Starfish Sleeping Position: Is It Good to Sleep With Arms Above Head?

Everybody has their preferred sleeping position that their body naturally finds during the night without conscious thought. Most people choose to either sleep on their side, their back, or their stomach, but some find themselves on their back with their hands above their head and legs spread — the starfish position. Although the starfish position can seem completely harmless, there are some debates going on, suggesting that it may not be optimal for one's health and sleep quality. This article looks deeper into this particular sleep position, discussing its potential drawbacks, safety, and who should avoid it.

What is the starfish sleeping position?

The starfish sleep position is when the person sleeps on their back with their legs spread and their hands above their head, resembling a starfish — hence, the name.

What does it mean to sleep with your arms above your head?

You may be sleeping in this position to accommodate a partner or a pet, get comfortable, avoid pain, or purely because it is a habit. You may even find yourself in this position if you prop yourself up with your arms behind your head to watch TV and fall asleep. There is no scientifically proven meaning behind the starfish position, but some factors may unconsciously cause you to sleep that way.

Is it good to sleep with your arms above your head?

There are both potential benefits and drawbacks to sleeping in a starfish position. It may help relieve some form of back, shoulder, and neck pain, but it also has the potential to worsen it in some cases. With this in mind, it would be best to consult a healthcare professional to determine the best sleeping position for your unique case of pain. Sleeping in a starfish position can also be beneficial to minimize the development of sleep wrinkles as well as reduce acne breakouts.

On the other hand, the starfish position is likely to worsen sleep apnea and snoring as well as acid reflux, thus, it should be avoided by people with these conditions. The pros and cons of certain sleeping positions are mostly based on observations, lacking scientific evidence, and should be taken with a grain of salt and judged based on individual experience.

Why do I sleep with my arms above my head?

There is no precise scientific explanation why some choose to sleep in a starfish position, however, there are some suggested reasons that may prompt one to sleep with their hands above their head:

• Comfort. The main reason why people consciously or unconsciously choose one sleeping position over the other is mere comfort. If sleeping like a starfish allows you to get some quality shut-eye and wake up refreshed with no aches or sores, that is a good enough reason.
• Physical relief. We tend to keep our arms down for the majority of the day. Raising them during sleep might be the body’s way to get a stretch in, potentially relieving some muscle tension in the shoulders and upper back.
• Body temperature regulation. Keeping your arms above your head and spreading your legs minimizes skin-to-skin contact, exposing more area through which the body can release heat.

Benefits of starfish sleeping position

Sleeping in a starfish position may have some benefits, such as:

Back pain relief

Back pain can be supported by modifying lifestyle risk factors. Sleep position and sleep posture influence spinal load during nighttime rest. Whether the symptoms are in the dorsal, lumbar, or cervical regions, different sleeping positions may be suitable for sleeping.

One study recommended sleeping on the back with dorsal or lumbar symptoms, while those with cervical symptoms were better off sleeping on their side. A major pitfall of sleep position studies is that they are usually small cohorts and based on self-reports, which can lack accuracy, as subjects are unaware of their sleeping position during the night. It is clear that the wrong sleeping position can exacerbate back pain, but to determine which position is correct for you, it is best to consult your doctor or physiotherapist.

Shoulder pain relief

Surprisingly, the starfish sleeping position has been associated with shoulder pain relief. Glenohumeral pain is one of the most common musculoskeletal complaints, with rotator cuff tendinopathy being the leading cause of shoulder pain. It was previously hypothesized that sleeping in a starfish position is bad for rotator cuff tendinopathy and that sleeping in a soldier position is the best option. However, a study found that the starfish position does not worsen the pain and may even act as a protective measure. There is a lack of studies specifically looking into it, and thus, no concrete scientific explanation is possible.

