I have a confession to make. I’m obsessed with my pillow. My wife Kathy will tell you that I’m extremely picky about my pillow, to the point where I panic if I forget to take my pillow while traveling.
There are a number of important features when choosing the right pillow, such as the dimensions, casing, firmness and filler materials.
However, there’s one feature that’s critical in choosing the right pillow: your ability to breathe properly. This is accomplished by proper neck positioning to optimize your breathing. Whether or not you snore or have obstructive sleep apnea, everyone is affected by neck positioning while you sleep.
In general, it’s important to prevent your neck from bending forward. The more you bend your head forward, the more narrow the space behind your tongue (see figure below). The more you bend your head back, the more open your airway. A good pillow has to provide enough support while lifting the head above the mattress, while simultaneously keeping the vertical line of the head parallel to the mattress. Imagine how you will lean forward to smell a rose, with your entire head and neck pushed forward with a slight tilt of the head upwards.
The “contour” pillow is one solution to this problem. Typically made of memory foam, it provides more support at the lower edge of the pillow at the level of your neck, and less support at the top of your head, tilting your head back slightly. These pillows are also touted to be ideal for proper spinal alignment, and to avoid pain or stiffness.
Bonus Tip #1 for Better Sleep
Regardless of which pillow type you use or sleep position you prefer, if you sleep with your mouth open, you’re more likely to have obstructed breathing and keep waking up. Opening your mouth will cause your tongue to fall back in your throat. Chin straps can be used with success in some people. Others find success by taping the lips closed. Needless to say, you have to be able to breathe properly through your nose for this to work.
3 Potential Problems with Any Good Pillow
You can start off in the proper position, but as the night progresses, you’ll slide down lower on the pillow, which will tend to produce a forward tilt of your head, leading to upper airway narrowing. Typically, you’ll wake up and have to readjust your pillow.
Especially with memory foam, body heat will soften the pillow to lose the support that’s given at your neck level, leading to your neck tilting forward.
Side or stomach sleepers won’t get any benefit from contour pillows, since you need the benefits of gravity to allow this pillow to work properly.
These concepts will apply to any type of pillow, regardless of filler materials. However, side and stomach sleepers may still benefit since the side of your head may make an impression in the memory foam, preventing your head from tilting forward while you sleep.
Bonus Tip #3 for Better Sleep
Do You Hate Hotel Pillows? If you don’t have the luggage space to carry your favorite pillow, create a makeshift roll-type pillow by rolling up a large towel and place it under your neck.
My Personal Pillow Experiment
For years, I used a typical memory foam contour pillow since I like to sleep on my back. It was much better than most other types of pillows I tried, but not perfect for the first two of the three reasons mentioned above. To remedy these two problems, I cut a hole down the middle of the lower edge of the pillow from side to side, and inserted a wooden dowel to stiffen the center part of the cervical or neck area. This definitely helped with the pillow softening problem, but not as much with the sliding down issue.
This worked for a while, but now the pillow kept sliding up my bed, losing the benefits of neck extension. To remedy this, I placed a small rectangular box between the pillow and the headboard to prevent upward migration of the pillow. So far, so good.
About a year ago, during an inventory of bedroom materials that can potentially be toxic, we decided to switch to a traditional Korean roll-type pillow filled with buckwheat hulls. I do remember sleeping very well with this type of pillow when visiting my relatives in Korea many years ago. The advantage of buckwheat is that it’s organic, breathable, stays cool, and holds its shape more effectively. It fits nicely below my neck, giving me an ideal breathing position.
I then experimented by making my pillow stiffer by adding more hulls. This seemed to help somewhat more, but I was still readjusting the shape to mold up the part of the pillow under my neck. Finally, I placed a long wooden dowel in the middle of my pillow, like what I did with my memory foam pillow.
Bonus Tip #2 for Better Sleep
Many people naturally extend that head back while sleeping on the side or stomach, to improve breathing. We see this quite often in young children. But you can’t always keep your head from tilting forward. One simple experiment you can do is to sleep with a soft cervical neck collar.
When Pillows Don’t Solve Your Sleep Problems
Choosing the right pillow can definitely help some people sleep better. But there will be others that can’t get a good night’s sleep no matter how many pillow are tried. Your problem may not be due to your pillow, or even your mattress. Muscle relaxation during deeper levels of sleep can lead to obstructed breathing, no matter how your head is positioned. At this point, it may be time to see a sleep doctor to see if you have obstructive sleep apnea or upper airway resistance syndrome.
What is your favorite pillow? Please tell me your pillow story in the comments area below.