15 ms·

Instinctive Sleeping and Resting Postures (2000)

369 points by alecst 3y ago

imperialdrive 3y ago
Excellent read right before shuteye.
verisimi 3y ago
Really interesting post. It is also quite counterintuitive - I personally think a lot of people are injured in sleep (including myself), and some of the postures indicated look like they could be very challenging/dangerous. Maybe the injuries come from lying on soft mattresses and a hard surface would be better as it provides more immediate feedback of bodily stress..?
- lolitan 3y ago
  Soft mattresses are really not suitable for sleeping. From my experience.
jiggawatts 3y ago
Is this considered unusual? I’ve used minor variations of all of these except the sleeping on the shins posture, and I’m from Europe, not some African tribe.
- arketyp 3y ago
  I very predictably have nightmares whenever I fall asleep flat on my back, sleep paralysis kind of things. In Germanic mythology the mare is a demon who sits on your chest, so my conclusion is that I'm not alone in this.
  - twowatches 3y ago
    I can't understand how anyone can sleep on their back. They snore and can't breathe it's like they're dying it's pretty obviously wrong.
    - agos 3y ago
      not everybody who sleeps on their back snores and can't breathe?
    - saberience 3y ago
      Surprise, surprise, people are different to each other. I pretty much can only sleep on my back, no other positions allow me to fall asleep. Also, I don’t snore. But I’m also very much in shape with no excess weight, snoring is generally correlated with ill health and being overweight.
      - kqr 3y ago
        Worth pointing out the false dichotomy here. I sleep better on my side, but I fall asleep better on my back! So ideally I'd go to bed on my back and then have someone push me over to my side once I'm sleeping...
    - toast0 3y ago
      I'm an expert snorer and can snore in any position. Probably central apnea, which only activates when most comfortable; previous sleep study showed nothing, presumably because I wasn't totally comfortable. I'd self medicate with a cpap if they were sold without a prescription. B1 with dinner/before bed helps, oddly. Also, my previous cats preferred to sleep on my chest, so they trained me to sleep without a lot of motion. Currenrly, one cat likes to sleep on my legs and overheats them, resulting in a lot of movement at night; the other cat will only briefly visit at night, but will help me stay in place for naps on the couch.
- helboi4 3y ago
  Yeah fr. The first one he showed I was like, duh... that is the most obvious way to sleep possible
flurb 3y ago
When I was 16, I inherited a bit of money. Not a large sum at all, but enough so that I could afford a new bed, a bookshelf and some nick-nacks from my local furniture store. Being 16, I didn't exactly put much thought into how kind my new mattress would be to my back down the line, and so I managed to find the firmest mattress known to man. At first, it was hard to sleep on, but I'm lazy, and so I kept it. That was a good decision. Today, I have a much softer mattress, and let me tell you, I'm suffering. Whenever I go camping in the summer, where I'm not in need of any insulation, I usually opt for just a simple, thin, foam sleeping pad, and it works wonder. The first couple of nights it's usually quite rough, not uncomfortable mind you, just hard to sleep as it's not as superficially comfortable, but after the initial acclimation my back's so much better.
- tetris11 3y ago
  When I was 28 at my peak fitness days, I opted for a firm mattress believing it would strengthen me as I got used to it. I never got used it. The slightest sound from outside would wake me. Sleeping on the side was a daily chore. I learned to sleep on my back and snore like a lion. Switched recently a soft mattress with shoulder support. Sleep on my side like a baby.
- taneq 3y ago
  This sounds easy to a/b test. Just sleep on the floor for a month, then your squishy mattress for a month, and document everything. (A month is just a guess, one or two weeks seems like transitional effects would dominate, hopefully after that you'd see more of the ongoing effects?)
  - flurb 3y ago
    Will do, I'll record a log and document the effects.
FredrikMeyer 3y ago
I find this article quite insubstantial. He lists alternative sleeping positions, but no sources backing up the claim that "western sleeping positions" (whatever that is) are worse. Also only one citation, and that is to back up the claim that there are 200 primates. Nice pictures though - I feel happy that I can sit (relatively) comfortably in the squatting position (as an European).
- talonx 3y ago
  It's a pity that not more published research is available on this.
- kqr 3y ago
  I think this clause near the end was what made the article make sense to me: > This observation must be recorded to allow further research in this direction This is just one person noting in public what could be a correlation, and then all the rest (confirming correlation, establishing causation) is up to someone else!
- roenxi 3y ago
  This appears to be a journal article. Why should it have citations? This is an arena where people are supposed to be doing primary research. "I have a PhD and this is my opinion" is probably at least 20% of academics.
  - lou1306 3y ago
    I can't possibly imagine sleeping posture being such a a pristine research area that there is no prior work on the topic
    - roenxi 3y ago
      There is a search bar right above this article if you want to look that research up. This is some physiotherapist recording his opinion; based on field experience. I'm going out on a limb and saying none of the other researchers in the field have been writing about his experience so there isn't anything to cite.
talonx 3y ago
Very interesting. The author of the paper is around, at least according to the internet, at 90+ years of age and still practising physiotherapy.
- ajb 3y ago
  And is also totally blind! [1] Which must have made taking these observations much harder. [1]https://www.csp.org.uk/frontline/article/thank-you-csp https://www.csp.org.uk/frontline/article/thank-you-csp
- danjc 3y ago
  Also thought that but the article is dated 2000.
  - talonx 3y ago
    Yes, but there is a report of him being around around 2022 also - https://web.archive.org/web/20220128114020/https://whyy.org/segments/a-physiotherapist-traveled-the-world-studying-sleep-and-says-most-of-us-do-it-wrong/ https://web.archive.org/web/20220128114020/https://whyy.org/...
kasperni 3y ago
Also, tribespeople don't spend most of their waking time sitting in front of a computer or TV.
kurren 3y ago
These and other anthropological elements are very well described by Esther Gokhale as the basis of her method (which has been a life changer, at least for me). You can find more on her website or book "8 Steps to a pan-free back".
twowatches 3y ago
I'm fairly sure the cause of back pain is sitting at desks, not the position I'm sleeping in.
- safety1st 3y ago
  I'm skeptical that there's anything especially unhealthy about sitting at a desk even for long periods of time. What's more plausible to me is that back pain comes from having a weak back and it's more about what you're not doing, which is training your back muscles. Over the course of about a year, weight lifting eliminated a range of aches and pains I'd developed throughout adulthood, including back, wrist and knee pain. For the back it's all about deadlifts. In hindsight it seems obvious, all the muscles supporting my spine are visibly larger and demonstrably more powerful, carrying my body around is a much easier job for them now. Sinking into a padded chair after a few big lifts also feels fantastic and now feels like a perk of my job lol
  - helboi4 3y ago
    I dunno. I never had chronic back or neck pain until I started working office jobs. When I was at university, I spent periods sitting at desks, but was never strapped to one for 8 hour shifts. I would sit down at a desk for max 4 hours at a time apart from during extreme crunch periods, and would spend the rest of my day walking around, lounging and chilling in different positions, excercising, etc. As soon as I started working at an office it became noticably harder to reach an over-10k step count daily, and even though I continued going to the gym and doing heavy back days, my left trap has become completely hardened up, and I've occasionally had lower back pain too during stressful times. I'm totally unable to train upper traps because they are literally like bricks. When I have a weekend where I walk and lounge a lot, or am off sick, or go on holiday, my traps feel significantly better and my workouts are better. It's a lifestyle where you are unnaturally in one position for too long that causes this.
  - Notatheist 3y ago
    >I'm skeptical that there's anything especially unhealthy about sitting at a desk even for long periods of time. What's more plausible to me is that back pain comes from having a weak back I figure few habits will give you a weaker back than sitting at a desk for longer periods of time.
awongh 3y ago
It’s crazy to think about how little we actually know about how the human body functions- not even to say what an “optimal” sleep position might be, but even a high quality study on how different sleep positions might affect the physiology of the body. I have yet to find any real serious scientific analysis of this.
- boffinAudio 3y ago
  The Soviets tried, but we didn't want to hear what they had to say: https://bldgblog.com/2007/02/sleep-labs-of-the-soviet-empire/ https://bldgblog.com/2007/02/sleep-labs-of-the-soviet-empire...
- lukan 3y ago
  "not even to say what an “optimal” sleep position might be" As with most things, maybe there isn't one optimal solution,as otherwise we all would have found out about it, by now and all use it? Human bodies and minds are quite different. So what is comfortable to one person might not work for the next person. Maybe people have pain in the back or in the neck, forcing them into other positions. People with stomach problems rather lie on their stomach. Some people people sleep alone, others together. I know my sleeping position varies a lot and there is no single best one for me.
  - BizarroLand 3y ago
    "Optimal" depends on how deep down the rabbit hole you want to go. "Slept well and wake refreshed" might be one version of it, but "slept like an infant in the womb and awoke younger and healthier" would be more optimal, if currently in the realm of science fiction.
