Sleep health

Research

Neurologist: Your Sleeping Position May Help Determine Cognitive Health

Research studies are increasingly associating the way a person lies in bed – your side, back or stomach – with brain health, particularly cognitive functionality as one ages.

Cognitive health is the ability to think, converse, learn, and remember clearly. It is needed to carry out many everyday activities effectively. The best sleep position for preventing cognitive decline, according to neurologists and studies, is sleeping on your side, particularly the left side.

A big caveat: The research is ongoing and findings represent notable correlations – not causations – between sleeping positions and cognitive health.

“It’s important to note that this is not a direct cause-and-effect relationship, but rather a potential association that needs further research to evaluate this possibility fully,” explains G. Peter Gliebus, M.D., a neurologist and director of Cognitive and Behavioral Neurology at Marcus Neuroscience Institute, part of Baptist Health, at Boca Raton Regional Hospital.

G. Peter Gliebus, M.D., neurologist and director of Cognitive and Behavioral Neurology at Marcus Neuroscience Institute, part of Baptist Health, at Boca Raton Regional Hospital.

Even at an association level, how can side-sleeping help your brain health?  To put it as simply as possible, certain sleeping positions can help the body clear toxins more efficiently. More specifically, studies have found that the glymphatic system , or the brain’s waste clearance system, is responsible for removing beta-amyloid, a protein fragment that's associated with Alzheimer’s disease, the most common type of dementia.

Dr. Gliebus said that “clearance” process occurs primarily at night.

“Researchers have found that sleeping position can impact the movement of blood and cerebrospinal fluid through the brain,” Dr. Gliebus says. “They have also discovered that sleeping on the side can improve cerebrospinal fluid clearance.”

Sleeping on your left side can also keep pressure off your internal organs. Staying your left side can also  help move waste through the colon while sleeping. Stomach and gastric juices are also lower than your esophagus, which can reduce digestive issues and heartburn.

The finding regarding sleep position and cognitive health are based mostly on animal studies. “There is no firm data to say whether this association, let alone causation, is actual,” Dr. Gliebus adds.

Additionally, a 2023 study found a “relatively strong association” between sleeping on your back and the neurodegeneration found in Alzheimer’s, Parkinson’s and other impairments. “Future prospective studies should test if there is a causal link between supine sleep and subsequent development of neurodegeneration,” researchers concluded.

Sleeping on your stomach, while possibly helpful in snoring prevention, can strain on neck and spine, and may not be of much help in contributing with glymphatic clearance, Dr. Gliebus said.

Dr. Gliebus reiterates that research is in early stages regarding sleep positions and brain health. “All of these associations must be tested,” Dr. Gliebus said. “The science on this topic is still very young, so valid conclusions or recommendations cannot be drawn.”

While side-sleeping to prevent cognitive decline remains deep in the research stage, there already is a strong connection between overall quality sleep - at least seven hours a night -- and mental and physical health, neurologists say.

An estimated one-third of all Americans have a sleep disorder, which could lead to chronic fatigue and health conditions like diabetes, heart disease or depression.

“What we do know is that getting enough sleep is crucial for optimal cognitive functioning,” Dr. Gliebus says. “Restorative sleep plays a key role in memory consolidation and managing the metabolic effects involved in ‘brain waste’ management.”

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