Let’s face it, we spend around a third of our lives asleep. Some people may spend their whole lives asleep but that is a different post. It is therefore logical to think that the things you are doing while you are sleeping will be contributing to your pain. If you are always sleeping in the same position then over a long period of time you will be always jamming up the same joints in your spine, shoulders and hips as well as compressing or stretching the soft tissues such as muscles, fascia, ligaments, joint capsules and tendons.
The million dollar question - Which pillow should I use?
If you ask a practitioner or bed sales person you will probably get many different answers, especially If they are trying to offload onto you a pillow they just want to sell you. Beware of buying a pillow because it was recommended, especially if someone is trying to sell it to you.
The most important thing with a pillow isn't the cost or whether astronauts have used them (tempur pillows), remember marketing is there purely to take your hard earned cash. The most important thing is that the pillow is the right size for your body. There is no one size fits all pillow and this is where it gets tricky. Just because one person found that a $250 Tempur memory foam pillow was right for them doesn't mean that it will be right for you.
The biggest factor in choosing a pillow is the position you spend most of your time in when sleeping, whether that is side sleeping, back sleeping, front sleeping or upside down. Most of us will go through a variation of these positions throughout the night and that is also a consideration. Sometimes when people talk about pillows there is this assumption that you just go to sleep on your back like Dracula and wake up in the same position. I always feel like saying to them "have you ever actually been to sleep?".
A comfortable sleeping position is usually one that we have been doing for a long period of time. This could have been since you were a child. As a child you are more flexible and your joints are healthier so you can get away with sleeping in a dodgy position. As we get older though we need to consider the impact sleeping positions are having on our pain.
If you sleep on your side then your will need a bigger pillow than if you predominately sleep on your back. You really need to try out the pillow before buying it. When you lie on your side the your neck should remain in alignment with the rest of your spine. It shouldn't be tilting one way or the other. Have someone photograph you while you are in the shop so you can see how your neck tilts.
A common side sleeping pillow is the contour type pillow. This has a scooped out section for your head and then a larger section that supports your neck. If you exclusively sleep on your side then this could be the pillow for you. But remember if your neck is not aligned properly you will end up in pain.
If you sleep on your back then you really don't need much of a pillow at all. Try not to use a really big pillow here or it will press your head forward into flexion. This can put pressure on the discs in the vertebrae which could lead to headaches or pain/tingling/numbness down the arms.
You are basically doomed to pain. If you have to sleep in this position then using a very thin pillow will also be important so as not to strain the neck too much.
What's the best way to sleep?
Back sleeping is the most neutral and comfortable for the body. It may seem unnatural at first but practicing really makes perfect. The more you can do this the more used to it your body will become and eventually you will find this easy.
The other considerations with all sleeping positions are the effects on the rest of the spine and also the hips and shoulders. If you sleep on your side then you will be jamming up the shoulder joint on the side you are sleeping on. This can lead to shoulder pain and also the potential for nerve compression leading to numbness or tingling down the arm. Side sleeping can also affect the hips and lower back if your top leg is rotating forward. You should really sleep with your knees together and a pillow between them.
What's on the market
Generally all of the big brands such as Denton, Dunlopillow, Tontine, Tempur, Ikea, Target, K-Mart all have variations of the same thing these days. There is a lot of competition so each brand has a similar catalogue. The biggest difference between them will be the price. Budget is a consideration. Often when buying a pillow there will be some trial and error i.e: you may not get the right pillow first time around. So if you drop $250 on a pillow and it doesn't work for you then you will have completely wasted that money as there are usually no refunds or exchanges on pillows. Some shops have trial pillows but this isn't very common.
Contour pillows or Ergonomic pillows
These are best for people who predominately sleep on their sides. They usually come in various sizes such as low, medium and high profile. To get an idea of which size you need your will need to measure the distance from your shoulders to your neck. If you have narrow shoulders you will need a low profile, if you have braod shoulders you will need a high profile. These pillows usually have a difference height on each side so there is some fine tuning with height.
These pillows claim that they are more supportive and "mold" to your unique head and neck shape so that they will be more tailored for you.
The biggest brand on the market (and most expensive) is the Tempur. They claim their memory foam is different to the generic memory foam that other brands use. They also have grades of density so if you like a firm pillow or a soft one you can choose.
Memory foam pillows are often made from latex and can be quite hot and sweaty, so this is also a consideration, especially in summer.
These pillows are usually made of goose down and can be very comfortable pillows. They are usually on the softer side, but as mentioned before can be "fluffed" up to make them more supportive.
These pillows are your standard soft pillows you get from Target or K-mart. In my opinion as long as you get the alignment right with the pillow you will have a good nights sleep. If the pillow if too firm and too high this is where you will get the most trouble. With a soft pillow you can bunch it up so it becomes bigger.
If you can find a shop where they have knowledge, maybe a physio or chiro on board who can assess and look at you sleeping with a pillow and then let you try it out this will give you the best result. More shops are doing this these days, but this also comes at a premium.
So there you have it. I hope this has given you some insight into the tricky world of pillows. The big takeaway here isn't that you need a fancy pillow, you just need to sleep in a position that best aligns your spine, shoulders and hips. If you get that right a $10 pillow from Target could do the job. I have been through many pillows over the years and the most comfortable one I use now is a goose down pillow. The last memory foam pillow I had was not that great and I find them too firm and give me headaches. But that may not be the same for you....
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