contrarian1234 3y ago
I love sleeping in the "lookout posture". I get very restful sleep. However after a couple of days it leads to a lot of pain in my back. I'm guessing some tendons get overstretched. No idea how to work around it though I should try the reverse with the elbow outward. Seems doable. The Tibetan kneel seems a big too hardcore though :)
- kqr 3y ago
  I have actually used that Tibetan kneel once! I was exhausted and had to sit on the floor for a while and then I just fell asleep like that. It surprised me enough that I've tried to recreate it but it seems I can only do it when I'm really tired. Maybe it's a matter of habit and I can learn to do it if I try often enough.
tejtm 3y ago
@dang please macro expand previous https://news.ycombinator.com/item?id=18024260 https://news.ycombinator.com/item?id=18024260 Sept 19, 2018 https://news.ycombinator.com/item?id=32531484 https://news.ycombinator.com/item?id=32531484 Aug 20, 2022
delichon 3y ago
I bought a very strange mattress six months ago. This isn't an advertisement -- I can't strongly recommend it -- but it's called SONU Sleep. It has a "channel" along the top that you can lower your arm into when sleeping on the side. I got it due to persistent shoulder pain from side sleeping. Gradually I've adjusted to it and am now sleeping better. But that's an argument against my usual paleo heuristic: this sure isn't how we evolved to sleep over millions of years. I wonder if I'd sleep well in orbit.
- anonu 3y ago
  If you're sleeping better, why cant you "strongly recommend" it?
  - delichon 3y ago
    It has been a difficult adjustment that has taken months. I've had neck and shoulder pain while learning to use it. It sure isn't for everyone. I got the firm mattress, but it is still softer than I like. And it's at a premium price that may not be worth paying if you already sleep well on a conventional bed.
vasco 3y ago
> Forest dwellers and nomads suffer fewer musculoskeletal lesions than “civilised” people > I tried to carry out surveys to collect evidence but they were meaningless, as tribespeople give you the answer they think you want. Could they simply have higher thresholds for complaining?
- leoedin 3y ago
  They're also incredibly active compared to any "civilised" people. There's a lot of evidence that sedentary lifestyles are bad for bodies. Presumably they're also, on average, younger than "civilised" peoples. Life expectancy for an Amazonian Tribe was just 53 years. https://www.sbs.com.au/food/article/how-to-eat-like-an-amazonian-and-slow-down-ageing/atocalaj4 https://www.sbs.com.au/food/article/how-to-eat-like-an-amazo... Muscle and joint issues are a symptom of aging. If nobody's making it to 60, then aging really isn't the same issue.
  - kqr 3y ago
    Life expectancy of 53 does not usually mean nobody makes it to 60. In the early 1900s[1], life expectancy at birth in England was 53, but at the same time, as long as you survived until you were 20, your life expectancy had increased to over 60. If you lived to 50, you could expect to become 70. https://ourworldindata.org/images/published/Life-expectancy-by-age-in-the-UK-1700-to-2013_3080.png https://ourworldindata.org/images/published/Life-expectancy-... ---- [1]: Not counting the years of the Spanish flu!
    - matthewfcarlson 3y ago
      To the parents point, you sort of made their point. “If you made it to x”. By having fewer older members of their population they likely had few joint problems reported overall. I would expect any reasonable study to control for this variable but a survey would not.
    - chaorace 3y ago
      Life expectancy is such a consistently deceptive measurement that I often wonder why it's not been replaced. Surely there must be more useful ways of quantifying lifespans, something like a "median age of currently living people"?
danw1979 3y ago
I’m sure there are some great points in this paper but this bit of un-evidenced bit of speculation turned me off: > It has been noted that guide dogs working in towns breathe the same pollutants as humans yet do not have asthma. Could this be because when they lie on their chests the kickback from the upper ribs keeps the corresponding vertebrae mobile, allowing the sympathetic system to work efficiently? Or could it be one of the many other physiological differences between humans and dogs ? I think the author notes that this is mostly a collection of anecdotal observations, but linking a primarily inflammatory disorder like asthma with musculoskeletal problems is a bit far fetched in my layman’s opinion. Sounds a bit like chiropractic quackery to me.
- dmix 3y ago
  He lists his profession as a physiotherapist so probably crossed into the chiropractic side a bit, some of his personal photos are a little hippy-ish. The article is also premised on one large appeal to nature (tribal people untainted by modern society do it therefore it is natural and therefore good). https://en.wikipedia.org/wiki/Appeal_to_nature https://en.wikipedia.org/wiki/Appeal_to_nature
  - tlb 3y ago
    Appeal to nature is bad as a source of ultimate truth, "nature does it this way therefore it must be better." But it's good as a source of hypotheses, "nature does it this way, perhaps we should try it?" This paper seems more like the second.
    - dmix 3y ago
      I don't see the difference between those two statements absent scientific data. That's merely a useful seed of an idea, not a sufficient premise for an argument.
      - DANmode 3y ago
        Hypotheses are not for arguments. They are indeed a seed for discovery. What are you talking about, Willis?
admissionsguy 3y ago
To add to the anecdotes, I have been sleeping on a flat rice straw tatami matt (without anything else) for 2 months. It's pretty hard and I have bruises on my ribs, but I have way less back and neck pain than before. I usually fall asleep in position similar to Figures 4 and 5 in the paper. The reason I started doing this is that after moving to a new house I bought an expensive memory foam mattress which made my back hurt every morning.
onetimeuse92304 3y ago
For my entire life I slept in one of those postures ("the lookout"). I had a bunch of problems (pain in the chest, pain in the back, some problems with my knees not loaded symmetrically, my feet getting "extended" for quite a long time causing problems with Achilles). I also had a problem with restlessness -- these positions cannot be maintained for long without moving, I would be changing my position very frequently. Couple of years ago I have injured my ACL and had to learn to sleep on my back. Now I am much happier sleeper. Now I generally do not move at all during night (I wake up exactly as I have fallen asleep and my sleep tracker tracks way less movement). All of the pains gone.
- nightowl_games 3y ago
  Pillow or no pillow? Hard mattress? No mattress?
  - onetimeuse92304 3y ago
    I use a very thin pillow when sleeping on my back. I find sleeping without pillow a bit uncomfortable. Although I am sure I could get used to my head being pushed back a bit, I still dislike the head just resting on the hard mattress and trying to naturally roll left/right. The pillow helps me keep my head looking straight ahead (almost vertically). As to mattress, I prefer a mid-to-hard latex mattress with a cover.
    - radlad 3y ago
      In the article, the lookout position involves the lack of a pillow. One can imagine that the additional height of the pillow would cause you to raise your head, lower your chest, and arch your back, potentially causing the issues you reported. That being said, this is an article of anecdotal observations by a physiotherapist - it is not the result of any kind of study.
      - onetimeuse92304 3y ago
        It is really thin pure goose down pillow. Folded, it is less than 1/4in when compressed. I don't think the height of the pillow makes a huge difference.
pcrh 3y ago
Amazing demonstrations of casual racism in that article. It reads as if it was written in 1850 rather than 2000. There's no plausible reason to suppose that Tibetans or "tribesmen" have more natural sleeping positions than "civilized" (i e. White) people.
- lonelyasacloud 3y ago
  > There's no plausible reason to suppose that Tibetans or "tribesmen" have more natural sleeping positions than "civilized" (i e. White) people. So Tibetan tribal society is likely to have exposed its members to the same level of furniture and mattress adverts as the average American or European then?
  - pcrh 3y ago
    Tibetans traditionally sleep on beds that are not much different from European beds. The porters shown in the article are "camping", so to speak, i.e. not in their typical sleeping postures.
dsalzman 3y ago
The interesting point of this article to me is not the positions but the sleeping surface. Due to my newborn I’ve been sleeping on the floor on a thin yoga mat for over three months and my back and joints feel great. The pressure from the hard ground is like stretching while you sleep. Took a few weeks to get used to it though.
- sameoldtune 3y ago
  I have a Japanese futon mat[1] under my bed that I roll out if I have muscle soreness. If it weren’t for my partner (who insists on sleeping in a bed) I would sleep on the floor 100% of the time. After getting used to floor sleeping I can never feel truly relaxed in a bed-I feel like the padding is putting pressure on my lumbar spine. [1] https://www.futonbedsfromjapan.com/ https://www.futonbedsfromjapan.com/
itronitron 3y ago
The text referencing Figure 2 seems to mistakenly swap the top and bottom images. When the legs are in the reverse recovery position (fig (fig2,2, bottom), the penis lies on the lower thigh and is protected. In this position the Achilles tendon of the leading foot can be inserted in the gap between the big toe and the first lesser toe to help correct a bunion. Note that the top picture in Figure 2 shows the Achilles tendon of the leading foot between the big toe and adjacent toe of the trailing foot. I would conclude then that the top position is actually the one that protects the penis.
- wizzwizz4 3y ago
  Figure 1 also has the images the wrong way around, though it's harder to see because they're meant to be side-by-side. I think it's a problem with the HTML conversion.
ano-ther 3y ago
This came up on HN a while ago already. I tried it out and found that quadrupedal lying (fig 5) did help my lower back pain.
