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The Right Pillow: An Underused Treatment Option for Pain and Sleeplessness

How to choose a pillow that will help you get a better night's sleep
Woman in bed with neck pain


You should wake up every morning feeling refreshed and ready to tackle the day. But for many people, going to sleep at night is an endless struggle to get comfortable—with mornings often bringing pain, stiffness, soreness and exhaustion instead of the boost you need to get through everyday life. You or your partner might also be snoring or dealing with other sleep-related issues that interfere with a good night's sleep, too—like frequent nighttime waking or insomnia.

Some people try to fix their sleep and pain problems with an expensive new bed, sleeping pills, or pain medication. But did you know that sometimes the fix you're desperately seeking is as simple as finding a different type of pillow?

"Pillows affect everything from nerves and muscles to blood flow [during sleep]," says Dr. Scott Weiss, a licensed physical therapist, board-certified athletic trainer, and exercise physiologist who co-owns Bodhizone Physical Therapy & Wellness in New York City. “People that suffer from constant waking through the night and are mindful of neck stiffness during sleep should seriously consider getting a new pillow," he argues, adding that chronic headaches and even eye-squinting are other possible warning signs.

Having the wrong pillow for your body type, age—or any chronic medical conditions you might have such as arthritis—can manifest in all kinds of ways during the day, notes Dr. Erik Korzen, DC, a chiropractic physician with Dynamic Physical Health in Mokena, Illinois.

Korzen says signs that you're using the wrong pillow can also include excessive snoring, neck pain and stiffness in the morning, shoulder and upper back pain, tingling or numbness in the arms and hands, or just a general feeling of malaise on waking. "I am focused on treating patients in pain through conservative means, which includes lifestyle modifications—i.e., [changing] your pillow," Korzen notes.

We asked these two health experts for their recommendations on how different pillow types can address common sleep or pain problems.

1. First, consult with your healthcare professional.

You may need a different type of pillow depending on what medical condition(s) you have—and you may not even be aware of which sleep-related issues or overall medical problems are contributing to your pain, either. Also, chronic conditions like arthritis, diabetes, or even pregnancy can affect what kind of pillow is best for you—so consulting a physician, chiropractor, physical therapist or sleep therapist is always the best place to start your pillow search, Korzen stresses. (Arthritis is not just a condition of the elderly, either—symptoms can appear as early as your 30s.)

"If someone has a [medical] diagnosis or is experiencing certain symptoms, contacting a trusted healthcare professional is highly recommended," Korzen says, adding that he often has his own patients bring their current bed pillows to his office and has them lie down on them during exams so he can determine if they're the right fit or not.

2. Look for moderate support regardless of pillow type.

No matter what pillow style or type of filling material they are considering, most people should look for a pillow with moderate support, stresses Weiss, who has treated both average Americans and elite athletes such as Olympians, NHL players, and WNBA players. “Pillows that are too soft can contort the neck and affect the [surrounding] muscles," he explains. "Pillows that are too firm start out great, but force your neck to be in an unnatural position, and can take time to break in and get used to. [Both] can cause a pretty rough morning."

Korzen agrees. "Pillows with less density or firmness tend to cause various [pain] symptoms in patients," he says, noting he also recommends against beds that are too soft.

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3. Analyze your sleep positions, problems, and preferences.

People who prefer to sleep on their backs often need a different type of pillow than people who typically sleep on their stomachs or sides, experts say. Not only that, some conditions like pregnancy, acid-reflux disease, snoring, or sleep apnea call for sleepers to switch their usual sleep positions in order to address condition-related sleep problems—and sometimes, a pillow change can make doing so a lot easier and less disruptive.

"I always recommend that stomach sleepers use soft, down-based pillows," Weiss says. "Back sleepers should stay with moderate support, and side sleepers should opt for firmer pillows to support their necks. Pillows can also be used under the knees for back sleepers, between the knees for side sleepers, and under the pelvis for stomach sleepers." Snorers should avoid sleeping on their backs, Weiss adds, and he recommends wedge pillows or firm orthopedic pillows to help provide proper neck support for side sleepers.

Korzen notes that pregnant women and people undergoing significant weight loss can benefit from body pillows, though these large pillows are generally considered unsafe for small children due to suffocation risks. Moreover, if you have to use a bunch of different pillows to get comfortable every night, it can be a sign you're using the wrong kind of pillow for you. "If you have the right kind, you should only need one," Weiss stresses, and Korzen agrees, while adding that a few people do need additional pillow support for their lower bodies.

Korzen also points out that many of his patients with chronic headaches find relief by switching to water-filled pillows, while orthopedic pillows can be great for people with arthritis. Buckwheat and memory-foam pillows mold to fit the sleeper's head while maintaining firmness, and can be a good option for those who haven't found relief with more traditional pillows, he adds.

4. Try out different pillows until you find the right fit.

Every individual is unique, so often the best way to find the ideal pillow for you is through trial and error, experts say. (Look for retailers with liberal return policies in case you need to do a swap or two.)

Korzen notes that it can sometimes take as many as 7 to 10 tries before you find the pillow that provides partial or full relief of your pain or insomnia issues. He adds that one 70-year-old patient in his practice eventually saw a 50% reduction in her morning pain symptoms once they'd finally found the right pillow for her unique body and medical conditions. "From a simple lifestyle modification [perspective], this was a great result," Korzen says—even if it did take several different pillow trials first.

Not only that, your body's sleep and support needs change as you age, so be prepared to need different pillow styles and types depending on your life stage, Weiss notes. "Over time, everyone needs to change their pillows to ensure that they are getting as sound a sleep as possible."

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