Switching from side sleeping to back sleeping is possible, but it takes deliberate effort and usually a few weeks of consistent practice before it starts to feel natural. Most people who attempt the change find themselves rolling back onto their side during the night, so the key is using physical cues and pillow setups that keep your body in place while you adapt.
Why Side Sleeping Can Be a Problem
Side sleeping is the most common position, and for many people it’s perfectly fine. But it does come with specific downsides that motivate some people to change. The most significant is shoulder pressure. When you sleep on the same shoulder for hours, the rotator cuff tendons get compressed between the upper arm bone and the shoulder blade. Over time, this repeated compression can lead to bursitis, tendonitis, or even rotator cuff tears. If you already have shoulder pain, side sleeping almost certainly makes it worse.
Hip pain follows a similar pattern. The bottom hip bears your body weight all night, which can irritate the bursa (a fluid-filled cushion) on the outside of the joint. People who alternate sides sometimes develop problems on both sides.
There’s also a cosmetic factor. A study highlighted by the Aesthetic Society found that pressing your face against a pillow creates “sleep wrinkles” on the forehead, lips, and cheeks that worsen over time as skin loses elasticity. Unlike expression lines caused by muscle movement, these compression wrinkles can’t be treated with Botox because they’re purely mechanical. Sleeping on your back eliminates facial contact with the pillow entirely.
What Makes Back Sleeping Better
Back sleeping distributes your weight more evenly across the widest surface of your body, which reduces pressure points on any single joint. Your spine can settle into a more neutral position because gravity pulls evenly rather than creating a lateral curve. The Mayo Clinic recommends placing a pillow under your knees when sleeping on your back, which relaxes the lower back muscles and preserves the natural curve of the lumbar spine. Your neck pillow should keep your head aligned with your chest and back, not propped too high or sinking too low.
That said, back sleeping isn’t ideal for everyone. People with obstructive sleep apnea tend to have significantly more breathing disruptions on their back. Research comparing sleep positions found that breathing interruptions averaged about 50.7 events per hour during dream sleep while on the back, compared to 39.2 events per hour in the same sleep stage while on the side. During lighter sleep stages, the difference was even more dramatic: 22.9 events per hour on the back versus 15.9 on the side. If you snore heavily or have been diagnosed with sleep apnea, switching to back sleeping could make things worse.
Setting Up Your Bed for Back Sleeping
The biggest challenge isn’t falling asleep on your back. It’s staying there. Most people roll onto their side unconsciously within the first hour. A strategic pillow arrangement can act as a physical barrier that interrupts that automatic roll.
Start with a pillow under your knees. This is the single most important adjustment because it takes tension off your lower back, making the position more comfortable and reducing the urge to shift. Then place a pillow on each side of your torso, snug against your ribs and hips. These flanking pillows create resistance when your body tries to turn. They don’t need to be large, just firm enough that rolling over them requires enough effort to partially wake you up.
Your head pillow matters more than you might expect. A pillow that’s too thick will push your chin toward your chest, creating neck strain that makes you instinctively shift to your side for relief. Look for a pillow that fills the space between your neck and the mattress without lifting your head at a steep angle. Contoured cervical pillows with a raised edge under the neck and a lower cradle for the head work well for back sleepers, though a relatively flat standard pillow can do the job too.
The Tennis Ball Method (and Why It Often Fails)
You may have seen advice about taping a tennis ball to the front of your shirt so rolling onto your side becomes uncomfortable. This is actually a well-studied technique, though it was originally designed to keep people off their backs rather than on them. The principle works in reverse too: attach something bulky to both sides of a snug sleep shirt so that turning sideways creates discomfort.
The short-term effectiveness is real. Studies published in the Journal of Clinical Sleep Medicine found that it works initially for about 42% of people. But long-term compliance is poor. Research shows that only 20% to 30% of people actually stay in the intended position through the night, and up to 25% manage to sleep in the wrong position despite the ball being there. The main reasons people abandon it are discomfort and disrupted sleep quality, which defeats the purpose.
If you want to try a physical deterrent, a rolled-up towel tucked into a fitted shirt pocket is gentler than a tennis ball and may be enough to trigger a subconscious correction without waking you fully. But for most people, the pillow barrier method is more sustainable.
Building the Habit Gradually
Don’t expect to become a back sleeper overnight. Your body has likely spent years defaulting to a side position, and the neural pathways that control your sleep posture are deeply ingrained. A more realistic approach is gradual exposure.
Start by falling asleep on your back every night, even if you wake up on your side. The goal in the first week is simply to begin the night in the new position. Your body will roll, and that’s normal. Each night, you’re training your brain to associate back sleeping with the onset of sleep, which is the first step toward maintaining the position longer.
In weeks two and three, focus on returning to your back whenever you wake during the night, whether that’s to use the bathroom or just a brief awakening. This reinforces the position during natural sleep cycle transitions, which is when most rolling happens. By week three or four, many people notice they’re spending longer stretches on their back before turning.
Some people find it helpful to slightly elevate the head of the bed by placing a wedge under the mattress or using an adjustable bed frame. A gentle incline of 10 to 15 degrees can make back sleeping feel less flat and exposed, which addresses the psychological discomfort some people feel when lying face-up.
When You Might Want to Keep Side Sleeping
Not every side sleeper needs to switch. If you have sleep apnea or heavy snoring, side sleeping is actually the recommended position because it keeps your airway more open. Pregnant people in the second and third trimesters are advised to sleep on their side to improve blood flow. And if you have acid reflux, left-side sleeping can reduce symptoms by keeping the stomach below the esophagus.
If your reason for switching is shoulder or hip pain, you might also consider optimizing your side sleeping setup before abandoning it entirely. A firmer mattress, a pillow between the knees, and a thicker pillow under the head to keep the spine straight can solve many of the problems associated with side sleeping without requiring a full position change. The best sleep position is ultimately the one that lets you sleep deeply without pain.