hnbad 3y ago
It's odd that the paper goes to great lengths to talk about protecting your penis from insects but at the same point seems to ignore women completely - all the illustrations depict men. Having met women (shocking, I know), bust size can be a significant factor in ergonomics so it would be interesting to see how that factors into it. Also anecdotally, pregnant belly-sleepers frequently rely on cushioning and people may prefer certain sleeping positions after having given birth or suffering from certain ailments. I'm also certain that waist size (esp. obesity) may alter preferences. It's an interesting paper but given the lack of substance this feels more like a school presentation than something you'd find in an academic journal.
- kqr 3y ago
  > Also anecdotally, pregnant belly-sleepers frequently rely on cushioning I mean, undergoing pregnancy is in and of itself not great for one's health (especially without modern healthcare), so I don't know how much that specific thing should be factored into healthy lifestyle choices. In particular, pregnancy puts a lot of pressure on internal organs in a way that means one should not be surprised to have only one working sleeping position by the third trimester. At that point it's governed by Newton and another growing human, not choice. (To be clear, I'm not saying pregnancy is a bad lifestyle choice, just that pregnancy is not kind to the human body.)
  - hnbad 3y ago
    > I don't know how much that specific thing should be factored into healthy lifestyle choices. I'm pretty sure the average human is not healthy, even in the societies analysed, especially if you factor in injuries, disabilities or pregnancy. If anything the perfectly "healthy" able body is the exception to the human experience. So yes, if we want meaningful advice on healthier sleeping postures we should take various illnesses, disabilities, ailments and conditions into account. At least this seems like a fair consideration if we already dedicate this much text to reducing the risk of insect bites on your penis.
- kaitai 3y ago
  Yes, I wondered about this as well. I understand why the author might not have observed women sleeping, and certainly wouldn't have photos, but one might at least mention it (especially given all the attention to the penis). Bust size & placement for sure has a significant effect on where arms can be placed, among other things. It seems that the author's observations are primarily from various camping-equivalents, more so than home life. To my sibling commenter, whether pregnancy is or isn't "healthy" isn't quite the point, IMO. Various stages of pregnancy do occupy a non-trivial part of many people's lifespan and significantly change the ergonomics of sleep. Given that humans have been getting pregnant for a long time, it is a big miss to not even mention that it hasn't been considered. Academic training tries to impress on most authors that they should mention what they're ignoring and why, not least to set up the citation train for the future and support grant applications.
btbuildem 3y ago
The Tibetan caraveneers sleeping on their shins is metal af. As a bonus, in that position, the penis is protected from instects. Did that little observation, erm, stand out to anyone else?
- deleted 3y ago
  [deleted]
- malfist 3y ago
  Penis and insects are mentioned in quite a few places in the study. Author seems very preoccupied with that.
- orthoxerox 3y ago
  You never think about ants crawling up your urethra until one of them tries.
Izkata 3y ago
The images for Figure 2 are reversed. Both the caption and the description in the paragraph below refer to the bottom image while describing the top one.
ErigmolCt 3y ago
"Pillows are not necessary". It is but good position in sleep depends on an individual itself. Some people find pillows essential for comfort and proper spinal alignment
bee_rider 3y ago
IMO it would be better for the government to keep this sort of general library content on a url that doesn’t contain NIH. They have the disclaimer, > As a library, NLM provides access to scientific literature. Inclusion in an NLM database does not imply endorsement of, or agreement with, the contents by NLM or the National Institutes of Health. Anyway, it seems like an interesting collection of anecdotes that would be a good place to start searching. I don’t see as much value in some of his speculations. The bit about dogs not getting asthma seems a little out of scope. Actually, do dogs get asthma? Quick googling seems to provide contradictory answers, with the general trend that apparently cats get it more often, and apparently dogs get some sort of allergic reaction thing that is technically not asthma, but is very similar?
- anonu 3y ago
  > keep this sort of general library content on a url that doesn’t contain NIH. Why? The author makes it clear its purely anecdotal. Someone might come across this and decide to do a further, more scientific study. I would argue that this is valuable content that could lead to better insights on our sleep. Not having it on the NIH website would make it less likely to be viewed.
  - hn_throwaway_99 3y ago
    Because inclusion on the NIH website, in the same general format as peer-reviewed articles are given, can give it the aura of being promoted or at least vetted by NIH, even with the disclaimer. If you look through Snopes there are tons of examples of hoaxes and false gossip that end up spreading because they are found on an "official" website (or official-looking website), even if that official website is just a library where anyone can publish.
- hn_throwaway_99 3y ago
  Totally agreed. I also liked some of the anecdotes in this article, but I always have to do an eye roll when I read an article that claims that "primitive" cultures don't suffer from disease X, and look they do thing Y that modern cultures don't, so of course thing Y must be the the reason for the difference! Conveniently ignoring the 6387 other stark differences in culture, behaviors and diets between the cultures. I think the hypothesis of how sleeping positions affect back pain would be worth studying, but that's all it is, a hypothesis.
m_dupont 3y ago
I tried some of the positions in this article while trying to get used to sleeping on the floor in an attempt to fix my back pain. These hurt like hell
anonu 3y ago
I will be trying more of these suggested positions. Coincidentally, I had a 5 degree wedge under my mattress to lift my head up slightly to reduce snoring. This resulted in increased lower back pain. Removing it reduced this lower back pain substantially. In some sense, the vertical use of our vertebrae is a design anti-pattern. We evolved from animals that walked on all fours, and vertebrae are much better suited for this horizontal position. This is why we suffer from slipped discs and other ailments that are not common in other animals.
colloydi 3y ago
More than a few middle-aged westerners would find it impossible to sleep with bent knees owing to a high prevalance of artherosclerosis (I think). Also one of the great pleasures of life is turning over in bed repeatedly during a lie-in. Don't know whether it's to do with lymph circulation and/or detoxifying the brain. More investigation needed!
carpdiem 3y ago
It would be interesting to know how the comfort or suitability of these postures is affected by physiology. For example, even the suitability to obtain a deep squat may be affected by things like hip joint geometry: https://www.otpbooks.com/stuart-mcgill-hip-anatomy/ https://www.otpbooks.com/stuart-mcgill-hip-anatomy/
karaterobot 3y ago
I notice that all of the sleep positions are either on the stomach or side. I usually go between side and stomach when sleeping, and can't really fall asleep very well on my back. But, my impression is that most people go between side and back, with stomach sleepers being a minority (I've even heard it called weird). This study backs that up (54% side, 37% back, 7% stomach) https://www.dovepress.com/sleep-positions-and-nocturnal-body-movements-based-on-free-living-acce-peer-reviewed-fulltext-article-NSS https://www.dovepress.com/sleep-positions-and-nocturnal-body... I wonder if the difference is cultural, or technological: that is, do we learn to sleep a certain way, or is it that the mattress changes the equation somehow and makes people 5x more likely to sleep on their back than on their stomach? In the past, I've hypothesized that it's cultural, and my just-so etiology for the phenomenon is that it comes from TV and movies. It's much easier to get a good shot of an actor delivering dialog while lying in bed on their back, compared to their stomach, so we see people sleeping on their back and learn to do it that way. This is all just uninformed speculation, and of course it assumes the original, linked article is valid at all.
- spondylosaurus 3y ago
  How do you breathe when you sleep on your stomach? My back and hips feel amazing when I try it, but my neck starts to hate me from the way I have to twist around to get air.
  - ecshafer 3y ago
    When you sleep on your stomach you turn your head to the side, breathing is easy.
  - tejohnso 3y ago
    Try putting a pillow under the shoulder that your mouth is closest to. A slight lifting of the shoulder might relieve the neck strain.
  - karaterobot 3y ago
    Looks a lot like figure 4 in that article, but with my arms wrapped around a pillow. The arms hold up the head, and the neck isn't rotated so much that it hurts. There's usually a little twist at the hips, and my legs are kinda jackknifed as in the second figure 2 picture (I just noticed the caption points out how "the penis is protected from insects", ha ha). Very comfortable, though my ribs will get a little sore after a while, so I rotate with a side sleeping position throughout the night.
WaitWaitWha 3y ago
