#287 Is Left or Right Side Sleeping Best for Your Heart?

Is Left or Right Side Sleeping Best for Your Heart?

Most of my cardiac patients sleep better on their right side.  Is right side sleeping best for your heart?  In this article, I discuss the science of behind right versus left side sleeping.

Gravity and Left vs. Right Side Sleeping?

Gravity plays a role in where the heart goes during sleep.  For example, if you sleep on your left side, then gravity will pull your heart toward your chest wall.  In contrast, gravity pulls the heart toward the center of the chest with right side sleepers. This subtle change in where gravity pulls your heart may affect symptoms, cardiac output, or even your heart rate.

Why Back Sleeping is Probably Bad for the Heart

If you are carrying any extra weight, back sleeping is definitely bad for your heart.  This is because when you sleep on your back, the extra weight collapses your airway (sleep apnea).  And studies show that sleep apnea dramatically increases your risk of heart failure and atrial fibrillation.

Stomach sleeping is another possibility.  However, as I have learned personally, stomach sleeping is a perfect recipe for neck and back issues.

4 Reasons to Sleep on Your Right Side

If you suffer from heart issues, talk with your doctor about whether you should sleep on your right or left side.  Based on the science, here are four reasons why you may want to consider sleeping on the right.

1.  Less Shortness of Breath

As far back as 1937 doctors have noted that heart patients breath better sleeping on their right side.  Indeed, the worse the cardiac function, the more likely people are to sleep right side down.  While the reason for this isn’t entirely clear, it may have to do with a better venous return and lower pressures within the heart and lungs.

2. Better Cardiac Output

For the same reasons as number one above, cardiac output may be better with right side sleeping.  Once again, gravity pulling the heart toward the center of the chest may optimize cardiac performance.

3. Fewer Palpitations

No one likes the sensation that their heart isn’t beating correctly.  As the heart is in the center of your chest with right-sided sleeping, studies show that palpitations become much less noticeable.  In contrast, when you are on your left side, the heart is pulled to the chest wall, and you may feel every irregular beat of your heart.

While many atrial fibrillation patients have noted that they have fewer arrhythmias when sleeping on the right side, I could find no studies supporting this finding.  Thus, when it comes to sleeping and arrhythmias, I suggest sleeping in whatever position that seems to help.

4. Lower Heart Rate and Less Sympathetic Nervous Activity

The sympathetic nervous system is the fight or flight response.  This fight or flight response makes the heart rate and blood pressure go up.

For most of my patients, sympathetic nervous system stimulation makes their heart failure, chest pain, or arrhythmias worse.  And when it comes to sleeping and sympathetic stimulation, studies show that right-sided sleeping may be better.

3 Reasons to Sleep on Your Left Side

Not everyone does best with right side sleeping.  In fact, there are three distinct groups of people that may do worse.

1. Acid Reflux Sufferers

People suffering from acid reflux may sleep better on their left side.  This is because studies show that acid reflux may be worse with right side sleeping.  Thus, if your acid reflux is causing you more symptoms than your heart, you may want to consider sleeping on your left side.

2. Vagus Nerve Arrhythmias

The vagus nerve connects the heart, brain, and gut.  Because of this connection, vagus nerve activation may be an important cause of arrhythmias.

With vagus nerve stimulation, you get increased parasympathetic activity which is the exact opposite of the fight or flight response with sympathetic stimulation.  Thus, to quiet your vagus nerve at night, studies suggest that you may want to try sleeping on your left side.

3. Too Slow of a Heart Rate at Night (Bradycardia)

If you have ever worn a heart monitor, your doctor may have told you that your heart beats too slow at night.  If this is the case, sleeping on your left side could stimulate a sympathetic response and increase your heart rate.

Does it Really Matter Which Side You Sleep On?

For those of you who suffer from sleep issues, you may be asking does it matter which side is down?  I know for myself that I feel incredibly grateful for a great night of sleep regardless of which side is down.  Indeed, trying to force sleep on my right or left side would only intensify my insomnia.

