the mattress, is particularly heavy.
If you like to lie on your back, it can put pressure on your low back, especially if your legs are out straight. Regular use of a pillow under the knees is not advisable, as this can lead to shortening of the hamstring muscles, which then put strain on the lower back. Also, in this position, your neck may either be dropped back too much or feel tilted forward. Pillows can be used to enable the neck to be in line with the spine.
If you sleep on your front, watch out for over-rotation in the neck or in the lumbar spine. Achiness in the lower back lying on your front is due to the abdomen creating a foward drag on lumber spine ligaments, particularly if para-spinal muscles are not strong. Lying on your front all night is, generally, not advisable for your low back, although younger spines may well be able to cope with it. (The only time this position may be conducive, is ironically if you have an acute disc compression, which is typically aggravated by flexing, sitting or bending forward).
The best position for the spine is lying on your side, right or left. This is so the spine from the head and neck to the pelvis and sacrum (the bone between your upper buttocks) is basically straight with no curves or twists, and with an overall slight forward curve, as if you were bending forward slightly. This ensures that there is no undue loading on muscles or ligaments, the joints are not compressing against each other and the nerves (which exit from between the joints of the spine) are not being squeezed by the joints.
Most people assume that they are continuously ‘on the move’ or cannot imagine controlling how they sleep, but it is possible to adapt to a side lying sleeping position and it is certainly worth trying, to avoid long term back issues. Further advice on any of this can, of course, be given in consultation with an osteopath.