I am very uncomfortable with this paper to be called scientific research. It certainly appears the author had extensive life experiences, but does not demonstrate any of the data he collected. > If you are a medical professional and have been trained in a “civilised” country you probably know next to nothing about the primate Homo sapiens and how they survive in the wild. Starting off by insulting an entire population and making assumptions about what they do or do not know is odd. The disrespect continues on how an entire medical field "do not know that nature has provided". The author continues on to further disrespect by moving medical professionals in to "so called civilised people", and makes medical conclusions of "suffer[ing] unnecessarily from musculoskeletal problems". And, this is just in the first paragraph. The second paragraph goes into the author's background how he lived amongst tribal people, commanded a platoon of African soldiers, and organized expeditions to meet native peoples and study their sleeping and resting postures. > I tried to carry out surveys to collect evidence but they were meaningless The author collected evidence, and the evidence was meaningless (alternative hypothesis false?) so... he discarded it? Would it not make sense to attach it and explain why it was meaningless? One of the conclusions is > Forest dwellers and nomads suffer fewer musculoskeletal lesions but then... > Arabs in the Sahara will sit in the position shown How is the Arabs in the Sahara backing up forest dwellers conclusion? NIH publishing this is odd. At least it was not written by ChatGPT.
- sdwr 3y ago
  How is this not science? He has a hypothesis - modern sleep devices are not as good for the spine as the bare ground. He suggested a reason why - pressing against the ground during sleep acts as therapy. He has data - life experience, pictures, and demonstrations. Maybe it doesn't pattern match as science to you, but the raw science is all there. A few hundred years ago, this is how most science was conducted - by individuals with specific bones to pick. Is it conclusive? No. Is it worth being part of the conversation? Absolutely!
- Herodotus38 3y ago
  Remember that the NIH does not publish (edit: to be clearer this is the National Library of Medicine which falls under the umbrella of the NIH, and its URL), it just organizes articles like a local library but on a much larger scale. It's a common misconception. This article was published by the British Medical Journal as an interesting anecdote from a physical therapist. The NIH makes things available for searching but does not endorse anything that they have available.
frame_ranger 3y ago
Rest and vest brahs, rest and vest.
eightnoteight 3y ago
I never focussed much on sleeping postures, but one day I read this article about how acid reflux goes away if you side-sleep on your left hand side i.e stomach is at a lower height than when you sleep on your right hand side that really changed my life, it was like, how did I waste 28 years of my life without finding this trick :D
- polishdude20 3y ago
  I actually noticed when I sleep on my left side, I start to feel out of breath. Like ,I can breathe normally but something makes me feel I need to take deeper breathes almost as if some blood flow is getting cut off.
0xbadcafebee 3y ago
I am a subject of the species Sapiens, genus Homo. Subject is a civilized example of the species. An unfortunate side-effect of being civilized is an encouragement to collect paper, with which subject is to trade for essential goods. The method subject has devised to collect these trade papers involves sitting on a soft yet sturdy apparatus and being bent at an approximately 90-degree angle at the hip and knee joints, and looking at a glowing rectangle while subject taps on a noisy set of squares. Of the unfortunate side-effects of civilization, one is risk of injury. Of the several injuries subject has sustained in this pursuit (including to eyes, fingers, wrists, and elbows) is injury to subject's neck. In particular, a musculoskeletal injury of the muscles supporting the head on the spine, due to repeated stress from looking at a downard angle at glowing rectangle, as opposed to looking straight ahead. This injury did result in up to 11 months of recuperation. During this time period, finding a way to rest the neck and head was extremely difficult and painful. After completing several weeks' worth of paper collection, some attempts were made at recuperation outside in nature. Upon attempting to sleep on the ground, rest was significantly painful and uncomfortable. Thus were attempted many months of trial and error at attempting to find positions with which to rest in a comfortable manner, while allowing the neck to heal. At the end of recuperation, the result of attempts at finding resting positions was quite unexpected. Rest for this subject no longer requires (nor benefits from) pillows when side-sleeping, and back-sleeping is easier, though still not preferable. The explanation for this change appears to be an adaptation in musculoskeletal alignment when sleeping. This subject now acquires a particular alignment of head, neck, spine, shoulder, chest, back, and hips, that keeps any one body part from receiving undue strain. Sleep quality is consistent with sleep quality before injury, with the benefit of no longer needing props to assist in sleep quality. The linked article's conclusion appears to be supported by subject's experience. Subject additionally notes that a single ear is enough to be alerted to most dangers. When sleeping outside, or in an enclosed cabin, such things as mice, deer, and the occasional canid, do tend to wake the subject, as well as odd sounds such as socks falling off the bed onto a plastic bag, or elastic bed sheet end-corners snapping upwards. Whether non-h.sapiens species are also alerted to the latter sounds with one ear open has not been formally evaluated.
keybored 3y ago
This is so fascinating. I slept (on my back) on the floor for a while. It was at times amazing—I would wake up and feel ready to go. Not like my muscles were weak or temporarily atrophied. Like, I didn’t know that was possible after a full nights sleep. There seems to be so much potential in just reflecting on an considering what a “paleo” approach to something would be. And then you can just do that. You don’t even need to buy hundreds of dollars worth of supposedly ergonomic equipment. Just sleep in a funny-looking position. Just squat instead of sitting on a chair… if you can bare the social awkwardness or ridicule. It’s so simple. Why do we make things complicated? Well in part because “modern humans” cannot just do these things without becoming regarded as merely a modern human with eccentric hobbies. Because that’s what you get pegged as!—not as a modern human who rediscovered (through YouTube/the Web) some ancient wisdom but as a paleo-hipster, just another quirky modern human subculture. And in part that is correct. You cannot be, say, a Western Buddhist who has all the know-how and experience of a born-in-the-culture (Asian) Buddhist. And in that same way you cannot become a non-modern… human. But wait. Why would you want to? You are who you are. You may be a Buddhist from Scranton, PA who has no relation to Asian culture. Or an office worker who squats at the office. But why is that weird? Yeah you’re not a “real Buddhist” in that terribly essentialist sense, and you’re not a born-in-the-culture kind of human who has never used a chair. But why do you have to be that in order to make these (eccentric) choices for yourself? If it works for you, just go for it you paleo-hipster.
- pedalpete 3y ago
  I also slept on my floor for about 5 months - until I saw a huge cockroach (common in Sydney) run across my floor and hide under my pillow. I agree, it felt great. When I moved into my new, almost cockroach free apartment, I built my own shikibuton by taking a futon cover and stuffing it with a comforter and a thin foam mattress topper. The whole thing is about 7cm (2.7 inches) thick. I roll it up each morning and have been sleeping like this for the last 8 months. I also use only 1 thin pillow, and for a while was placing it lengthwise along my spine, which is apparently good for fixing the hunchback posture of modern humans.
- DANmode 3y ago
  > Why do we make things complicated? Because we genuinely care more about how people perceive us ("am I acting normal?") than how we feel. That's been engrained over generations, for most humans.
friend_and_foe 3y ago
There are a lot of things that we do that wild animals and wild people don't do, and a lot of things they do that we don't do. If "do what they do" were a panacea we wouldn't be living like this in the first place. They don't have access to antiparasitic medications, for example. Another example, they don't stare at screens ever. Plenty of our habits are better for us and plenty are worse, and the same is true for them. I'm sure plenty of habits of all people have trade offs. We have a higher life expectancy. What's a better metric for healthy lifestyle than that? It doesn't mean everything is better, but it is a good yardstick for determining if we are doing more right than wrong to our health, all in all. So just "this is how it's done in nature so we are wrong about how we do it" isn't a good heuristic. A dog will lay on something soft given the opportunity.
ornornor 3y ago
I wish I could sleep without a pillow but my nose completely clogs if I do. And that’s after surgery to remove a very small part of the bone in my nostrils to widen the passage. The mucosa inside my nose just swells too much and clogs my nose which keeps me from breathing which translates to terrible sleep. Is anyone planning on trying these sleeping techniques? I’d be curious to hear about your experience and if you noticed any difference at all.
garfieldnate 3y ago
The part about musculoskeletal issues really hits home for me. Can anyone recommend a book or site to learn to diagnose and fix musculoskeletal issues where possible? For example, I've had one leg longer than the other for most of my life, and it has caused my a lot of back pain. I went to a physical therapist and he figured out pretty quickly that the two major pieces of my pelvis were twisted and not aligned with each other, and he had a simple move I could do to crack it back into place (essentially just squeezing a pillow between my legs). Now it's part of my morning routine, and I'm working on hip flexibility and strength as well. But I also get other misalignments and I would like to feel empowered to free myself from pain where possible.
- donatzsky 3y ago
  Consider your footwear. Most people don't realise it, but modern shoes are generally pretty terrible for the body. They make your feet weak, "disconnect" you from the ground, and the elevated heels put a lot of strain on many parts of your body and shortens your ham-strings. My favourite is Vivo Barefoot, but there are many brands now. Make sure to look for a wide toe box, flexible sole, and zero-drop (no elevated heel).

