Use the right pillow to protect your neck while sleeping

DEAR DOCTOR K: I tend to have a lot of neck pain. Would it help to buy a special pillow, or make any other adjustments to the way I sleep?

DEAR READER: As with so many things, an ounce of prevention may be worth a pound of cure when it comes to neck pain. And how you sleep at night can make a big difference.

Two sleeping positions are easiest on the neck: on your side or on your back. Whichever you prefer, choose an appropriate pillow.

If you sleep on your back, choose a rounded pillow to support the natural curve of your neck, with a flatter pillow cushioning your head. You can achieve this by tucking a small neck roll into the pillowcase of a flatter, softer pillow. Or, use a special pillow that has a built-in neck support with an indentation for the head to rest in. I’ve used a “memory foam” pillow like that for many years, and it has greatly reduced the number of times I’ve awakened with neck pain.

If you sleep on your side, use a pillow that is higher under your neck than your head. This will help to keep your spine straight.

Sleeping on your stomach is tough on your spine because the back is arched and your neck turned to the side. Preferred sleeping positions are often set early in life and can be tough to change. (Not to mention that we often wake up in a different position from the one we used to fall asleep.) Still, it’s worth trying to start the night sleeping on your back or side in a well-supported, healthy position.

Feather pillows tend to easily conform to the shape of the neck. They will collapse over time, however, and should be replaced every year or so.

Memory foam pillows come both in traditional shapes, and in what I call a double hump shape to support your neck – the kind I use. Both types of pillows generally do a better job of conforming to the contour of your head and neck than older types of pillows (such as feather pillows or regular foam pillows).

Manufacturers of memory foam pillows claim they help promote proper spinal alignment. Avoid using too high or stiff a pillow. This keeps the neck flexed overnight and can result in morning pain and stiffness.

But we sleep not only in beds. Sometimes we sleep while riding in a plane, train or car. And who hasn’t dozed off while watching TV? In any of these circumstances, a horseshoe-shaped pillow can help. It will support your neck and prevent your head from dropping to one side if you doze. If the pillow is too large behind the neck, however, it will force your head forward.

We spend a third of our lives asleep in bed. Plus, the evidence is growing that good quality sleep each night brings many health benefits. For those reasons, I think it is worth investing in beds and pillows that give you the best quality sleep — including protecting your neck.

Dr. Komaroff is a physician and professor at Harvard Medical School. To send questions, go to AskDoctorK.com, or write: Ask Doctor K, 10 Shattuck St., Second Floor, Boston, MA 02115.