Pillow Talk. (About Actual Pillows, Not the Other Kind)

Ah, the frustration of finding the perfect pillow! Have you found yours, yet? Once you do, your spouse or kid will probably steal it or your dog will chew it up. Or, do you have that pillow that has been perfect for longer than you are willing to admit and it is just moments away from disintegrating in the middle of the night as you blissfully rest? I know how it is. I wish I was writing this article with the perfect solution for everyone. Alas, there is no perfect solution but there are some general guidelines that can help.

First off, finding the right pillow can take time and you may need to invest a little in several different pillows. How much is up to your commitment to a perfect night’s sleep and how important it is for your neck to feel good in the morning.

The most important factor to consider is that you need to keep your head and neck is a neutral position relative to the shoulders. If your head is closer to one should over the other or flexed forward or extended back, you are no longer in a neutral position. This can put a strain on the joints of the neck and cause shortening of one side of the neck muscles and conversely lengthening of the other side. Because we spend so much of our lives sleeping, it is vital that you keep your neck and head in a position that puts little stress on all of the structures.

For side sleepers the biggest issue typically is finding  a pillow thick enough to take up the space between the shoulders and the head. This is especially hard if you have broad shoulders. A firmer pillow is usually your best bet because it will hold its shape all night. Down pillows tend to be fine for the first few hours then compress during the night. I, personally, sleep on a water based pillow that holds it shape really well but is soft enough to be comfortable. It has over a gallon of water in it so it weighs a ton which makes it hard to change the pillow case, but what do you do?

Back sleepers typically need a fairly thin pillow or no pillow at all depending on the curvature of the upper back. The shape of your neck will largely determine the style of pillow. If you have a good curvature (which is ideal), a pillow that helps maintain the arch can be great. If your neck is unfortunately straight or reversed, then that style of pillow might be very uncomfortable. Some say that using a pillow as a neck orthotic to restore the ideal curvature is a good idea. I could definitely make that argument but sacrificing sleep might not be worth it.

OK, I know the what you are thinking, “I switch from side to back all night.” Let me say it right now, unless you are just the right structure, there is not really a pillow that is dual purpose. Sorry! If you have a pillow thick enough to take up the space between the head and shoulders, it is going to be too thick to sleep on your back and vice versa.  Furthermore, if you are a stomach sleeper, there is no way to keep your head in neutral and still breath unless you have a slot for your mouth and nose.

There you have the basic guidelines. Happy hunting. FYI, just because pillows are expensive doesn’t mean they are going to be a good fit for you. Still, cheap is cheap. The pillows I sell in my office are around $50, if that is useful. Good luck and sweet dreams!

3 Comments

  1. Dr. Thomas,
    I’m a back sleeper and hardly ever use a pillow. For me, the cheap ones are best because they are really thin.

    By the way, I’ve heard that for side-sleepers placing a thin pillow between your legs is really good for the lower back. Is that right?

  2. Ugh! I’m one of the unfortunate stomach/side sleepers. I go through pillow phases. I have at least 6 pillows, I trade them out from time to time. Oddly enough my latest pillow belongs to my Miniature Dachshund, Roxy! She has this big leopard print pillow. I was tired one day and she was laying on it and I went over to the pillow to pet her. 3 hours later I was waking up with my head on this pillow SO REFRESHED!!! So I stole the poor dog’s bed. The only problem is, she still thinks its hers so my head has to share a pillow with a dog. 😛

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