It is commonly asked, “What is the best pillow and mattress combo for me?” There isn’t a ‘one size fits all’ combination but there are guidelines you can follow to find the right two for you. In terms of pillows, it depends on what type of sleeper you are. Are you a side sleeper like most of the population or do you prefer to sleep on your back? You may even fit into the small percentage that are tummy sleepers, in which case you may not currently use a pillow. The following will delve into each style of sleeping and the better options of pillow for neck and spine support.
Did you know that people can change sleeping positions up to 20 times in one night? The brain does this to relieve the pressure on the body parts in contact with the mattress. The softer the mattress, the less pressure on the body however, it also takes more energy and effort to change sleeping positions which may result in waking up and an increase in body temperature from the extra effort required. A mattress that is too firm will increase the number of position changes during sleep which may also reduce quality of sleep. Thus, a medium firm mattress will provide enough support to easily move around on the mattress but not so hard that excessive changes will occur. Check your mattress to see if it is becoming too spongy in places, it may be time for a new one.
Side-lying is the most common sleeping position found in adults, with 59-73% of their sleeping time spent in side-lying (Gordon et al., 2009). What you want to consider if you sleep in this position is keeping your cervical spine (neck) neutral. Ideally you would like your chin in line with your sternum, just like if you were standing up. Side sleepers require a thicker pillow than back sleepers as they need to take up the space the shoulder creates whilst laying on their side.
Sleeping on your back is a close second in preference of sleeping positions. The ideal pillow for a back sleeper will actually be thinner than that of a side sleeper due to the smaller space that is between your head and mattress. Much like side sleepers, a neutral neck is desired so that there isn’t an overload of pressure on the structures in your neck while you sleep. Aligning your head, neck and chest similar to that in standing is what you want to achieve. This will usually be 1 pillow, unless it is super soft in which case you may need more support, or a new pillow.
The least favourable sleeping position due to the increased pressure placed on the neck and the lower back. In order to breathe, tummy sleepers will turn their neck to the side. This will lead to increased pressure along one side of the neck (Karwowski, 2006) which may see an increase in discomfort or more frequent waking. Furthermore, the lower back is placed into more lordosis (has bigger arch in it) which once again, places more pressure on the structures in the lower back. Tummy sleepers may find they wake with a stiff or jammed lower back. If this is the case, try to sleep with a pillow underneath your stomach to help reduce the arch in the lower back.
It’s a position that allows the body to relax, the muscles and energy systems to recover from the previous day and to get ready for the next. Having a straighter spine during sleep allows the body to enter a more relaxed state. If there is too much of an angle along the spine, commonly the neck or lower back, you may experience discomfort during the night and either struggle to get to sleep or wake frequently from being uncomfortable. This is why having the correct support can help maintain proper spinal alignment whilst you sleep.
About the writer
Paora Waaka is a Physiotherapist (MAppSci) for PB Physio. He specialises in musculoskeletal physiotherapy for sports and performance specifically field based sports eg AFL, NRL, Rugby Union, and soccer. Waaka has a keen interest in shoulders will help you achieve your personal best in your physical goals/sports.
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