Pillow Talk: The Importance of Sleep Posture

Choosing the Right Pillow. New Heights Physical Therapy in Vancouver WA and Portland OR.

By: Gema Sanchez, PT

Having the right pillow can make all the difference in getting a good night’s sleep, especially if you have head or neck pain. The purpose of a pillow is to support to your head and neck in good posture as you sleep. Which pillow fits you best depends on two factors: the side/shape of your body and what position you sleep in.

Neutral Position

The first step to choosing the perfect pillow is understanding what position your head and neck should be in. Whether you are sitting, standing or laying down, the optimal head position is neutral. In neutral, your head is positioned centered on your body facing forward, not tipped or rotated in any direction. This position optimizes spinal alignment and minimizes stress on the muscles, ligaments and tendons. When you are laying down, the pillow should be supporting your head so that it can rest in a neutral position.

One good way to see what position your head is in when you are sleeping is to have someone sit at the side of your bed and take pictures of you laying down with your pillow.  Look at the pictures and analyze the position of your head in relationship to your body. Is is positioned in neutral? When you are laying on your side, the pillow needs to fill the space between the bed and your head. If the pillow is too thin, your head will be tipped down toward the bed and if it is too thick your head will be tipped up toward the ceiling. When laying on your back, the pillow needs to fill the space between the bed and the back of your head. If the pillow is too thin, your head will be tipped back toward the bed and if it is too thick your head will be tipped up toward your chest. Also, look at the curve of your neck. Your pillow should be completely filling that space and supporting your neck.

Pillow Types

A good pillow is made of something that is both flexible and resilient. You need to be able to form it to the curve of your neck to support it but it still has to be solid enough to support the weight of your head. Feather pillows or synthetic pillows with similar qualities to feathers do this very well. They are also easy to reshape as you change sleeping position.

Memory foam pillows do a good job of supporting the head when you are laying on your back, but are often too firm to cradle and support the neck well. You can’t fold them to adjust the thickness, so they are usually not thick enough to provide good support when you are laying on your side.

Some pillows are shaped specifically for back or side sleepers. But they are not one size fits all. The curved part of the pillow meant to support your neck is not adjustable, so for many people, they are either too large or too small. Also, very few people stay in one position when they are sleeping. So, for instance, if you are using a pillow designed for a side sleeper and you roll onto your back, the pillow cannot adjust to your new position and will not give you the support you need.

The Pillow Test 

Pillows wear out over time, so if your pillow is older, check to see if it still has enough loft to do it’s job. Try this test: fold the pillow in half and release it. It should bounce back to it’s original shape. If it doesn’t, it is no longer able to loft up and provide you with enough support. Replace it.

Stomach Sleepers

What about sleeping on your stomach? If you have neck pain, you have likely been told that you should not sleep on your stomach. Applying what we now know about head posture, you can see that the reason for this is that in order to breathe while you are sleeping on your stomach you have to position your head rotated to the extreme right or left. This position is very stressful on the neck.  If you can train yourself to avoid sleeping in this position, do. But changing your preferred sleeping position can be very difficult and you may find yourself rolling onto your stomach in your sleep. In order to protect your neck while laying on your stomach you need to position your head as close to neutral as possible while still allowing room to breathe. One way to do this is by resting your forehead on the edge of the pillow. This allows your head to stay in neutral while providing room to breathe. Another is to ditch the pillow altogether and rest your head in the crook of your elbow. This allows you to breathe with your head positioned only slightly in rotation.

Here’s to perfect pillows and a good night’s sleep!

Flourishing During the Holidays

By: Gema Sanchez, PT

Fall and winter are upon us, bringing with them our most active and intense season of holidays and celebrations. The short days and long nights of winter are mother nature’s rest period after the long days of spring and summer. We, like the plants and animals, are meant to use the dark and cold to rest and rejuvenate in preparation for warming in the spring. But, humans are social creatures, and the long dark days are also the perfect time to spend intimate time with our loved ones and enjoy the stored abundance from our summer gardens. So, how do we handle this flurry of activity and responsibility at the very time when our minds and bodies are ready for rest?  Stress management. Recognize and nurture your stress management techniques and you will emerge from the holiday season joyful and at peace. Taking good care of yourself is the key. Here are some tips:

  1. Rest. Aim to keep rest and activity in balance, too much of either won’t serve you. You will be tempted to skip sleep, but don’t. Invest in this and everything will be easier. Make rest and sleep a priority and schedule it in as just as important as all the other things you are trying to accomplish. If you are rested and alert, you will be able to move through the season peaceful and focused. And don’t forget to rest your mind. This is the time when those mundane tasks like washing dishes and folding laundry can give you the microbreaks your mind needs to function well. Try practicing mindful meditation whenever you are performing these tasks. Clear your mind and focus only on the task at hand. When you are washing the dishes, be aware of the soap and the water and the fork in your hand. When your mind wanders, just gently bring it back to the task. Try to let go of the endless to do list and let your mind go blank. You will emerge with more energy and clearer thinking.


  1. Eat well. Yes, we all love the richness and decadence of holiday food, and by all means indulge! But the remainder of the time, use food to nurture and nourish your body. Make a simple, healthy pot of soup to eat during the week. Pile up on the abundance of healthy winter veggies and citrus fruits. Drink lots of water and healing teas. Think of it as your training and rest period prepping you for the marathon of delicious decadent food and alcoholic libations of the season. This goes beyond the holiday parties and dinners; how to manage that ever present barrage of temptation in the lunch room at work? Try this tip: make a small plate of all the tempting goodies in the kitchen and bring it to your desk. Go ahead, pick all you favorites. Snack from this plate instead of the plates in the kitchen, you’ll be less tempted to overeat and still get to sample all the fun!


  1. Be realistic. Don’t overextend yourself. Aim for quality, not quantity. Prioritize. You have a lot to do normally, and now in addition to your normal work and household chores and responsibilities, your events calendar ramps up. You have guests or you are traveling, managing children during the holiday breaks and hosting or attending parties. This is not the time to schedule you annual dental and eye appointments. Clear your schedule and make room. Have lunch with your friend in January, not on the day you are picking your parents up from the airport. Take a moment to really look at your invitations, and balance those that you need to attend with those that you want to attend. You don’t have to attend them all. Allow yourself to leave early if you are not enjoying yourself and stay late if you are.


  1. Accept help when it is offered and ask for help when you need it. If you are hosting parties and guests, and someone offers to help, say yes! Cooking prep is so much more fun when you have help and companionship. Let your guests help set and clear the table and do the dishes. If you are finally off your feet and resting and someone offers to fill your glass, let them! Set food up as self-serve whenever you can. Rely on your loved ones. Make holiday meals potluck or at least ask for help with food prep. If you are a guest, help in any small way you can like making your bed, tidying up after yourself and entertaining the kids. If you don’t have plans during the holidays, reach out and offer to help. Your help can be a welcome gift to those who have too much to do. Many hands make light work.


  1. Exercise. You knew this was coming, right? I know, this is when you least feel like you can spare the time, but do. Like sleeping and eating well, keeping your mind and body healthy using exercise is critical to your enjoyment of the season. If you don’t have time to work out as much as you want to, do an abbreviated version of your workout. Maybe attend your class 1x/week instead of 3. Take a twenty minute walk instead of your usual forty five minutes. If one of your houseguests likes to be active, take them on a walk with you and enjoy the conversation. If you are visiting, offer to take on some of the “to do” list so your host can go for their run. Dance while you’re doing the cleaning. Take the dog to the park. And if you don’t have holiday plans, resist the urge to binge and oversleep. Care for yourself especially well and get some form of exercise every day.