At last night’s Manhattan AWAKE group, someone asked about pillows and sleep apnea. There were a number of good suggestions made by Mike, including the PAPillow and Oxygen Pillow. For some reason this issue came to mind this morning, and I had this thought:
Regardless of the type of pillow, your airway is greatly influenced by your head position. If you remember the ABCs of CPR, the first thing to address is the airway, Check the mouth and then tilt the head back with the chin lifted upwards. The reason you have to position the head like this is that by extending the head, you’re opening up the airway significantly. Whenever I look at patients’ airways with a fiberoptic camera, even with a little bit of head extension, the airway can open up dramatically. With a bit of flexion (chin towards chest), the airway closes significantly. The anatomy is such that with head flexion, the epiglottis and the tongue base pulls away from the back of the throat. I’ll look through my records to see if I have any photos of this.
This is why the contour pillows can help people sleep better, by supporting the neck but lowering the top of the head lower than the level of the neck. Of course, this only works if you’re lying on your back. Sometimes even side sleepers will contort their heads so that it’s coked back.
Some Asian cultures use buckwheat, log-roll type pillows which also mimic this effect. I think this also why I hate hotel pillows, which are the typical fluffy down pillows. Instead, I roll up a towel to the perfect height, and I usually sleep very well.
What kind of pillow do you use? Please enter you answer in the comments box below.