For anybody who has been up late into the night trying to count sheep to fall asleep, knowing that they must be up early in the morning to go to work, there’s no question that insufficient sleep is frustrating.
More than that, sleep problems are becoming a nationwide epidemic. According to the Centers for Disease Control and Prevention (CDC), more than a quarter of the U.S. population reports having occasional difficulty sleeping.1 Furthermore, approximately 10 percent of the U.S. population suffers from insomnia. Sleep problems have been linked to a number of other medical problems, including diabetes, cardiovascular disease, and obesity.1
The upshot of all these nights spent staring at an alarm clock is that it is not unlikely your patients may be suffering from inadequate sleep. In fact, that very lack of sleep may be precisely what brings them into your office. How many times have you heard one of your patients complain about neck, back or shoulder pain, and explain it as having “slept funny” the night before?
Of course, you adjust their neck, spine, or shoulder. However, you know that until your patient can get a good night’s rest on a consistent basis, the adjustment won’t hold. They’ll invariably be back again with the exact same complaint about their pain.
When you start asking your patients questions about how they sleep, it should be quickly obvious that their pillow may well be the culprit for their lack of sleep. Depending on their preferred sleeping position, they may need a particular type of pillow to hold their neck and spine in the proper neutral position.
Prone (Stomach sleepers)
It’s widely accepted that sleeping in the prone (face-down) position is the worst for protecting the position of the neck and spine.2 The neck must be turned to one side or another, thereby not aligning with the spine. It may also pinch nerves leading to the shoulders and arms. Encourage your patients to break the habit of sleeping on their stomach. If that is not feasible for them, a super flat pillow is best or placing their head directly on the mattress. Adding a flat pillow under the stomach or hips also helps to keep the back in alignment in this position.
Supine (Back sleepers)
This is considered the best position in which to sleep, as the neck and spine are in a neutral position.2 However, the wrong pillow can still force them out of alignment. Your patients should look for a pillow that is relatively low in height. A very fluffy, thick pillow (such as the ones used in many hotels) will shift the head too high, thereby throwing the neck out of alignment. A lower pillow will position the neck in a more neutral position. Your patients who sleep supine should also have a low pillow under their knees for additional support.
Side-sleeping will also keep the neck and spine in neutral positions. However, you will want to recommend a pillow that will fill in the gap created by the ear and the shoulder. In this case, you should recommend a higher pillow than you would for patients who sleep supine. A pillow of medium to high thickness will fill in this gap while still providing support for the neck. Patients who sleep in the side position should also have a low pillow along the length of the trunk tor additional support and another between the knees to avoid friction from the legs rubbing against each other.
Poor sleep can be a frustrating cycle for patients to break. With the right pillow for their preferred sleeping position, they can finally rest easy at night.
- Centers for Disease Control and Prevention. Sleep and sleep disorders. Accessed 7/5/2016.
- Gordon S, Grimmer K, Trott P. Sleep position, age, gender, sleep quality and waking cervico-thoracic symptoms. Internet Journal of Allied Health Science Practitioners 2007 5(1).