Thus, I can’t definitively answer the question, is left or right side sleeping best for your heart.  The answer is a personal choice based on your specific situation and what feels best for you.

Do you prefer sleeping on the right or left side?  Please leave your thoughts and questions below.  For questions, please be patient as it may take me a few weeks to post a response.

Want to read more about sleep optimization?  Please check out this article I wrote called 10 Ways to Cure Insomnia without Medications.

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Disclaimer Policy: This website is intended to give general information and does not provide medical advice. This website does not create a doctor-patient relationship between you and Dr. John Day. If you have a medical problem, immediately contact your healthcare provider. Information on this website is not intended to diagnose or treat any condition. Dr. John Day is not responsible for any losses, damages or claims that may result from your medical decisions.

18 Comments
  1. I have AF and GERD (and Osteoarthritis)

    Eating can make my HR leap into AF. When I get a full blown attack of reflux I almost always go into AF

    I believe they are intrinsically linked as do thousands of other AF sufferers but no one takes us seriously and if we mention it, it’s usually waved off as unimportant by heart specialists( from the many hundreds of conversations I’ve had with other AF sufferers) Shame as a huge part of research could be just asking people with AF.
    Left side sleeping is good for my AF but bad for my GERD and both are bad for my Osteo 🙂

  2. I have found less palpitations sleeping on right side. I have previously slept on left for years and have had terrible palpitations. Perhaps someone should ask AF patients if this improves the condition. I have found
    That there is little help for patients with AF once blood thinners and beta blockers have been prescribed so
    Cardiac departments should look at recommending sleeping positions, diet, support groups. I went to a local heart support group but everyone there had had heart operations no one like me with AF and I felt quite isolated.

  3. I suffered with AFIB for 2 years then had an ablation that (fingers crossed for 7 months) has completely cured my AFIB. I was unaware of any difference about which side I slept on before the AFIB began. Now I sense a chest restriction or compression or squeezing sensation when I lie on my left side. So now I am a committed right side sleeper since none of those sensations are present when I’m on my right side.

  4. I the summer I like to sleep on my back. In the winter, on my right side is best but-it seems like my knees being together is uncomfortable after a few hours as is, well, ….crowding in the crotch area when sleeping on either side.

  5. I sleep on my stomach. I know it’s not the best position for muco-skeletal reasons, but what about heart health for people with PVCs or afib?

    • Hi Carl,

      I’m not aware of any studies looking at stomach sleepers and arrhythmias. I also haven’t had any stomach sleeping patients who have shared their experiences with me. Thus, I’m not able to answer this question…

      Sorry,

      John

  6. Great article,.. I have what doctor’s thought was dexicardia (sp?) turns out my heart is shifted to the right side of my chest due to left diaphragm pushing left lung up (and consequently “squished”) and the heart is turned vs turned backwards. So sleeping on the left will make more sense. I often wonder if this has any bearing on the on set of PVCs which recently started. I’m 65, on a blood thinner as I have intermittent a-fib. Do not take meds (yet) for the afib. Thanks for a very good article, glad I discovered your website.

  7. I prefer the left side but I have numerous painful PVC’s and have found exactly what you said is true. I don’t feel the irregular beats as bad when I lie on my right side. Recently, I saw a cardiologist who put me on a low dose of Meroprolol ER (12.5) and it has made a huge difference. I love your news letter and thank you for sharing your knowledge with us.

  8. I sleep about 75% on my left side and 25% on my right. I am most comfortable on my left but my body needs a little mixing up during the night.

  9. Hi Doctor,
    Love your book and blog.
    I sleep better on right side.
    One thing, in your book you don’t give us info on if you resolved your EoE. Did you?

    • Hi Vee,

      Fortunately, the eosinophilic esophagitis has been in remission for several years. I’m no longer on meds. Previously I took Prilosec and swallowed a steroid asthma drug.

      Hope this helps!

      John

  10. Mine does that also..
    I know the reason is when I turn I restrict the blood flow causing an itching sensation. When the flow of blood gets back in ryhthem the itch will subside.

  11. I like to change and sleep both right and left, however lately when I sleep on left side area around my right hip itches! Strange?