Table 3

Mapping of results, conclusions and recommendations

AuthorResultsConclusionsRecommendations
Abanobi et al,43 2015ORs for LBP were in relation to a combined group of prone and side lying sleeping. ‘Sleeping with back (face up) increases the risk of developing LBP by 1.9 times.’ (p. 355) (95% CI 0.43 to 8.56)* ‘The result showed the possibility of reducing the burden of LBP by appropriate training and improvement in habits such as…bad sleeping postures.’ (p. 336)Not provided
Cary et al,42 2016‘The time spent in each of the sleeping postures… expressed as a percentage of the time spent asleep, did not differ significantly according to the level of morning symptoms’ (p. 5). Independent Samples Jonckheere-Terpstra Test; supine rj=0.03;
SSL rj=0.00;
¾ SL rj=0.34; prone rj=0.31.
‘Participants who spent greater periods of time in SSL, had less mornings of symptoms per month than those that slept in ¾ SL or prone.’ (p. 5)Not provided
Desouzart et al,17 2016No between-group comparison reported. Between group effect size calculated to be 0.81 (95% CI −0.11 to 1.72).‘It may be concluded that the indication of the ideal way to lie down, which corresponds to a recommended sleeping posture with the ideal position to place the pillows, as well as the ideal way to get up.’ (p. 239)Ideal sleep posture, pillow use and way to get up, as per experimental group, ‘is an added value for the prevention and decrease of the pain and/or discomfort in the spine in active seniors.’ (p. 239)
Gordon et al,13 2007‘Subjects who reported sleeping mostly in an upright position were significantly more likely to report all waking symptoms of interest compared with subjects who slept in other positions.’ (p. 6) Waking cervical pain OR 2.5 (95% CI 1.1 to 5.5), cervical stiffness OR 2.6 (95% CI 1.1 to 5.8), headache OR 2.2 (95% CI 1.0 to 5.0), scapular/arm pain OR 2.5 (95% CI 1.1 to 5.3).
‘Supine…was not found in this study to be significantly protective of waking symptoms, when compared with other sleep positions.’ (p. 6) Waking cervical pain OR 1.4 (95% CI 0.8 to 2.5) and cervical stiffness OR 0.9 (95% CI 0.5 to 1.6).
‘Prone…was not significantly associated with waking symptom’ (p. 6). Cervical pain OR 1.5 (95% CI 0.7 to 3.2) and cervical stiffness OR 1.1 (95% CI 0.5 to 2.6).
‘Subjects who reported that they slept mostly on their side were significantly less likely to report waking cervical pain… compared with subjects who slept in any other position.’ (p. 4) Waking cervical pain OR 0.6 (95% CI 0.4 to 0.9) and scapular/arm pain OR 0.7 (95% CI 0.5 to 0.9).
‘On the basis of this research, SL can be confidently recommended as the best sleep position in terms of minimising waking symptoms.’ (p. 6)
‘Need for health professionals to consider individual’s sleep position and waking symptom history, as part of clinical reasoning for treatment, and when developing a management plan for patients with troublesome waking symptoms.’ (p. 6)
  • *The CI was recalculated as it was suspected wrong due a typographical error. The original value was 0.431.

  •  ¾ SL =  ¾ side lying;  rj = effect size r for Jonckheere-Terpstra test .

  • LBP = low back pain; SSL = supported side lying; VAS =  Visual Analogue Scale.