Mary Ellen Kramp

Mary Ellen Kramp

DPT

How Well Are You Sleeping?

One topic I find myself discussing with many, many people is sleeping. People just never seem sure as to what type of pillow to use or in what position is best to sleep. The one thing they all seem so sure about is that they have a firm mattress. That is one thing we all learned, right? Let me give my two cents.

Topic #1: pillows. There are many mistakes that people make with using and choosing pillows. Many people make the mistake of putting the pillow under the shoulders. This negates a lot of the support that the pillow was to provide to the head and neck. Keep the pillow just under the head and neck. Most of the support should be under the head, it is the major portion of the weight. The neck itself does not need the direct support from the pillow as much as the head. Some neck support is needed, but strain results when there is more support under the neck than the head.

If possible for your body, do not use more than one pillow under your head. Except for a few people, more than one pillow is too much. If you have breathing problems and need to sleep elevated, it is better to raise the entirety of the head of the bed and not sleep on multiple pillows.

The type of pillow you need depends on which position you sleep in. If you are a back sleeper, you should only typically need a thin pillow. You want just enough support to take any strain off your neck. Some people prefer the contoured pillows, but those work well only if you are the same size as the model they used to make that pillow.

If you are a side sleeper, the pillow needs to be thick enough to bring your neck into a neutral alignment. Not too low so the head is straining to reach the pillow and not too thick so the head is being cocked toward the opposite shoulder. Contoured pillows usually do not work as well for side sleepers, unless you have a large head compared to your neck. Again, the support needs to be mostly under the head.

If you are a tummy sleeper, you will need thin pillow or no pillow at all. You just need enough support to keep your neck aligned with the rest of your spine. If you cannot lie on your stomach with your head comfortably turned to the side, then sleeping on your stomach is not for you.

If you are someone who tosses and turns and has no one position, it becomes a bit trickier to find a good pillow. Try something that is very flexible and can be squished up for more support or flattened out for positions that require less support.

Unfortunately, it is very difficult to find out in a store what pillow will work for you. Finding the right pillow is very dependent on your sleeping position, your body size, and how your body sinks into the bed. Since you cannot bring your bed to the store and sleep on that pillow for a night or two, you may have to purchase a few pillows that will end up on the kids’ bed or in the guest room before you find the right pillow.

Topic #2: sleeping positions. As for sleeping positions, I personally feel that someone can sleep in any position that is comfortable for him/her. (And yes, I disagree with the people who tell you that you should never sleep on your stomach.) My advice is to get into a position and do a mental check of your body. See if there are any areas that you are tense and if you seem to be trying to hold in that position. If you are, change your position. If, for example, you always sleep on your left side and you find that your neck or right shoulder always seem sore and stiff in the morning, when you are in bed at night focus on your neck and right shoulder and try relaxing the muscles. If the muscles were tense and you had to relax them, you may need to alter your sleeping position. This may mean sleeping on your back, changing your pillow, or getting something like a body pillow to rest your right arm upon to relieve the tension in the shoulder and neck. Find whatever you need to do to get the muscles relaxed. That is the ultimate goal for sleeping: all muscles relaxed!

Topic #3: type of bed. This one has baffled me for years. I do not know when “firm mattress” got contorted to the point of people thinking that they needed to be sleeping on bricks. Firm should mean evenly supportive. The mattress that you bought 30 years ago when you got married and has a major sag in the middle that you have to struggle to get out of is not firm. At the other end of the spectrum, the $3000 mattress that is so firm that your body cannot relax on it, does not do your body any good, either. I have had several patients tell me that when they sleep on the multi-thousand dollar mattress they bought, they wake up in pain. But, when they sleep in a child’s bed or on the futon, they feel much better. I am a fan of waterbeds and airbeds. These types of beds you can adjust to exactly what you need. You can also try a mattress pad to put on a bed that is too firm. It may have enough give to it to allow your body to relax better at night. Just remember that you do not have to spend thousands of dollars on a mattress, or have it so firm that you cannot relax on it. The mattress should be of high enough quality to support you evenly and comfortably and durable enough that it will not be sagging in a few years.

Good luck and remember to be relaxed and be comfortable!