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Choosing the Right Pillow

Many people have trouble sleeping, and there are a lot of factors that affect sleep and sleep quality. Stress/anxiety, pain, poor diet, inactivity, illness, are some of the main culprits. A poor fitted pillow can also be a culprit and result in neck pain, tension HA, poor sleep quality, snoring, and acid reflux. Although not always a cure all, choosing the right pillow may help you sleep. Below are a list of things to consider when choosing the right pillow.

Things to Consider

1. The purpose of a well fitted pillow is that it supports your head and neck so that your neck is in neutral (in line with the rest of your spine – see picture below). A neck that is in neutral alignment will reduce risk of tension head aches or neck pain.

2. Choosing Pillow Thickness: Picking your pillow thickness has a lot to do with sleeping position: Side, back, or stomach sleeper, the goal is to achieve the right amount of support to keep your head and neck in neutral.

  • 1. A slide sleeper will need a slightly thicker pillow, to make up for the lift caused by your shoulders, to support the neck.
  • A back sleeper will not need as thick of a pillow in order to achieve that neutral spine alignment.
  • A stomach sleeper will need the thinnest pillow, or no pillow at all when sleeping.

3. Choosing Your Filling.  There are many different types of fillings available. Options include, down, wool, cotton, latex, or memory foam.  Filling will effect how firm or soft your pillow is, and following the above keys, you want your head and neck to remain neutral. So a thick but soft pillow may not be ideal for a side sleeper who needs their head to be more supported with a firmer pillow.

4. Personal Considerations: For someone who snores a lot, has a runny nose, or has acid reflux, propping your head up 5-10 degrees with a thicker/firmer pillow may help alleviate those symptoms.

5. Typically, you will need to sleep with a new pillow for several nights before determining whether or not the pillow will work out.  If you wake up with neck pain, headaches or have any other breathing or sleeping difficulties associated with the pillow for more than 1 night, then try and find another pillow. If you have tried multiple pillows and have consistent pain it may be time to talk to a physician or trusted PT to see if it needs to be addressed by a health professional.

6. Older pillows should be replaced every 18 months or so, because over time they can accumulate illness, allergens, such as mold, dead skin cells, and dust mites. Pillow protectors can help extend the life of your pillow. You can test if a pillow is viable by seeing if it springs back after you fold it in half. If it doesn’t spring back, it’s time to get a new one.

7. Safety first! If you are having consistent neck pain while sleeping or when you wake up it may be an issue larger than your pillow.  Consider seeking professional help from a physical therapist or doctor to figure out the cause of your pain.

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