Sleep – Choosing the Right Pillow

In our next article on sleep, we are looking at Pillows.

Pillows are used to provide support for the head, neck, and upper spine while the body is lying in bed in a resting position but also create a feeling of comfort, important for a good night’s sleep and feeling well rested. Rest and sleep are the body’s chance to heal itself from the postural, physical and emotional stresses of the previous day.

The Pillow should be designed to keep the spine in natural alignment.
The human neck curves slightly forward (to sustain the weight of the head when upright), and it’s important to maintain this curve when in a resting position. If the height of the pillow is too high when sleeping sideways or on the back, the neck is bent abnormally forward or to the side, causing muscle strain on the back of the neck and shoulders. This type of position may also cause narrowing of the air pipe, resulting in obstructed breathing, and sometimes snoring, which can hinder sleep. Conversely, if the height of the pillow is too low, the neck muscles can also be strained.

Based on the body’s measurements and personal preference, the pillow should maintain a height of 4 to 6 inches, properly supporting the head and neck (and shoulders when lying on back).

A large part of what makes a good pillow is personal preference. If the pillow feels comfortable, it’s likely to help one relax, get a good night’s sleep, and feel well rested in the morning.

To help the pillow conform to various sleep positions, it is best if the pillow can be adjusted to fit the unique shape and curves and sleeping position of the user. A pillow should mold to your individual shape and alleviate any pressure points.

It is important to note that not all pillows work well for everyone. A short trial of a few days should be enough time to decide whether or not the pillow is providing benefit.

Shoulder position is also important. The shoulder should not be placed at 90 degrees to the mattress as this may trigger spasms in the trapezius muscles. The trapezius muscles perform a variety of actions, including acting as a platform for elevating the skull, so it is very important that they relax completely during sleep. If the shoulder is placed slightly forward on the mattress, in front of the sleeper, assuming the mattress can accommodate this position, the risk of applying pressure on the trapezius muscles and forcing the scapula (shoulder blade) towards the spine is reduced. In contrast, when positioned in the 90 degree position, sleepers may wake up with neck and upper arm pain and altered sensation to the little and ring fingers.

Knee pillows.

Using a traditional pillow either between the knees (when sleeping on the side),  or below the knees (when sleeping on the back) is important to relieve strain on the lower back.
When sleeping on the side, bending the knees and placing a pillow between the knees keeps the spine in the neutral position. Without this, the upper leg rotates, rotating the pelvis, and distorting the natural line of the spine.

When sleeping on the back, placing a pillow underneath the back of the knees helps reduce the load on the lower back. With a pillow/s underneath the knees, the lumbar spine is flattened, putting less force on the pain sensitive facet joints of the spine.


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We are friendly Chiropractors in North London, NW3. Ideally situated close to central London, we have parking space and are just a few minutes' walk from Finchley Road tube station and Finchley Road and Frognal overground, linking us to Canary Wharf and the City.

Our chiropractic patients are typically from the North West London area but also travel from far afield due to our good results, appointments that aren't rushed and our attention to our patients.