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Comment by onetimeuse92304 | Hacker News Reader

For my entire life I slept in one of those postures ("the lookout"). I had a bunch of problems (pain in the chest, pain in the back, some problems with my knees not loaded symmetrically, my feet getting "extended" for quite a long time causing problems with Achilles). I also had a problem with restlessness -- these positions cannot be maintained for long without moving, I would be changing my position very frequently.

Couple of years ago I have injured my ACL and had to learn to sleep on my back. Now I am much happier sleeper. Now I generally do not move at all during night (I wake up exactly as I have fallen asleep and my sleep tracker tracks way less movement). All of the pains gone.

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As a back sleeper, get a pillow or cushion under your knees/legs. Otherwise the arch of your back is in constant stress when you sleep and can lead to back problems. You can guess how I know.

That doesn't sound like good advice. Your hip flexors are likely very tight/shortened, so you put a pillow underneath your knees/legs to prevent them from stretching at night and thereby make them even more shorter?

Pillow or no pillow? Hard mattress? No mattress?

I use a very thin pillow when sleeping on my back. I find sleeping without pillow a bit uncomfortable. Although I am sure I could get used to my head being pushed back a bit, I still dislike the head just resting on the hard mattress and trying to naturally roll left/right. The pillow helps me keep my head looking straight ahead (almost vertically).

As to mattress, I prefer a mid-to-hard latex mattress with a cover.

In the article, the lookout position involves the lack of a pillow. One can imagine that the additional height of the pillow would cause you to raise your head, lower your chest, and arch your back, potentially causing the issues you reported.

That being said, this is an article of anecdotal observations by a physiotherapist - it is not the result of any kind of study.

It is really thin pure goose down pillow. Folded, it is less than 1/4in when compressed. I don't think the height of the pillow makes a huge difference.

(This is my preferred type of pillow as well - an old, thin down one - and I can tell the difference when I sleep with or without it.)

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