Do you sleep like a soldier at night? On your back, stiff, seemingly ready to jump up at a moment’s notice?
Back sleepers, especially those who enjoy the rigidity of the “soldier” sleep position, may find that they experience one uncomfortable side effect: acid reflux.
Acid reflux, or gastroesophageal reflux disease (GERD), causes symptoms like heartburn, regurgitation of stomach contents through the esophagus, chest pain, nausea, problems swallowing or chronic cough or hoarseness, according to the National Institute of Diabetes and Digestive and Kidney Diseases.
If you are prone to getting acid reflux, then studies have shown that this sleeping position can make it worse. We asked the experts to learn more about soldier sleep and how you can adjust your nighttime routine to ease symptoms of GERD (because no one should have to suffer for falling asleep in their preferred way).
What is the “soldier” sleep position?
Think of this as a soldier standing ready at attention — except, it’s just you sleeping with your back straight and your arms at your sides.
In the soldier sleep position, your body is “in a neutral, straight posture with legs extended and arms resting alongside the torso,” Daniella Marchetti, a licensed clinical psychologist and a certified sleep specialist at RISE, told HuffPost.
“It’s essentially a classic supine position with minimal limb movement or flexion,” she added. “Some sleepers naturally adopt this posture because it feels structured, symmetrical and reduces pressure on the sides of the body.”
Dr. Raj Dasgupta, quadruple board-certified in pulmonary, sleep, internal and critical care medicine and chief medical adviser for mattress review site Sleepopolis, describes the soldier sleep position as “a very rigid, ‘at attention’ posture.”
“[This is] unlike more relaxed back-sleeping positions where arms might rest on the chest or stomach,” he added.
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Back sleeping, especially rigid back sleeping like in the “solider” position, can exacerbate acid reflux.
The soldier sleep position can exacerbate acid reflux.
If you experience acid reflux, then the soldier sleep position might be making it worse. “The soldier position is fine for many people, but if you have nighttime reflux, sleeping flat is usually the worst position,” Dasgupta said.
It’s all about gravity.
“Acid reflux is strongly influenced by gravity and positioning of the esophagus,” Marchetti explained. “When someone lies fully flat, stomach contents can more easily move upward toward the esophagus, especially if the lower esophageal sphincter is relaxed or weakened.”
“Without head or torso elevation, there’s not much preventing acid from traveling back into the esophagus,” she continued. This makes for a very uncomfortable night, as it can trigger symptoms of acid reflux, such as heartburn, throat irritation, coughing and nighttime awakenings.
“Supine positioning alone doesn’t cause reflux, but it can exacerbate susceptibility in individuals already prone to it,” Marchetti added.
There are other downsides of the soldier sleep position, too.
Even those without acid reflux may not enjoy the soldier sleep position, as there are several other downsides to snoozing in this way.
“Beyond reflux considerations, flat supine sleep can sometimes contribute to increased snoring or airway collapse in susceptible individuals, worsened obstructive sleep apnea (OSA) in some patients, back discomfort if mattress support is inadequate, and reduced comfort for people with certain pain conditions,” Marchetti said.
She added that not everyone will experience these side effects, as “they depend on airway anatomy, body composition and mattress support.”
Dasgupta warned that sleeping rigidly on your back in the soldier sleep position may “aggravate lower back pain if your mattress doesn’t support the natural curve of your spine.” He added, “Arm numbness or shoulder discomfort can occur if the arms are pinned at the sides for a long period.”
On the flip side, there are some distinct advantages to sleeping like this.
“Back sleeping, including the soldier position, can reduce facial wrinkles and prevent pressure on one side of the body,” Dasgupta said. “It can also be good for spinal alignment if your mattress provides proper support.”
Marchetti also praised the “genuine advantages” to this sleep position, “like promoting neutral spinal alignment when properly supported, reducing pressure on shoulders and hips, [and] decreasing facial compression which can accelerate the fine lines associated with aging.” Marchetti added that “soldier” sleep can also “feel comfortable for individuals with joint asymmetries.”
Increase your chances of a great night’s sleep by investing in a good mattress. Both experts recommend a mattress with at least medium firmness if you are a soldier sleeper. According to Marchetti, this helps “maintain spinal neutrality without excessive sink.”
If your mattress is too soft, it can “allow the torso to collapse, potentially worsening both discomfort and airway mechanics.”
How to adjust your sleep position if necessary:
There is some good news for those who prefer the soldier sleep position but suffer from acid reflux. You don’t have to totally abandon the way you sleep. Our experts shared the following tips for small adjustments you can make to try to reduce your reflux symptoms.
- Elevate the upper body by raising the head of the bed by 6–8 inches or using a wedge. (Stacking regular pillows under your head isn’t always enough.
- Avoid late meals by finishing food two or three hours before bed to reduce stomach volume and acidity.
- Limit foods that can trigger reflux. These include alcohol, heavy fats, chocolate, spicy or acidic foods, caffeine and large meals in general.
- Support spinal alignment with proper pillow height. This prevents neck flexion that may increase discomfort.
- Try to maintain a healthy weight and avoid wearing too-tight clothing around the abdomen, which can worsen reflex.
If none of these seem to help, try sleeping on your left side instead of in the soldier sleep position. “The stomach’s anatomical orientation means the esophagus sits above gastric contents more favorably on the left side, reducing acid exposure,” Marchetti said. “Studies have shown left-side sleeping can decrease reflux episodes compared to right-side or flat/supine positions.”
Dasgupta also suggested this. “Left-side sleeping is the gold standard for acid reflux as it keeps the junction between the stomach and esophagus higher than the stomach contents, which reduces nighttime heartburn,” he explained. “Slightly elevating the upper body while on your back can also help, but pure flat-back sleeping is usually worse for reflux.”
Keep in mind, there is no 100% foolproof sleeping position that will prevent or “fix” acid reflux. “Nighttime symptoms are multifactorial,” Marchetti said. “Important contributors include meal timing and composition, body weight and abdominal pressure, alcohol and medication effects, and sleep fragmentation.”
Be sure to talk to your medical provider if you experience persistent nighttime reflux, sleep apnea or other problems sleeping.