369 points by alecst 3y ago

Excellent read right before shuteye.

Really interesting post. It is also quite counterintuitive - I personally think a lot of people are injured in sleep (including myself), and some of the postures indicated look like they could be very challenging/dangerous. Maybe the injuries come from lying on soft mattresses and a hard surface would be better as it provides more immediate feedback of bodily stress..?

lolitan 3y ago
Soft mattresses are really not suitable for sleeping. From my experience.

jiggawatts 3y ago

Is this considered unusual? I’ve used minor variations of all of these except the sleeping on the shins posture, and I’m from Europe, not some African tribe.

arketyp 3y ago
I very predictably have nightmares whenever I fall asleep flat on my back, sleep paralysis kind of things. In Germanic mythology the mare is a demon who sits on your chest, so my conclusion is that I'm not alone in this.
- twowatches 3y ago
  I can't understand how anyone can sleep on their back. They snore and can't breathe it's like they're dying it's pretty obviously wrong.
  - agos 3y ago
    not everybody who sleeps on their back snores and can't breathe?
  - saberience 3y ago
    Surprise, surprise, people are different to each other. I pretty much can only sleep on my back, no other positions allow me to fall asleep. Also, I don’t snore. But I’m also very much in shape with no excess weight, snoring is generally correlated with ill health and being overweight.
    - kqr 3y ago
      Worth pointing out the false dichotomy here. I sleep better on my side, but I fall asleep better on my back! So ideally I'd go to bed on my back and then have someone push me over to my side once I'm sleeping...
  - toast0 3y ago
    I'm an expert snorer and can snore in any position. Probably central apnea, which only activates when most comfortable; previous sleep study showed nothing, presumably because I wasn't totally comfortable. I'd self medicate with a cpap if they were sold without a prescription. B1 with dinner/before bed helps, oddly. Also, my previous cats preferred to sleep on my chest, so they trained me to sleep without a lot of motion. Currenrly, one cat likes to sleep on my legs and overheats them, resulting in a lot of movement at night; the other cat will only briefly visit at night, but will help me stay in place for naps on the couch.
helboi4 3y ago
Yeah fr. The first one he showed I was like, duh... that is the most obvious way to sleep possible

flurb 3y ago

When I was 16, I inherited a bit of money. Not a large sum at all, but enough so that I could afford a new bed, a bookshelf and some nick-nacks from my local furniture store. Being 16, I didn't exactly put much thought into how kind my new mattress would be to my back down the line, and so I managed to find the firmest mattress known to man. At first, it was hard to sleep on, but I'm lazy, and so I kept it. That was a good decision. Today, I have a much softer mattress, and let me tell you, I'm suffering. Whenever I go camping in the summer, where I'm not in need of any insulation, I usually opt for just a simple, thin, foam sleeping pad, and it works wonder. The first couple of nights it's usually quite rough, not uncomfortable mind you, just hard to sleep as it's not as superficially comfortable, but after the initial acclimation my back's so much better.

tetris11 3y ago
When I was 28 at my peak fitness days, I opted for a firm mattress believing it would strengthen me as I got used to it. I never got used it. The slightest sound from outside would wake me. Sleeping on the side was a daily chore. I learned to sleep on my back and snore like a lion. Switched recently a soft mattress with shoulder support. Sleep on my side like a baby.
taneq 3y ago
This sounds easy to a/b test. Just sleep on the floor for a month, then your squishy mattress for a month, and document everything. (A month is just a guess, one or two weeks seems like transitional effects would dominate, hopefully after that you'd see more of the ongoing effects?)
- flurb 3y ago
  Will do, I'll record a log and document the effects.

FredrikMeyer 3y ago

I find this article quite insubstantial. He lists alternative sleeping positions, but no sources backing up the claim that "western sleeping positions" (whatever that is) are worse. Also only one citation, and that is to back up the claim that there are 200 primates. Nice pictures though - I feel happy that I can sit (relatively) comfortably in the squatting position (as an European).

talonx 3y ago
It's a pity that not more published research is available on this.
kqr 3y ago
I think this clause near the end was what made the article make sense to me: > This observation must be recorded to allow further research in this direction This is just one person noting in public what could be a correlation, and then all the rest (confirming correlation, establishing causation) is up to someone else!
roenxi 3y ago
This appears to be a journal article. Why should it have citations? This is an arena where people are supposed to be doing primary research. "I have a PhD and this is my opinion" is probably at least 20% of academics.
- lou1306 3y ago
  I can't possibly imagine sleeping posture being such a a pristine research area that there is no prior work on the topic
  - roenxi 3y ago
    There is a search bar right above this article if you want to look that research up. This is some physiotherapist recording his opinion; based on field experience. I'm going out on a limb and saying none of the other researchers in the field have been writing about his experience so there isn't anything to cite.

talonx 3y ago

Very interesting. The author of the paper is around, at least according to the internet, at 90+ years of age and still practising physiotherapy.

ajb 3y ago
And is also totally blind! [1] Which must have made taking these observations much harder. [1]https://www.csp.org.uk/frontline/article/thank-you-csp https://www.csp.org.uk/frontline/article/thank-you-csp
danjc 3y ago
Also thought that but the article is dated 2000.
- talonx 3y ago
  Yes, but there is a report of him being around around 2022 also - https://web.archive.org/web/20220128114020/https://whyy.org/segments/a-physiotherapist-traveled-the-world-studying-sleep-and-says-most-of-us-do-it-wrong/ https://web.archive.org/web/20220128114020/https://whyy.org/...

kasperni 3y ago

Also, tribespeople don't spend most of their waking time sitting in front of a computer or TV.

kurren 3y ago

These and other anthropological elements are very well described by Esther Gokhale as the basis of her method (which has been a life changer, at least for me). You can find more on her website or book "8 Steps to a pan-free back".

twowatches 3y ago

I'm fairly sure the cause of back pain is sitting at desks, not the position I'm sleeping in.

safety1st 3y ago
I'm skeptical that there's anything especially unhealthy about sitting at a desk even for long periods of time. What's more plausible to me is that back pain comes from having a weak back and it's more about what you're not doing, which is training your back muscles. Over the course of about a year, weight lifting eliminated a range of aches and pains I'd developed throughout adulthood, including back, wrist and knee pain. For the back it's all about deadlifts. In hindsight it seems obvious, all the muscles supporting my spine are visibly larger and demonstrably more powerful, carrying my body around is a much easier job for them now. Sinking into a padded chair after a few big lifts also feels fantastic and now feels like a perk of my job lol
- helboi4 3y ago
  I dunno. I never had chronic back or neck pain until I started working office jobs. When I was at university, I spent periods sitting at desks, but was never strapped to one for 8 hour shifts. I would sit down at a desk for max 4 hours at a time apart from during extreme crunch periods, and would spend the rest of my day walking around, lounging and chilling in different positions, excercising, etc. As soon as I started working at an office it became noticably harder to reach an over-10k step count daily, and even though I continued going to the gym and doing heavy back days, my left trap has become completely hardened up, and I've occasionally had lower back pain too during stressful times. I'm totally unable to train upper traps because they are literally like bricks. When I have a weekend where I walk and lounge a lot, or am off sick, or go on holiday, my traps feel significantly better and my workouts are better. It's a lifestyle where you are unnaturally in one position for too long that causes this.
- Notatheist 3y ago
  >I'm skeptical that there's anything especially unhealthy about sitting at a desk even for long periods of time. What's more plausible to me is that back pain comes from having a weak back I figure few habits will give you a weaker back than sitting at a desk for longer periods of time.

awongh 3y ago

It’s crazy to think about how little we actually know about how the human body functions- not even to say what an “optimal” sleep position might be, but even a high quality study on how different sleep positions might affect the physiology of the body. I have yet to find any real serious scientific analysis of this.

boffinAudio 3y ago
The Soviets tried, but we didn't want to hear what they had to say: https://bldgblog.com/2007/02/sleep-labs-of-the-soviet-empire/ https://bldgblog.com/2007/02/sleep-labs-of-the-soviet-empire...
lukan 3y ago
"not even to say what an “optimal” sleep position might be" As with most things, maybe there isn't one optimal solution,as otherwise we all would have found out about it, by now and all use it? Human bodies and minds are quite different. So what is comfortable to one person might not work for the next person. Maybe people have pain in the back or in the neck, forcing them into other positions. People with stomach problems rather lie on their stomach. Some people people sleep alone, others together. I know my sleeping position varies a lot and there is no single best one for me.
- BizarroLand 3y ago
  "Optimal" depends on how deep down the rabbit hole you want to go. "Slept well and wake refreshed" might be one version of it, but "slept like an infant in the womb and awoke younger and healthier" would be more optimal, if currently in the realm of science fiction.

