Patients with neck pain often have trouble sleeping. Sometimes the issue is simple –
after laying in one position for too long, their neck gets sore and they have to change positions, so they toss and turn a bit.
Other times, the problem isn’t really the neck pain, it’s the burning pain or tingling running down the arm (radiculopathy), which suggests more serious nerve compression which may require a visit to the surgeon.
Most often, patients just can’t find a position of comfort, their neck hurts whenever they get into a bad position, and they can’t get to sleep, much less sleep through the night. Sound familiar?
It’s not a minor issue: Inability to get a good night’s sleep leads to exhaustion, exhaustion makes it hard to cope with pain, pain interferes with function, and inability to function leads to depression, anxiety, and more problems sleeping. What can we do to get a better night’s sleep without resorting to surgery?
First, we need to set ourselves up for success - to adopt good sleep mechanics or “hygiene”: stick to a consistent sleep schedule, including weekends, get some good exercise each day, don’t drink coffee or caffeinated pop late in the afternoon, and get outside for at least 15 minutes every day. Also, avoid late night television and evening cocktails – even if you do get to sleep you won’t sleep as well.
Second, get together a good comfortable sleeping arrangement, that works for you. The thing patients ask me about most – the best pillow for your neck.
There is no universal “best pillow” for everyone (no matter what they say in the ads!). Pillows come in all shapes, sizes, styles, and materials. The best pillow for you depends on what type of neck problem you have, what type of sleeper you are, and how you tend to sleep most comfortably – are you a side-sleeper or a back sleeper?
The main goal is to keep your spine in a neutral alignment and allow your muscles to relax while you are asleep. The best pillow is the one that has the proper firmness and height (loft) to help you maintain your best alignment throughout the night. Here are four important points to consider:
1. The wrong pillow is an old one, an overstuffed or worn-out one, or one that’s too flat to support you comfortably in any position. You don’t need to buy an expensive new pillow, but you need one with a firm fill, proper contour, and enough loft to hold your head in good position for hours without settling out.
2. For stomach sleepers, the pillow needs to be thinner. This is a tough position for most neck patients. For side-sleepers, the loft needs to be considerably thicker and the pillow needs to be firm enough not to flatten out while you’re resting. That means a “fluffy” or “soft” pillow may not hold you in good alignment throughout the night. There are a number of pillows that allow you to adjust the amount of filler material so you can customize the perfect firmness and support that works for you. If you are a back-sleeper, you need a pillow soft enough to let your head sink in a bit, but firm enough to support your neck. Some pillows accomplish this by sewing in a preformed divot in the center, providing a firmed roll at the edge under your neck.
3. There are a number of contoured pillows on the market, and a number of websites that “prove” the value of a specific brand, and they may advertise memory foam over latex foam. Check multiple sites to get an unbiased opinion. Most contoured pillows have special ergonomic designs that try to hold your neck in its best natural alignment. They may have a shallow center cavity to gently cradle your head, and a firmer, mounded rim for cervical support. These are pillows primarily intended for back-sleepers.
4. Some people will find that a simple roll-pillow gives them the best comfort during the night. Others may find that they do best with two pillows – one for starting out on their back, and a second one to support when they want to sleep on their side.
You don’t need to buy the most expensive down-stuffed pillow you can find, but don’t skimp. The well-made designs are often available in cheaper versions, but the materials will be different and the support will be lacking.
Obviously, there are no hard and fast rules, and some trial and effort is inevitable. Hopefully this will guide you in the right direction, and help you get a good night’s sleep.
Thanks for reading and let me know what other questions you might have!
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I'm Dr. Rob McLain. I've been taking care of back and neck pain patients for more than 30 years. I'm a spine surgeon. But one of my most important jobs is...