Could the way you sleep reveal something deeper about your mental health?

If you regularly find yourself in the mountain climber or flamingo positions during the night, some TikTok videos suggest that it could indicate that your nervous system is active, reflecting high-stress levels and emotional discomfort.

While compelling, there’s little evidence to back it up. “It’s somewhat controversial. The original paper [on sleep positions] was done by a psychiatrist in the late 70s, so it’s not well studied.” Bruce Tammelin, MD, medical director of Providence St. Joseph Hospital Sleep Disorders Center, told Verywell.

Rather than sleep position, recent research has focused on how sleep quality affects both physical and mental health. For example, a recent study suggests that sleeping on your side may help drain waste from the brain, potentially reducing the risk of Alzheimer’s disease.

The most significant connection research has found is how stress and sleep impact each other, regardless of your sleep position.

How Stress Affects Your Sleep 

When you are under stress, your body responds by activating the hypothalamic-pituitary-adrenal (HPA) axis, which releases cortisol, a critical hormone in managing your body’s reaction to stress.

In addition to controlling our sleep-wake cycle, cortisol helps us regulate our metabolism and reduce inflammation. Prolonged, elevated cortisol levels or chronic stress can disrupt these processes, leading to inflammation, chronic pain, depression, and even the progression of Alzheimer’s and Parkinson’s disease.

Cortisol levels are meant to slowly decline throughout the day. When elevated cortisol levels persist into the evening, this hormonal imbalance interferes with the production of melatonin, a hormone that helps your body sleep properly. With time, these high cortisol levels can lead to sleep disorders like insomnia and exacerbate anxiety and depression.

This creates an unhealthy cycle in which stress leads to poor sleep, amplifying stress and making it even harder to sleep.

“If you don’t get highly efficient and unfragmented sleep, you can either have anxiety or depression,” adds Tammelin. However, patients who receive treatment for their sleep problems often see significant improvements in their mental health, too.

Studies have found that many sleep disorders, including sleep apnea, restless leg syndrome, insomnia, narcolepsy, daytime sleepiness, and nightmares, are more common in people experiencing mental health difficulties.

Neurodivergent people, particularly those with ADHD, often face even greater challenges in getting quality sleep due to low melatonin levels at night, sensory issues, or a more active nervous system.

How To Reduce Stress Before Bed 

Certain nighttime behaviors, like teeth grinding and covering your ears while sleeping may indicate nervous system activation, but they’re not necessarily a reflection of your daytime stress levels, Kyoungbin K. Im, MD, a board-certified psychiatrist specializing in sleep medicine and associate professor at UC Irvine, told Verywell.

They may actually be activations or reactions to physical stress at that moment. However, some sleep disturbances, such as sleepwalking, night terrors, and other movement-related disorders, are commonly seen in people under a lot of stress, said Im.

If stress interferes with your sleep, establishing a bedtime routine and incorporating relaxation techniques before bed can help signal your body that it’s time to unwind.

Here are some ways you can help your body get the rest it needs:

• Keep work and daytime activities out of the bedroom
• Avoid anything stimulating within three hours of bedtime
• Practice progressive muscle relaxation before bed

With these simple modifications, you can create a more restful sleep environment and allow your body and space to rest and recover.