Pillow Talk: Tips from a Physiotherapist on Choosing a Pillow you’ll Love

I sleep on my side / back / stomach; what kind of a pillow should I get?

We often go to sleep one way, but wake up in another. Amy says this is a good thing, not something to be frustrated by. She recommends that we change sleeping position through the night. “Changing positions is good and gives the body a change in pressure (contact with the bed) as well as a change in the muscle and joint positions.” (Amy Guidinger BScPT, BScKin, CGIMS)

Back sleepers typically prefer a supportive pillow that isn’t too thick and aggressive. Memory foam pillows can be great, giving a little more support under the neck. Add a little extra support to a typical pillow by rolling up a hand towel and slipping it inside your pillow case along the bottom of the pillow; this can help you decide if a contoured pillow is something you’d like…

Side sleepers should have the most firm, supportive pillows. A gusset style pillow will make sure you get more support under your neck (wide sides instead of simple seams). If you roll between your back and your side, look for a gusseted pillow with medium support.

Tummy sleepers beware; this is the least recommended sleep position according to the National Sleep Foundation, especially if you tend to keep your head pointed one way. You’ll be looking for a thin pillow that doesn’t push your neck too far out of alignment.

What about secondary pillows? I see a lot of talk about body and knee pillows.

A pillow under or between your knees can provide some much needed support for those with back pain. When you sleep on your side, a king sized pillow can offer support for the top leg and arm. When you sleep on your back, a pillow under your knees can take the strain off your spine. If you have neck pain, a contoured pillow can offer additional support.

If sleeping on your stomach isn’t great for your neck, how do you break that habit?

Sleeping on your front demands the most range of motion in your neck and puts the most pressure on your back. Often people get into a habit of sleeping with their head turned only one way. “I discuss this if someone comes to me with neck pain and they are a hard core tummy sleeper. Changing sleeping position habits is often quite difficult. I tell people not to stress out about it but rather to try to fall asleep in their side or back.”

Sleeping with your arms overhead is also another habit that might lead to shoulder or neck stiffness or numbness and tingling in the arms or hands.

What are some of the common mistakes people make when choosing a pillow?

Choosing a pillow that is too aggressive and does not allow for flexibility for changes in sleep positions.

Changing too quickly – I recommend when changing your pillow to have a break in period where you alternate nights with your old pillow.

What else do you think is important for good sleep habits?

Pillows break down over time and need to be changed. The National Sleep Foundation recommends changing your pillow every 1-2 years. This is partly due to cleanliness (dust mites and their waste can be up to 10% of the weight of a 2 year old pillow!)

While a good quality and comfortable pillow and mattress are very important, it is only one piece to the puzzle. I often see people who think that they developed a problem in their neck or back because they slept wrong. After more discussion, we often find out that there was a change in their activity (more or less), a long stressful drive, or a combination of activities that have accumulated over several days or weeks that have likely contributed to their problem too.

Maintaining a regular physical activity routine that consists of cardiovascular, strength, and flexibility exercises is important for sleep and overall health.

A nutritious and balanced diet, hydration, and healthy stress management behaviours are also key to having a good sleep.