Thanks to my colleague George Russell, DC for today’s article.

Pillow Talk

Dr. George Russell answers your questions about your most intimate bedroom companion: Your Pillow.

Dear Dr. Russell,

I am a 53-year old single man who enjoys sipping tawny Port while watching Friday Night Lights. I also enjoy sleeping on my back. Is it the Port, the limited range of FNL actors, or sleeping on my back that causes neck pain, headaches, and lost nights of sleep? Should I get one of those shaped pillows that have a little curve for your neck? 

— Tawny Tim in Texas

Dear Tim,

Fear not-I’m not going to tell you to give up your favorite spirit or TV series.  The problem is, indeed, your sleeping position. However, the chances of finding a pillow with a shaped edge that supports your neck are slim.  There’s no standard neck size, and so most special neck pillows don’t work.  One nice alternative is a small buckwheat pillow.

Buckwheat pillows are nifty because they conform to your shape and retain that shape.  So you can adjust the pillow to give yourself the neck support that’s right for you.  Memory foam pillows do the same thing, but they tend to get hot, especially in the summer.  Memory foam pillows are also relatively thin so if you turn to sleep on your side, they may not give enough support.

Regular Pillow

Buckwheat Pillow

Dear Dr. Russell,

I love my sister-in-law, but she has like twenty-six annoying habits.  Like, you know, about the pillows and stuff.  She’s all, “your pillows are giving Rodney head forward posture”, and I’m all “they are not”.  What can I do to stop her constant nagging?  

— Angry Ann at Union Square

Dear Ann,

Perhaps there is a heaven, where we won’t use pillows, and where we are permitted to smite sisters-in-law with impunity.  But until then, there are good reasons to use pillows, and there are ways to use them that don’t create posture problems.

When the chin is higher than the forehead, the neck is arched.  This wakes up the nervous system.  When the chin is slightly lower than the forehead, the neck is in a little bit of a forward bend, which is quieting to the nervous system.  Since it’s not relaxing to sleep with a protruding chin, it’s better to support the head than not to.  The truth is that the site of neck misalignment is most often not the source.

Just because you have head-forward posture doesn’t mean your head and neck are the problem.  In other words, head-forward posture may be the result of alignment issues in many other parts of the body.  If you and your husband want to work on correcting head-forward posture, you should consider seeing your local chiropractor.  I also know of some bedbug-ridden hotels with minimal pillow supplies for your sister-in-law the next time she comes to NYC.

Georgie,

This is your Aunty Ruby.  Remember when you used to run into my bedroom with that recurring nightmare of a furry beach ball with teeth?  Well, then you probably remember that I’m a side-sleeper.  Lately my neck is crimped on the lower side, plus my lower back is sore.  Now that you’re a bigwig doctor in the Big Apple, could you give your old aunty some advice?   

— Aunt Ruby

Dear Aunt Ruby:

As a side-sleeper, you should use pillows high and firm enough that your neck is parallel with the bed.  Because I recall your being broad-shouldered, you are going to need a pretty firm pillow to get enough support.  A pillow between the knees will help with low back pain, because it keeps your pelvis and hips neutral.  Oh, and I still have a recurring nightmare, only now it features a hairy suitcase with legs.

hey doc-sometimes i sleep face-up and sometimes i sleep face-down, go figure, I guess I go both ways, ha ha.  sometimes my lower back hurts. anywho, i’m about to buy a new mattress.  what kind should I go for? 

— Casual Chaz in Chelsea

Dear Chaz:

If you find that your lower back hurts when you sleep face-up (on your back), stretch your psoas before bed.  (Call your local chiropractor to show you some psoas stretches.) You could also tuck a pillow or two under your knees, thighs or calves to help lengthen your lower back. A firm mattress, or a memory foam mattress, is recommended for most people.  I don’t recommend sleeping face down and because in this position your neck and back are twisted, and one knee tends to bend way up, which really screws with the lower back. If you must sleep face down, tuck a pillow under the shoulder you’re turned away from, and lodge a pillow or two under the side of the pelvis that’s lifted.  Finally, if you sleep face-down more than you do face-up, that’s the only time when a soft mattress will be better for your back.

Dear Dr. Russell:

Lately I’ve liked my body pillow more than my husband.  Should I stop all contact with my body pillow or divorce my husband?

— Holding on in Hell’s Kitchen.

Dear Holding:

You must stop comparing your feelings for your body pillow with those for humans. My guess is that you love to sleep on your side and that your husband isn’t crazy about having you cling to him as a Koala bear hugs a tree.  Give your husband his space.  Yield to the body pillow.  Body pillows support the top shoulder and the sacroiliac joints of the low back. There is also a body pillow made to curve under your head. Enjoy the cozy fire with your husband, but after the lovin’, reach for the pillow without guilt.

Body Pillow

Dr. Lavine has been an innovator in the use of movement and touch to promote health since 1981. He practices in New York City and Princeton, NJ.