Did you know people spend about one-third of their lives sleeping? Therefore, which type of pillow is best? It’s a question we are asked often.

Research previously into this topic was not of high quality and hence pillow prescription has largely been provided on the anecdotal suggestions of expert colleagues and professional associations. The range of advice provided by expert colleagues and pillow manufacturers was confusing for both physiotherapists and their patients. However, recent research has been done by Dr. and Associate Professor Susan Gordon, Associate Professor Patricia Trott and Professor Karen Grimmer-Somers. Associate Professor Dr. Gordon is head of the Physiotherapy Department at James Cook University. Here is what they found;

The first investigation was a random, population-based telephone survey conducted to identify the behaviour of cervico-thoracic symptoms in the community. 46% of 812 participants reported waking with arm pain (27%), headache (19%), cervical pain (18%) and cervical stiffness (17%). Of particular interest are two contrasting groups: those who did not retire with neck symptoms but woke with them, and those who did retire with neck symptoms but woke without them. This indicates that something was happening overnight that assisted to abolish or produce symptoms.

The survey also showed that most people reported sleeping on their side (72%) for most of the night so the research studied symptom behaviour associated with pillow use in side sleepers.

Participants were randomly allocated to pillows (polyester, foam regular shape, foam contour shape, latex rubber and feather). Participants kept a diary, slept on all 5 pillows for a week, with a one-week wash-out period between pillow trials.

42.5% of patients reported no symptoms when sleeping on their own pillow. However, 50% of patients reported regular waking symptoms, failure to relieve retiring symptoms, uncomfortable pillows, and/or poor-quality sleep.

Participants own pillow performed similarly to the polyester and foam pillows in terms of production of waking symptoms and maintenance of retiring pain.

The shape of the foam pillow appeared to make no difference to waking pain or the abolition of night pain. The contour pillow was less comfortable and provided poorer quality sleep and hence was less efficacious for these reasons. Contour pillows were initially developed to support the cervical lordosis when sleeping on your back however, 43% of people using contour pillows in the phone survey were side-sleepers.

The feather pillow was a consistent poor performer in all measures and therefore cannot be recommended to patients requesting a pillow better than their own.

The rubber pillow performed consistently well and was a better performer than participants own pillow in all measures and should be recommended as an alternative should people seek a better performing pillow than their own. Furthermore the rubber pillow can be recommended in the management of waking cervical pain and headache and to improve sleep quality and comfort.

Thanks to the APA for their permission in allowing us to reproduce snippets of this article for your reading MPA In-Touch Magazine Issue 3 2012. ‘Sleep On It’ pg. 16-18.