Choosing the “Right” Pillow
Pillows. Do They Matter?
Yes-ish..
Today we’re talking about pillows and how to set yourself up for a successful nights sleep.
Pillow Talk
First, some people can sleep on a rock solid floor with no pillow, sleep 8 hours and wake up feeling great. I used to be one of those people.
In fact I vividly remember going camping in Oklahoma in the middle of summer when it was about 105 degrees and the cot that I was sleeping on was making me hotter and hotter as the night went by. Finally I crawled on to the floor of the tent, which was essentially a layer of plastic on bed of gravel, twigs, and dirt, and fell fast asleep with no pillow at all and my neck at an angle that would make me visibly nauseas to see now. I woke up the next morning feeling great and spent the entire next day tubing on a leech filled lake.
Needless to say if I tried that today I would not be spending much time at all enjoying the lake but would be spending my morning and the rest of the day moving my neck in all sorts of ways to try and get it to “move and feel better”.
On the other side of the page are some who can sleep in “perfect alignment” with the “perfect pillow” and still wake up in discomfort or pain.
There is no perfect pillow. Walk around and observe the people you pass and you will quickly realize that the sizes of people necks, shoulders, and heads vary greatly. People’s pain thresholds, past injuries, and habits make it nearly impossible to say this one pillow or two pillows will work for everyone…. BUT there are some general guidelines that can help.
Alignment First
My general advice for choosing a pillow is. Alignment first.
Back Sleepers
If you are sleeping on your back you don’t want a pillow that is so large it is pushing your head forward to where you feel stress on the back or front of your neck. You also don’t want a pillow that is so soft or flat that your neck flattens out to the bed when you lay on your back.
Our neck has a curve called a lordotic curve and it makes a C-Shape. Shown in the picture on the right. In the back of our neck we have pain sensitive structures such as the facet joints. When we lay on a pillow that is too high it straightens out this curve and increases the pressure on these facets joints as well as increasing pressure on the disc in the cervical spine.
Now what about when we lay on a pillow that is too flat? The same rules apply. When we lay on a pillow that is flat and doesn’t support the neck and head it causes our neck to flatten out and increase the stress at the top of the neck where the head meets the skull and at the base of the neck.
So we don’t want a pillow that is too high, and we don’t want a pillow that is too low. The research has shown that many people find the most comfort well a pillow that has a height of 7-11 centimeters or 3-4.5 inches tall. On top of that some research has shown that a pillow that helps to reinforce/support the curve of the neck can also provide more comfort and stability. What I mean by that is some pillows are designed where it is slightly larger where it meets the base of the neck and then lower where the head rest allowing the head to relax and fall slightly back. That being said some individuals who have a reversed cervical curve or a very straight cervical spine might find this extra support to cause more pain than it relieves.
Side Sleepers
If you are sleeping on your side the same rules apply.
Think of your shoulders and you neck forming a 90 degree angle. A pillow that pushes your head up and increases that angle past 90 degrees to where you feel tension on your neck isn’t going to set you up for success as it is going to increase tension on the muscles on the side of the grease angle and compress the structures on the side of the lower angle.
On the flip side you don’t want a pillow so thin that when you lay on it your head falls to the bed and that now 90 degree angle is a lot less and the side against the pillow is compressed while the side facing up has more tension on the muscles.
Perfect Pillow
There isn’t a perfect pillow but above are general guidelines that can set you up for a more restful sleep. If you’re a patient with us and have questions about your pillow and how it could be affecting your sleep bring it in and we’ll take a look and make a recommendation if its need.
Putting your body in a more aligned position while you sleep decreases the chance of an asymmetrical pulling of the muscles on one side or the other and reduces the chance of laying in a position that will put pressure on the pain sensitive structures of the neck.
The above has been my philosophy on pillows for a long time and the research backs it up. When it comes to picking between a firm pillow or a soft pillow it really doesn’t matters as long as you try to stick to the above rules and it fits your comfort level. We all toss and turn around 20 times a night, much of this is due to us trying to relieve the pressure on our body and get in a more comfortable position, your pillow can and will affect that. Sleep is a fundamental aspect of our health and utilizing a pillow that helps us sleep through the night with less interruptions and that results in us waking up without pain can be a key factor in helping to reduce neck pain and discomfort.
I hope you enjoyed this blog and as always feel free to reach out with any questions to drcoffman@optimizecolumbus.com
References
Ahmed Radwan, Nicholas Ashton, Trever Gates, Austin Kilmer, Michael VanFleet, Effect of different pillow designs on promoting sleep comfort, quality, & spinal alignment: A systematic review, European Journal of Integrative Medicine, Volume 42,2021,101269,ISSN 1876-3820
Liselott Persson (2006) Neck pain and pillows – A blinded study of the effect of pillows on non-specific neck pain, headache and sleep, Advances in Physiotherapy, 8:3, 122-127, DOI: 10.1080/14038190600780239
Ren S, Wong DW, Yang H, Zhou Y, Lin J, Zhang M. 2016. Effect of pillow height on the biomechanics of the head-neck complex: investigation of the cranio-cervical pressure and cervical spine alignment. PeerJ 4:e2397 https://doi.org/10.7717/peerj.2397