Q: What Is the Best Pillow to Use When Sleeping?

This answer isn’t the same for everyone. No two people should use the same pillow. The point of a pillow is to support the natural curvatures of the spine and keep it aligned throughout the night when your body is in recovery and repair mode. Sleep position plays a significant role in the type of pillow you should use. As a general rule of thumb, back sleepers should use a thinner pillow to support the head and neck, while side sleepers need a slightly larger pillow to fill in the space between the mattress and head/neck due to the width of the shoulders. It is not advised to sleep on your stomach, as it's very detrimental to both your neck and lower back resulting in pain, headaches and numbness or tingling in the arms/legs.

The best way to sleep is on your back on a firm mattress, which allows the spine and surrounding muscles to decompresses overnight. This also supports the natural curves of the spine and doesn’t compress any of your joints. A close alternative to sleeping on your back would be your side with the use of the proper pillows to support not only your head and neck but also your hips and shoulders. Sleeping while holding a pillow in front of you and another between your knees will allow your shoulders and hips to stay aligned, along with the spine.

If you are a side-sleeper, and your pillow is too small

Neck: Your neck is forced to scrunch up and tilt downward on one side. Compressing the spinal facets and impinging nerves, blood, and muscles on this side. The other side is over stretched, and can weaken the muscles there. Over time this can create limited range of motion, neck pain, headaches, numbness and tingling in the arms, weakness, and other complications.

Shoulder: Your lower shoulder is taking all the weight of your upper body. Compression of the glenohumeral joint can cause problems in the labrum, bursa, tendons and muscles of the arm and scapula, not to mention strain on the very delicate AC joint and clavicle.

Spine: Your spine is forced into an awkward ‘S’ shape. It is forced to dip down from your hips in the lumbar spine, then up over your shoulder (which remember, is bearing all this weight), then curve down again as your head weighs it down the other way. This can cause pain, if you have any disc issues such as herniation, degeneration, or spinal impingement this sleeping position can make these more painful.

Hips: Because your lumbar spine is forced up by gravity, so are your hips pulled out of alignment. This effect is worse if you don’t have a pillow between your legs. If you have sciatic pain symptoms, achy hip or knee joints, arthritis in any of these joints, take a good look at your sleep position!

If your pillow is too high

Neck: Your neck is forced up into the other direction, scrunching one side and stretching out the other. We see similar problems as with a too-small pillow. Over time you might develop thoracic outlet syndrome, neck pain, headaches, numbness/tingling in the arms, weak and/or tight muscles, and limited range of motion.

Shoulder: This one is a bit easier on your lower shoulder, but it still isn’t ideal for good ol' glenohumeral joint. Instead of your shoulders being straight across like a T, you are forcing them into a tilted angle. The upper shoulder will be dragging down on the torso because it is too high, compression the upper thoracic spine.

Spine: The spine is again forced into an awkward ‘S’. This time the lumbar spine being being forced down then curving up and over the too-high pillow. This can again cause pain, aches, and exacerbate symptoms of existing spinal problems.

Hips: With your lower hip now ‘down’ and your upper hip pulled up, we see that lower hip taking on more weight than it should. You really don’t want the hip joint and knee joints grinding together while you sleep, as it can weaken the capsule, joint, and connective tissues.

Doctors recommend between 7-9 hours of sleep. Less then 6 hours a night and your brain is operating the same as it does with a .08 blood alcohol level. More than 9 hours and you are disrupting the delicate hormone cycle in your body. We talk about posture all the time, and how repetitive motions and postures can cause issues in the body. Seven to nine hours is a long time to be out of alignment! It is hard to ‘even out’ in the morning and achieve a good posture.

Side sleeping does complicate things when picking a good pillow. Everyone has a different body shape so keep a few measurements in mind when picking the right pillow: neck girth, shoulder width, neck length, and distance from base of skull or ear to the top of the shoulder. This is why we support the Pillow-Wise pillow here at the office. We take these measurements of your body and take into account the position you sleep in, along with the firmness of your mattress and come up with the perfect pillow thickness for your specific situation.

The best thing to do is get a custom-fitted pillow for your head, and also sleep with either a long body pillow or two smaller pillows for between your knees to take pressure of your hips, and under your arm to decompress the upper shoulder. The spine should be in alignment your shoulders and hips even. This position will help your muscles relax the most, and you will get your best rest.

Norwalk Sports & Spine carries Pillow-Wise, made with Dutch memory foam, that is machine washable and made from completely non-toxic materials. This is the pillow we recommend, and we can measure and find your perfect fit right in our office.