contrarian1234 3y ago

I love sleeping in the "lookout posture". I get very restful sleep. However after a couple of days it leads to a lot of pain in my back. I'm guessing some tendons get overstretched. No idea how to work around it though I should try the reverse with the elbow outward. Seems doable. The Tibetan kneel seems a big too hardcore though :)

kqr 3y ago
I have actually used that Tibetan kneel once! I was exhausted and had to sit on the floor for a while and then I just fell asleep like that. It surprised me enough that I've tried to recreate it but it seems I can only do it when I'm really tired. Maybe it's a matter of habit and I can learn to do it if I try often enough.

tejtm 3y ago

@dang please macro expand previous https://news.ycombinator.com/item?id=18024260 https://news.ycombinator.com/item?id=18024260 Sept 19, 2018 https://news.ycombinator.com/item?id=32531484 https://news.ycombinator.com/item?id=32531484 Aug 20, 2022

delichon 3y ago

I bought a very strange mattress six months ago. This isn't an advertisement -- I can't strongly recommend it -- but it's called SONU Sleep. It has a "channel" along the top that you can lower your arm into when sleeping on the side. I got it due to persistent shoulder pain from side sleeping. Gradually I've adjusted to it and am now sleeping better. But that's an argument against my usual paleo heuristic: this sure isn't how we evolved to sleep over millions of years. I wonder if I'd sleep well in orbit.

anonu 3y ago
If you're sleeping better, why cant you "strongly recommend" it?
- delichon 3y ago
  It has been a difficult adjustment that has taken months. I've had neck and shoulder pain while learning to use it. It sure isn't for everyone. I got the firm mattress, but it is still softer than I like. And it's at a premium price that may not be worth paying if you already sleep well on a conventional bed.

vasco 3y ago

> Forest dwellers and nomads suffer fewer musculoskeletal lesions than “civilised” people > I tried to carry out surveys to collect evidence but they were meaningless, as tribespeople give you the answer they think you want. Could they simply have higher thresholds for complaining?

leoedin 3y ago
They're also incredibly active compared to any "civilised" people. There's a lot of evidence that sedentary lifestyles are bad for bodies. Presumably they're also, on average, younger than "civilised" peoples. Life expectancy for an Amazonian Tribe was just 53 years. https://www.sbs.com.au/food/article/how-to-eat-like-an-amazonian-and-slow-down-ageing/atocalaj4 https://www.sbs.com.au/food/article/how-to-eat-like-an-amazo... Muscle and joint issues are a symptom of aging. If nobody's making it to 60, then aging really isn't the same issue.
- kqr 3y ago
  Life expectancy of 53 does not usually mean nobody makes it to 60. In the early 1900s[1], life expectancy at birth in England was 53, but at the same time, as long as you survived until you were 20, your life expectancy had increased to over 60. If you lived to 50, you could expect to become 70. https://ourworldindata.org/images/published/Life-expectancy-by-age-in-the-UK-1700-to-2013_3080.png https://ourworldindata.org/images/published/Life-expectancy-... ---- [1]: Not counting the years of the Spanish flu!
  - matthewfcarlson 3y ago
    To the parents point, you sort of made their point. “If you made it to x”. By having fewer older members of their population they likely had few joint problems reported overall. I would expect any reasonable study to control for this variable but a survey would not.
  - chaorace 3y ago
    Life expectancy is such a consistently deceptive measurement that I often wonder why it's not been replaced. Surely there must be more useful ways of quantifying lifespans, something like a "median age of currently living people"?

danw1979 3y ago

I’m sure there are some great points in this paper but this bit of un-evidenced bit of speculation turned me off: > It has been noted that guide dogs working in towns breathe the same pollutants as humans yet do not have asthma. Could this be because when they lie on their chests the kickback from the upper ribs keeps the corresponding vertebrae mobile, allowing the sympathetic system to work efficiently? Or could it be one of the many other physiological differences between humans and dogs ? I think the author notes that this is mostly a collection of anecdotal observations, but linking a primarily inflammatory disorder like asthma with musculoskeletal problems is a bit far fetched in my layman’s opinion. Sounds a bit like chiropractic quackery to me.

dmix 3y ago
He lists his profession as a physiotherapist so probably crossed into the chiropractic side a bit, some of his personal photos are a little hippy-ish. The article is also premised on one large appeal to nature (tribal people untainted by modern society do it therefore it is natural and therefore good). https://en.wikipedia.org/wiki/Appeal_to_nature https://en.wikipedia.org/wiki/Appeal_to_nature
- tlb 3y ago
  Appeal to nature is bad as a source of ultimate truth, "nature does it this way therefore it must be better." But it's good as a source of hypotheses, "nature does it this way, perhaps we should try it?" This paper seems more like the second.
  - dmix 3y ago
    I don't see the difference between those two statements absent scientific data. That's merely a useful seed of an idea, not a sufficient premise for an argument.
    - DANmode 3y ago
      Hypotheses are not for arguments. They are indeed a seed for discovery. What are you talking about, Willis?

admissionsguy 3y ago

To add to the anecdotes, I have been sleeping on a flat rice straw tatami matt (without anything else) for 2 months. It's pretty hard and I have bruises on my ribs, but I have way less back and neck pain than before. I usually fall asleep in position similar to Figures 4 and 5 in the paper. The reason I started doing this is that after moving to a new house I bought an expensive memory foam mattress which made my back hurt every morning.

onetimeuse92304 3y ago

For my entire life I slept in one of those postures ("the lookout"). I had a bunch of problems (pain in the chest, pain in the back, some problems with my knees not loaded symmetrically, my feet getting "extended" for quite a long time causing problems with Achilles). I also had a problem with restlessness -- these positions cannot be maintained for long without moving, I would be changing my position very frequently. Couple of years ago I have injured my ACL and had to learn to sleep on my back. Now I am much happier sleeper. Now I generally do not move at all during night (I wake up exactly as I have fallen asleep and my sleep tracker tracks way less movement). All of the pains gone.

nightowl_games 3y ago
Pillow or no pillow? Hard mattress? No mattress?
- onetimeuse92304 3y ago
  I use a very thin pillow when sleeping on my back. I find sleeping without pillow a bit uncomfortable. Although I am sure I could get used to my head being pushed back a bit, I still dislike the head just resting on the hard mattress and trying to naturally roll left/right. The pillow helps me keep my head looking straight ahead (almost vertically). As to mattress, I prefer a mid-to-hard latex mattress with a cover.
  - radlad 3y ago
    In the article, the lookout position involves the lack of a pillow. One can imagine that the additional height of the pillow would cause you to raise your head, lower your chest, and arch your back, potentially causing the issues you reported. That being said, this is an article of anecdotal observations by a physiotherapist - it is not the result of any kind of study.
    - onetimeuse92304 3y ago
      It is really thin pure goose down pillow. Folded, it is less than 1/4in when compressed. I don't think the height of the pillow makes a huge difference.

pcrh 3y ago

Amazing demonstrations of casual racism in that article. It reads as if it was written in 1850 rather than 2000. There's no plausible reason to suppose that Tibetans or "tribesmen" have more natural sleeping positions than "civilized" (i e. White) people.

lonelyasacloud 3y ago
> There's no plausible reason to suppose that Tibetans or "tribesmen" have more natural sleeping positions than "civilized" (i e. White) people. So Tibetan tribal society is likely to have exposed its members to the same level of furniture and mattress adverts as the average American or European then?
- pcrh 3y ago
  Tibetans traditionally sleep on beds that are not much different from European beds. The porters shown in the article are "camping", so to speak, i.e. not in their typical sleeping postures.

dsalzman 3y ago

The interesting point of this article to me is not the positions but the sleeping surface. Due to my newborn I’ve been sleeping on the floor on a thin yoga mat for over three months and my back and joints feel great. The pressure from the hard ground is like stretching while you sleep. Took a few weeks to get used to it though.

sameoldtune 3y ago
I have a Japanese futon mat[1] under my bed that I roll out if I have muscle soreness. If it weren’t for my partner (who insists on sleeping in a bed) I would sleep on the floor 100% of the time. After getting used to floor sleeping I can never feel truly relaxed in a bed-I feel like the padding is putting pressure on my lumbar spine. [1] https://www.futonbedsfromjapan.com/ https://www.futonbedsfromjapan.com/

itronitron 3y ago

The text referencing Figure 2 seems to mistakenly swap the top and bottom images. When the legs are in the reverse recovery position (fig (fig2,2, bottom), the penis lies on the lower thigh and is protected. In this position the Achilles tendon of the leading foot can be inserted in the gap between the big toe and the first lesser toe to help correct a bunion. Note that the top picture in Figure 2 shows the Achilles tendon of the leading foot between the big toe and adjacent toe of the trailing foot. I would conclude then that the top position is actually the one that protects the penis.

