Dear Dr. Suzy,   

Q.  Why is sleeping on your stomach not good for your neck and back?

A. There is no way to sleep on your stomach without putting some torque or twisting in your spine, especially in the neck region. This can be harmful to the spinal column because it puts pressure on the delicate spinal nerves over an extended period of time, and may result in stiffness, neck pain, and headaches. 

The ideal position for sleeping is on your back, with a pillow under your neck to support the cervical curve. If you sleep on your side, try to switch sides frequently and position your pillow so that your head and neck are level with the bed and not tilted at an angle. Since there is less stress on the lower back when your legs are bent, try sleeping with a pillow under your knees if you are sleeping on your back, or between your knees if you sleep on your side.  

The most important furniture investment you will ever make is buying a high quality mattress. Sleeping on a lumpy, saggy mattress for prolonged periods of time can cause serious musculoskeletal problems and result in a dramatic loss of energy.

Q. What kind of pillow should I use?  I wake up with a stiffness in my neck almost every morning and wonder if it is my pillow or my bed or if I am just getting old.

A. This is an important question since sleeping on a pillow that does not properly support your neck or causes it to tilt forward can gradually decrease the angle of the cervical curve and cause pain, stiffness and misalignment of the vertebrae over time.

There are three natural curves in the spine that naturally increase its strength and flexibility: the cervical curve in the neck, the thoracic curve in the mid back, and the lower back or lumbar curve. Just as the curve in a bridge or other structure increases its weight bearing capacity, so too, do the curves in your spine.

Loss of the cervical curve can be a result of overstretching of the ligaments, as is often seen after a serious car accident. This loss of curve can result in decreased weight bearing strength of the neck supporting the head and can cause pain and stiffness, possibly affecting vital nerve flow.

Sometimes it seems that I have been researching and searching for the perfect pillow for most of my adult life. There are a multitude of different types of cervical or neck pillows available on the market today. If you are like most people, you have tried at least a few different types, and hopefully found a pillow that you are comfortable with.

I personally have a stack of different pillows that I have given a chance and then thrown in the attic or given away. If you are still experimenting with different pillows, trying to find the perfect one, you may find the following information helpful.

As is often the case, the most expensive frequently advertised pillows aren’t always the best ones. Some people swear by Tempurpedic or memory foam type pillows that are made of a foam type material that bounces back after applied pressure is removed. I know many people who are extremely particular about pillows who say that they can’t sleep on anything but this type of pillow. A few people that I know prefer buckwheat filled pillows, but the noise they make as you are sleeping is annoying to some people.

Others prefer air or water filled pillows. The concept behind water based pillows is great, but many people find them to heavy or awkward to use. I’ll probably always experiment with pillows searching for the ideal one. At present, my favorite pillow is one that wasn’t even designed for sleeping, but rather for hugging or stress relief. Perhaps you have seen the lightweight, huggable, small roll shaped pillows covered in micro fiber type material and filled with tiny micro beads of polystyrene in drug stores or airport kiosks. I have several and prefer the more substantial higher quality versions. Since they are inexpensive, I simply buy a new one when the old one stretches out.

Also, feather pillows are ideal for providing support without being overly hard, and will conform to the contours of your neck more easily than a foam pillow. The problem with feather pillows, however, is that, often, they are simply too flat. If you are industrious, you can actually open up the seam and adjust the firmness by adding or removing more feathers until the pillow is more comfortable for you. You may even want to tie a ribbon around the middle to give it more of a butterfly shape. The procedure is a little messy, but many people have found it very effective.

The bottom line, in my opinion, is to use the first stepping stone once again and listen to the innate intelligence of your unique body rather than the marketing specialists on television.

Whenever possible, do not forget to take your most comfortable pillow with you when traveling, since hotel pillows are notoriously flat and hard, and often the cause of torticollis or stiffness in the neck region. I sometimes take a small pillow with me on extended airline flights along with a cozy scarf or wrap, since cold drafts (especially on planes and in hotel rooms) seem to frequently trigger stiff necks.