If you have neck pain, finding a comfortable sleeping position can be difficult.
With the wrong type of pillow and the wrong positions, your neck pain might get worse before it gets better. Instead of constantly trying new things and finding that nothing works, it is best to simply learn what sleeping positions will help your neck rather than hurt it.
Unfortunately, studies show that there is no one right way to sleep each night. But, studies have also found that there are some positions that are more harmful than others. It is best to avoid what hurts and to choose what feels good. But, if you are sleeping, it can be difficult to know what is working until you wake up the next more either in pain or not.
Choosing a pillow that relaxes the muscles and discs
The height of your pillow can affect the way your neck feels. In the journal PeerJ, the heights of pillows and their effects on the alignment of cranio-cervical pressure and cervical spine alignment were studied. According to the study, nearly 25% of the popular suffers from neck pain and pillow design is recognized as one of the culprits for neck pain. When pillows provide improper support, the cervical spine is stressed. This can create pain and headaches along with poor sleep.
The study used college students and they slept on B-shaped pillows that were paired with a pressure-sensitive mat to gather data. The subjects were told to lay supine with four different pillow heights, including 110 mm, 130 mm, 150 mm, and 170 mm. The researchers looked at the position of the neck while laying on these four pillow heights.
The researchers found that cranio-cervical pressure changed as pillows got taller.
As the pillows got taller, the pressure shifted from the cranial region to the cervical region with the peak pressure on the 170 mm pillow. Even though pressure increased as the pillows grew taller, the researchers were unable to make a recommendation for the ideal height of a pillow for supine sleeping. Ideally, the pillow should be a height that allows the discs and muscles to relax from all the heavy lifting they do through the day.
Positioning the hands with supine postures
Another study looked at the positioning of the neck during sleep and how it affected neck muscle activity. This study was published in the Journal of Physical Therapy Science. The idea was that sleep is vital to human health and maintaining energy. Without proper sleep, people have problems thinking, controlling their moods, and getting through the day without being tired. Good sleep also helps people fight chronic pain.
When people sleep in uncomfortable positions, they have biomechanical stress on their cervical spine and it increases stiffness, headaches, and arm pain. The sleep lab was used to study 20 men and women who agreed to participate. They were told to sleep supine in one of three postures:
With both hands at their sides
Both arms on the chest bent at 45°
Dominant hand on the forehead
Of the three postures, the dominant hand on the forehead posture was the least comfortable as it created stress in the right scalene muscle. Only one type of pillow was used, so no results were based on the pillow type. Like the pillow study in PeerJ, this study did not have any conclusive findings other than the need for a relaxed position that provided comfort. They did recommend not sleeping with your hands on your forehead because of the discomfort it brings to the scalene muscles and the other muscles near them.
Best side sleeping pillows
Side sleepers were analyzed in a study published in Manual Therapy. In this study, side sleepers used a variety of different types of pillows and recorded their comfort and sleep quality. The types of pillows included
Their usual pillow
They also used foam contour pillows and regular shaped pillows. Over 100 people were included in this study. The subjects had to report back about their walking and pain as well as sleep quality. The recommendation for side sleepers is that rubber pillows provide the most support. The subjects preferred rubber pillows over their own pillows and their own pillows were similar to the foam contour pillows. The only pillow that was not recommended was a feather pillow.
Avoiding stiffness and headaches in the morning
Other studies looked at sleeping posture and how those change throughout the night.
In a study published in Australian Journal of Physiotherapy, waking cervical pain was studied. They looked at over 800 households and their amount of waking cervical spine stiffness, headaches, and aches in their arms. The researchers also looked at gender and age. In the report, “Subjects most commonly reported waking with scapular or arm pain (27%) followed by headache (19%), cervical pain (18%) and cervical stiffness (17%).” The most common complaints came from women and adults over the age of 60.
The stiffness was most likely due to people not shifting out of uncomfortable positions through the night. As people age, they are less likely to shift position because they are more likely to have a lack of flexibility in their spines. In some cases, people stay in the same sleeping posture for nearly two hours. Younger people shift positions more frequently through the night, which could be the explanation for less stiffness and headaches upon waking.
But, there is an argument that increased movement actually places more pressure on pain-sensitive structures like the the cervical spine. So, again, like the other studies, very little is known about the best positions for sleeping to avoid neck pain.
It can be helpful to use a sleep app to record your movement through the night. If you find that you wake up with more pain on nights when you do not move much, it might be in your best interest to move and switch positions throughout the night. Go with what feels comfortable while sleeping on a supportive pillow that lets your neck muscles fully relax.