wizzwizz4 3y ago
Figure 1 also has the images the wrong way around, though it's harder to see because they're meant to be side-by-side. I think it's a problem with the HTML conversion.

ano-ther 3y ago

This came up on HN a while ago already. I tried it out and found that quadrupedal lying (fig 5) did help my lower back pain.

hnbad 3y ago

It's odd that the paper goes to great lengths to talk about protecting your penis from insects but at the same point seems to ignore women completely - all the illustrations depict men. Having met women (shocking, I know), bust size can be a significant factor in ergonomics so it would be interesting to see how that factors into it. Also anecdotally, pregnant belly-sleepers frequently rely on cushioning and people may prefer certain sleeping positions after having given birth or suffering from certain ailments. I'm also certain that waist size (esp. obesity) may alter preferences. It's an interesting paper but given the lack of substance this feels more like a school presentation than something you'd find in an academic journal.

kqr 3y ago
> Also anecdotally, pregnant belly-sleepers frequently rely on cushioning I mean, undergoing pregnancy is in and of itself not great for one's health (especially without modern healthcare), so I don't know how much that specific thing should be factored into healthy lifestyle choices. In particular, pregnancy puts a lot of pressure on internal organs in a way that means one should not be surprised to have only one working sleeping position by the third trimester. At that point it's governed by Newton and another growing human, not choice. (To be clear, I'm not saying pregnancy is a bad lifestyle choice, just that pregnancy is not kind to the human body.)
- hnbad 3y ago
  > I don't know how much that specific thing should be factored into healthy lifestyle choices. I'm pretty sure the average human is not healthy, even in the societies analysed, especially if you factor in injuries, disabilities or pregnancy. If anything the perfectly "healthy" able body is the exception to the human experience. So yes, if we want meaningful advice on healthier sleeping postures we should take various illnesses, disabilities, ailments and conditions into account. At least this seems like a fair consideration if we already dedicate this much text to reducing the risk of insect bites on your penis.
kaitai 3y ago
Yes, I wondered about this as well. I understand why the author might not have observed women sleeping, and certainly wouldn't have photos, but one might at least mention it (especially given all the attention to the penis). Bust size & placement for sure has a significant effect on where arms can be placed, among other things. It seems that the author's observations are primarily from various camping-equivalents, more so than home life. To my sibling commenter, whether pregnancy is or isn't "healthy" isn't quite the point, IMO. Various stages of pregnancy do occupy a non-trivial part of many people's lifespan and significantly change the ergonomics of sleep. Given that humans have been getting pregnant for a long time, it is a big miss to not even mention that it hasn't been considered. Academic training tries to impress on most authors that they should mention what they're ignoring and why, not least to set up the citation train for the future and support grant applications.

btbuildem 3y ago

The Tibetan caraveneers sleeping on their shins is metal af. As a bonus, in that position, the penis is protected from instects. Did that little observation, erm, stand out to anyone else?

deleted 3y ago
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malfist 3y ago
Penis and insects are mentioned in quite a few places in the study. Author seems very preoccupied with that.
orthoxerox 3y ago
You never think about ants crawling up your urethra until one of them tries.

Izkata 3y ago

The images for Figure 2 are reversed. Both the caption and the description in the paragraph below refer to the bottom image while describing the top one.

ErigmolCt 3y ago

"Pillows are not necessary". It is but good position in sleep depends on an individual itself. Some people find pillows essential for comfort and proper spinal alignment

bee_rider 3y ago

IMO it would be better for the government to keep this sort of general library content on a url that doesn’t contain NIH. They have the disclaimer, > As a library, NLM provides access to scientific literature. Inclusion in an NLM database does not imply endorsement of, or agreement with, the contents by NLM or the National Institutes of Health. Anyway, it seems like an interesting collection of anecdotes that would be a good place to start searching. I don’t see as much value in some of his speculations. The bit about dogs not getting asthma seems a little out of scope. Actually, do dogs get asthma? Quick googling seems to provide contradictory answers, with the general trend that apparently cats get it more often, and apparently dogs get some sort of allergic reaction thing that is technically not asthma, but is very similar?

anonu 3y ago
> keep this sort of general library content on a url that doesn’t contain NIH. Why? The author makes it clear its purely anecdotal. Someone might come across this and decide to do a further, more scientific study. I would argue that this is valuable content that could lead to better insights on our sleep. Not having it on the NIH website would make it less likely to be viewed.
- hn_throwaway_99 3y ago
  Because inclusion on the NIH website, in the same general format as peer-reviewed articles are given, can give it the aura of being promoted or at least vetted by NIH, even with the disclaimer. If you look through Snopes there are tons of examples of hoaxes and false gossip that end up spreading because they are found on an "official" website (or official-looking website), even if that official website is just a library where anyone can publish.
hn_throwaway_99 3y ago
Totally agreed. I also liked some of the anecdotes in this article, but I always have to do an eye roll when I read an article that claims that "primitive" cultures don't suffer from disease X, and look they do thing Y that modern cultures don't, so of course thing Y must be the the reason for the difference! Conveniently ignoring the 6387 other stark differences in culture, behaviors and diets between the cultures. I think the hypothesis of how sleeping positions affect back pain would be worth studying, but that's all it is, a hypothesis.

m_dupont 3y ago

I tried some of the positions in this article while trying to get used to sleeping on the floor in an attempt to fix my back pain. These hurt like hell

anonu 3y ago

I will be trying more of these suggested positions. Coincidentally, I had a 5 degree wedge under my mattress to lift my head up slightly to reduce snoring. This resulted in increased lower back pain. Removing it reduced this lower back pain substantially. In some sense, the vertical use of our vertebrae is a design anti-pattern. We evolved from animals that walked on all fours, and vertebrae are much better suited for this horizontal position. This is why we suffer from slipped discs and other ailments that are not common in other animals.

colloydi 3y ago

More than a few middle-aged westerners would find it impossible to sleep with bent knees owing to a high prevalance of artherosclerosis (I think). Also one of the great pleasures of life is turning over in bed repeatedly during a lie-in. Don't know whether it's to do with lymph circulation and/or detoxifying the brain. More investigation needed!

carpdiem 3y ago

It would be interesting to know how the comfort or suitability of these postures is affected by physiology. For example, even the suitability to obtain a deep squat may be affected by things like hip joint geometry: https://www.otpbooks.com/stuart-mcgill-hip-anatomy/ https://www.otpbooks.com/stuart-mcgill-hip-anatomy/

karaterobot 3y ago

I notice that all of the sleep positions are either on the stomach or side. I usually go between side and stomach when sleeping, and can't really fall asleep very well on my back. But, my impression is that most people go between side and back, with stomach sleepers being a minority (I've even heard it called weird). This study backs that up (54% side, 37% back, 7% stomach) https://www.dovepress.com/sleep-positions-and-nocturnal-body-movements-based-on-free-living-acce-peer-reviewed-fulltext-article-NSS https://www.dovepress.com/sleep-positions-and-nocturnal-body... I wonder if the difference is cultural, or technological: that is, do we learn to sleep a certain way, or is it that the mattress changes the equation somehow and makes people 5x more likely to sleep on their back than on their stomach? In the past, I've hypothesized that it's cultural, and my just-so etiology for the phenomenon is that it comes from TV and movies. It's much easier to get a good shot of an actor delivering dialog while lying in bed on their back, compared to their stomach, so we see people sleeping on their back and learn to do it that way. This is all just uninformed speculation, and of course it assumes the original, linked article is valid at all.

spondylosaurus 3y ago
How do you breathe when you sleep on your stomach? My back and hips feel amazing when I try it, but my neck starts to hate me from the way I have to twist around to get air.
- ecshafer 3y ago
  When you sleep on your stomach you turn your head to the side, breathing is easy.
- tejohnso 3y ago
  Try putting a pillow under the shoulder that your mouth is closest to. A slight lifting of the shoulder might relieve the neck strain.
- karaterobot 3y ago
  Looks a lot like figure 4 in that article, but with my arms wrapped around a pillow. The arms hold up the head, and the neck isn't rotated so much that it hurts. There's usually a little twist at the hips, and my legs are kinda jackknifed as in the second figure 2 picture (I just noticed the caption points out how "the penis is protected from insects", ha ha). Very comfortable, though my ribs will get a little sore after a while, so I rotate with a side sleeping position throughout the night.

