Benefits and Detriments of the Supine Position

The supine position is one of the most popular starting positions for yoga and pilates exercises, as well as various breathing exercises. Many postures that involve lying supine work the core muscles, such as the rectus abdominis, transverse abdominis, and obliques. Sometimes, supine exercises work the back and gluteal muscles, as well. Physical therapists and other experts will often recommend supine exercises for alleviating back pain.

According to a significant amount of research, sleeping in the supine position provides the most health benefits for the average person. This position promotes even alignment over the spine, which can reduce pressure on the back. Sleeping supine may also prevent gravity or bedding from creating wrinkles or other blemishes.

Obstructive sleep apnea occurs more often when the throat muscles relax. Because of this, it is most severe when a person sleeps in the supine position. When sleeping supine, the lungs can hold less air, and the airway muscles cannot dilate enough to compensate. Experts recommend that individuals with obstructive sleep apnea sleep on their sides or elevate their heads at a 30- to 45-degree angle.

Experts believe that sleeping in the supine position may make people more vulnerable to sleep paralysis, which causes the loss of muscle function while sleeping. In addition, individuals experiencing sleep paralysis often feel as if something is holding them down or is present in the room. This can cause extreme fear. Supine sleeping positions may trigger sleep paralysis because the soft palate collapses and obstructs the airway.

Gastroesophageal reflux disease (GERD), affects up to 20% of the population. In people with the condition, stomach acid regularly flows back into the esophagus. When lying in the supine position, more acid can reach the esophagus, and it can stay there for longer periods. This can lead to heartburn, coughing, or choking. Eventually, a person with GERD may develop severe complications such as bleeding ulcers.

One of the largest fields of study concerning the supine position is its relationship to pregnancy. Many studies indicate it is dangerous to lay in the supine position while pregnant. Notably, the posture can compress the inferior vena cava, leading to hypotension and lower blood flow to the fetus. During cesarean delivery, lying supine dramatically raises the risk of spinal anesthesia-induced hypotension.

Sleeping supine while pregnant has even greater consequences than simply lying in a supine position. In late pregnancy, supine sleep positions are a major risk factor for stillbirth. It also raises the chance that the child will be born with a lower birth weight, potentially due to reduced uterine blood flow.

Experts have attributed the significant decline in deaths from sudden infant death syndrome (SIDS) in recent years to having babies sleep in the supine position. The leading thoughts are that while sleeping in other positions, infants are more likely to re-breathe their carbon dioxide. While sleeping supine may cause them to sleep more lightly, this is not harmful. Additionally, sleeping in this position does not appear to increase the risk of choking, even in infants with GERD.

Some evidence suggests that the supine position may pose risks for people who rely on toilet aids. When lying supine, a patient with a catheter is more likely to have their urine reflux from their bladder to their kidney. This makes urinary tract infections significantly more likely. Other studies suggest that lying supine leads to more gas retention and constipation.

Surgeons prefer the supine position for the majority of surgeries. This allows access to the peritoneal, thoracic, and pericardial regions. The supine position also allows surgeons to operate on the head, neck, and extremities. Despite it being the most popular position, it poses several risks. Notably, the American Society of Anesthesiologists associates the position with a chance of peripheral nerve injury, though the reason behind the damage is unclear.

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