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Scoliosis causes the spine to bend and twist unnaturally, typically into the concave side of the curve. When the curvature occurs in the thoracic spine—the middle-upper back—this is referred to as thoracic scoliosis. While the thoracic region is the largest section of the spine, scoliosis can also affect the cervical (neck) and lumbar (lower back) areas. The diagnosis usually reflects the largest curve, so even if multiple curves exist, a dominant thoracic curve would label it thoracic scoliosis.

Scoliosis can significantly disrupt sleep. In adults especially, scoliosis can become compressive and lead to chronic pain, making it difficult to get comfortable and fall asleep. Even without pain, patients often struggle due to asymmetrical pressure points that prevent restful positioning. In severe cases, irregular spinal alignment can even interfere with rhythmic breathing during sleep.

Nighttime bracing may be prescribed in some cases. However, wearing a brace can also cause discomfort, making it harder for some individuals to sleep well. Many patients ask whether sleeping on a particular side—such as the concave side of the curve—or using a pillow to push against the curvature can help correct spinal alignment. While these ideas may seem logical, the amount of force generated by these positions is not sufficient to create any meaningful change in curvature.

The best sleeping position for someone with thoracic scoliosis is on their back. This position offers the most symmetrical body support, helping to minimize pressure points and maintain a neutral spine. A medium-firm mattress or one with a pillow top is generally recommended to cushion asymmetrical areas and reduce discomfort.

The second-best option is side sleeping, but it must be done carefully. Avoid twisting—keep the neck supported, place a pillow between the knees to prevent hip rotation, and maintain a straight, aligned posture. It doesn’t matter whether you sleep on the right or left side; comfort and symmetry matter more.

The worst sleeping positions include sleeping on the stomach or in twisted postures. These positions often require turning the neck unnaturally, introducing strain into the thoracic spine and potentially worsening the condition. There's even a theory—called "perocative sleeping position"—suggesting that such twisting may contribute to scoliosis progression.

The most corrective sleeping option is using a properly fitted scoliosis brace designed to apply pressure in the right areas during rest. While not always comfortable, it can have the most positive structural impact.

Ultimately, quality sleep is essential for overall health. If ideal positions aren’t immediately comfortable, work toward them gradually. Retraining your sleep posture takes time but can be done. Begin by falling asleep in a better position and adjust only when necessary. Symmetry during sleep will help promote better outcomes for scoliosis.

00:00 What is thoracic scoliosis?
00:56 How scoliosis affects sleep quality
02:04 Sleeping on your back
03:14 Sleeping on your side
03:52 The worst sleeping positions for scoliosis
04:47 The best sleeping position for scoliosis
05:17 The importance of good sleep

Click the link for a scoliosis consultation:
https://www.scoliosisreductioncenter....

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