WaitWaitWha 3y ago

I am very uncomfortable with this paper to be called scientific research. It certainly appears the author had extensive life experiences, but does not demonstrate any of the data he collected. > If you are a medical professional and have been trained in a “civilised” country you probably know next to nothing about the primate Homo sapiens and how they survive in the wild. Starting off by insulting an entire population and making assumptions about what they do or do not know is odd. The disrespect continues on how an entire medical field "do not know that nature has provided". The author continues on to further disrespect by moving medical professionals in to "so called civilised people", and makes medical conclusions of "suffer[ing] unnecessarily from musculoskeletal problems". And, this is just in the first paragraph. The second paragraph goes into the author's background how he lived amongst tribal people, commanded a platoon of African soldiers, and organized expeditions to meet native peoples and study their sleeping and resting postures. > I tried to carry out surveys to collect evidence but they were meaningless The author collected evidence, and the evidence was meaningless (alternative hypothesis false?) so... he discarded it? Would it not make sense to attach it and explain why it was meaningless? One of the conclusions is > Forest dwellers and nomads suffer fewer musculoskeletal lesions but then... > Arabs in the Sahara will sit in the position shown How is the Arabs in the Sahara backing up forest dwellers conclusion? NIH publishing this is odd. At least it was not written by ChatGPT.

sdwr 3y ago
How is this not science? He has a hypothesis - modern sleep devices are not as good for the spine as the bare ground. He suggested a reason why - pressing against the ground during sleep acts as therapy. He has data - life experience, pictures, and demonstrations. Maybe it doesn't pattern match as science to you, but the raw science is all there. A few hundred years ago, this is how most science was conducted - by individuals with specific bones to pick. Is it conclusive? No. Is it worth being part of the conversation? Absolutely!
Herodotus38 3y ago
Remember that the NIH does not publish (edit: to be clearer this is the National Library of Medicine which falls under the umbrella of the NIH, and its URL), it just organizes articles like a local library but on a much larger scale. It's a common misconception. This article was published by the British Medical Journal as an interesting anecdote from a physical therapist. The NIH makes things available for searching but does not endorse anything that they have available.

frame_ranger 3y ago

Rest and vest brahs, rest and vest.

eightnoteight 3y ago

I never focussed much on sleeping postures, but one day I read this article about how acid reflux goes away if you side-sleep on your left hand side i.e stomach is at a lower height than when you sleep on your right hand side that really changed my life, it was like, how did I waste 28 years of my life without finding this trick :D

polishdude20 3y ago
I actually noticed when I sleep on my left side, I start to feel out of breath. Like ,I can breathe normally but something makes me feel I need to take deeper breathes almost as if some blood flow is getting cut off.

0xbadcafebee 3y ago

I am a subject of the species Sapiens, genus Homo. Subject is a civilized example of the species. An unfortunate side-effect of being civilized is an encouragement to collect paper, with which subject is to trade for essential goods. The method subject has devised to collect these trade papers involves sitting on a soft yet sturdy apparatus and being bent at an approximately 90-degree angle at the hip and knee joints, and looking at a glowing rectangle while subject taps on a noisy set of squares. Of the unfortunate side-effects of civilization, one is risk of injury. Of the several injuries subject has sustained in this pursuit (including to eyes, fingers, wrists, and elbows) is injury to subject's neck. In particular, a musculoskeletal injury of the muscles supporting the head on the spine, due to repeated stress from looking at a downard angle at glowing rectangle, as opposed to looking straight ahead. This injury did result in up to 11 months of recuperation. During this time period, finding a way to rest the neck and head was extremely difficult and painful. After completing several weeks' worth of paper collection, some attempts were made at recuperation outside in nature. Upon attempting to sleep on the ground, rest was significantly painful and uncomfortable. Thus were attempted many months of trial and error at attempting to find positions with which to rest in a comfortable manner, while allowing the neck to heal. At the end of recuperation, the result of attempts at finding resting positions was quite unexpected. Rest for this subject no longer requires (nor benefits from) pillows when side-sleeping, and back-sleeping is easier, though still not preferable. The explanation for this change appears to be an adaptation in musculoskeletal alignment when sleeping. This subject now acquires a particular alignment of head, neck, spine, shoulder, chest, back, and hips, that keeps any one body part from receiving undue strain. Sleep quality is consistent with sleep quality before injury, with the benefit of no longer needing props to assist in sleep quality. The linked article's conclusion appears to be supported by subject's experience. Subject additionally notes that a single ear is enough to be alerted to most dangers. When sleeping outside, or in an enclosed cabin, such things as mice, deer, and the occasional canid, do tend to wake the subject, as well as odd sounds such as socks falling off the bed onto a plastic bag, or elastic bed sheet end-corners snapping upwards. Whether non-h.sapiens species are also alerted to the latter sounds with one ear open has not been formally evaluated.

keybored 3y ago

This is so fascinating. I slept (on my back) on the floor for a while. It was at times amazing—I would wake up and feel ready to go. Not like my muscles were weak or temporarily atrophied. Like, I didn’t know that was possible after a full nights sleep. There seems to be so much potential in just reflecting on an considering what a “paleo” approach to something would be. And then you can just do that. You don’t even need to buy hundreds of dollars worth of supposedly ergonomic equipment. Just sleep in a funny-looking position. Just squat instead of sitting on a chair… if you can bare the social awkwardness or ridicule. It’s so simple. Why do we make things complicated? Well in part because “modern humans” cannot just do these things without becoming regarded as merely a modern human with eccentric hobbies. Because that’s what you get pegged as!—not as a modern human who rediscovered (through YouTube/the Web) some ancient wisdom but as a paleo-hipster, just another quirky modern human subculture. And in part that is correct. You cannot be, say, a Western Buddhist who has all the know-how and experience of a born-in-the-culture (Asian) Buddhist. And in that same way you cannot become a non-modern… human. But wait. Why would you want to? You are who you are. You may be a Buddhist from Scranton, PA who has no relation to Asian culture. Or an office worker who squats at the office. But why is that weird? Yeah you’re not a “real Buddhist” in that terribly essentialist sense, and you’re not a born-in-the-culture kind of human who has never used a chair. But why do you have to be that in order to make these (eccentric) choices for yourself? If it works for you, just go for it you paleo-hipster.

pedalpete 3y ago
I also slept on my floor for about 5 months - until I saw a huge cockroach (common in Sydney) run across my floor and hide under my pillow. I agree, it felt great. When I moved into my new, almost cockroach free apartment, I built my own shikibuton by taking a futon cover and stuffing it with a comforter and a thin foam mattress topper. The whole thing is about 7cm (2.7 inches) thick. I roll it up each morning and have been sleeping like this for the last 8 months. I also use only 1 thin pillow, and for a while was placing it lengthwise along my spine, which is apparently good for fixing the hunchback posture of modern humans.
DANmode 3y ago
> Why do we make things complicated? Because we genuinely care more about how people perceive us ("am I acting normal?") than how we feel. That's been engrained over generations, for most humans.

friend_and_foe 3y ago

There are a lot of things that we do that wild animals and wild people don't do, and a lot of things they do that we don't do. If "do what they do" were a panacea we wouldn't be living like this in the first place. They don't have access to antiparasitic medications, for example. Another example, they don't stare at screens ever. Plenty of our habits are better for us and plenty are worse, and the same is true for them. I'm sure plenty of habits of all people have trade offs. We have a higher life expectancy. What's a better metric for healthy lifestyle than that? It doesn't mean everything is better, but it is a good yardstick for determining if we are doing more right than wrong to our health, all in all. So just "this is how it's done in nature so we are wrong about how we do it" isn't a good heuristic. A dog will lay on something soft given the opportunity.

ornornor 3y ago

I wish I could sleep without a pillow but my nose completely clogs if I do. And that’s after surgery to remove a very small part of the bone in my nostrils to widen the passage. The mucosa inside my nose just swells too much and clogs my nose which keeps me from breathing which translates to terrible sleep. Is anyone planning on trying these sleeping techniques? I’d be curious to hear about your experience and if you noticed any difference at all.

garfieldnate 3y ago

The part about musculoskeletal issues really hits home for me. Can anyone recommend a book or site to learn to diagnose and fix musculoskeletal issues where possible? For example, I've had one leg longer than the other for most of my life, and it has caused my a lot of back pain. I went to a physical therapist and he figured out pretty quickly that the two major pieces of my pelvis were twisted and not aligned with each other, and he had a simple move I could do to crack it back into place (essentially just squeezing a pillow between my legs). Now it's part of my morning routine, and I'm working on hip flexibility and strength as well. But I also get other misalignments and I would like to feel empowered to free myself from pain where possible.

donatzsky 3y ago
Consider your footwear. Most people don't realise it, but modern shoes are generally pretty terrible for the body. They make your feet weak, "disconnect" you from the ground, and the elevated heels put a lot of strain on many parts of your body and shortens your ham-strings. My favourite is Vivo Barefoot, but there are many brands now. Make sure to look for a wide toe box, flexible sole, and zero-drop (no elevated heel).