Neck pain relief

Some of us have experienced waking up from a night of sleep with a stiff neck. Similarly to back and shoulder pain, neck pain may also be exacerbated by sleeping postures. Different sleeping positions affect the scalene and trapezius muscles differently. As these muscles are on either side, sleeping on your back with your arms at your sides or above your head distributes muscle load equally, potentially reducing neck pain.

The starfish position may be beneficial because it allows the muscles to stretch and mobilize in a different direction, as most people spend the majority of their day with their hands down by their sides. However, it is important to highlight that stretching only one arm above your head can worsen neck pain as it would strain the spine and the surrounding muscles.

Reduced wrinkles

Sleeping on your side or stomach may cause facial compression, potentially contributing to facial sleep wrinkles if maintained for a prolonged period of time. Sleeping on your back removes the external forces on the face and is the best sleep position to minimize the development of sleep wrinkles. Sleeping on your back may also help those with skin sensitivity issues, as the face is not rubbed against the pillowcase.

Side effects and risks

There are some drawbacks and conditions with which sleeping in a starfish position should be avoided.

Sleep apnea and snoring

Sleeping on the back, including the starfish position, allows your tongue, jaw, and other soft tissues to relax, resulting in a narrowed airway and contributing to breathing difficulties. Back sleepers often keep their mouth open, resulting in snoring and exacerbated sleep apnea symptoms, leading to disturbed sleep. Changing your sleep position could alleviate issues associated with back sleeping.

Shoulder pain

Research has found that sleeping in a starfish position has a statistically higher risk of shoulder pain as compared to the soldier position. The starfish position was also associated with the increased risk of acromioclavicular degeneration, a condition in which anterior and superior shoulder pain is present, especially during overhead or cross-body movements.

Supraspinatus tendon pathologies are usually caused by overuse, especially overhead activities or trauma, causing pain when arms are raised above the head. It is believed that the starfish position can worsen the pain by increasing the intra-articular pressure.

Acid reflux

Supine sleeping positions may contribute to the development of acid reflux because, as stomach acid escapes your stomach during sleep, it can freely flow back to the esophagus and stay there for a prolonged time if the sleeper does not become aware. Individuals with acid reflux are better off sleeping on their left side. Using a wedge pillow may also help.

Who can’t sleep in this position?

While there are no strict rules of who should not sleep in the starfish position, there are some cases when other sleep postures may be better.

Individuals with sleep apnea, breathing difficulties, or a snoring tendency are better off sleeping on their side or stomach. People with supraspinatus tendon pathologies should avoid sleeping with their arms above their head, as it increases the pressure in the shoulder joint, making the pain and the pathology worse. Finally, people suffering from acid reflux (GERD) are strongly advised against sleeping on their backs. Additionally, pregnant women, especially later on, are advised against sleeping on their backs in general, including the starfish position.

How to stop sleeping in this position

If sleeping in a starfish position is uncomfortable or is not recommended due to pain or acid reflux, the easiest and cheapest option is to try sleeping in a different position. Try sleeping on your left side. Though it may not be comfortable at first and will require conscious efforts, your body will adapt in as little as a few nights. However, this may take up to a month for some, so be patient. A wedge pillow may help to get accustomed to a new sleeping position easier. A new mattress may also help change sleep position as there would be no indents.

If the raised hands are uncomfortable or are causing shoulder issues, using a weighted blanket may help keep them by your sides or on your chest during sleep without needing to completely change your sleeping position.

The starfish sleep position, characterized by laying on the back with arms extended above the head and legs spread, may offer benefits like improved spinal alignment and comfort. However, it’s not without its drawbacks. Shoulder pain, increased risk of acid reflux, and exacerbation of certain medical conditions, such as sleep apnea, are of particular concern. Adjustments like using a weighted blanket or gradually transitioning to alternative sleeping postures can mitigate discomfort. Ultimately, the suitability of the starfish position varies from person to person and is influenced by individual preferences and health considerations. Finding what works best for your body and seeking professional advice when in doubt is the best approach.