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Writer's pictureKim MacDonald MPT, DPT

How To Sleep To Prevent Neck Pain

Updated: Feb 1, 2022


neck pain sleep position

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My patients often ask me about sleeping positions and neck pain. Once I have a look at what position they are sleeping in, more often than not, that very position is the culprit of much of their pain!


A common muscle involved in sleeping and neck pain is the trapezius, particularly the upper trapezius. This muscle starts at the base of the skull and drapes down over the shoulders. It also frequently becomes tight and this tightness causes stiffness and difficulty looking over the shoulder. (It is also the one that you look for to someone to massage when your neck is bothering you!)

neck pain

Since this muscle attaches to the skull, it is also a massive contributor to waking with headaches. One of the most common ways I see people place undue stress on their neck is by reading/watching television in bed with several pillows under the head (sorry, I know it is a huge favorite). This puts extreme tension over the trapezius and promotes pain, inflammation, stiffness, and even headaches.




By having your head propped up too high in relation to your body, this puts the upper trapezius on an extreme stretch over the hours that you may be sleeping. After several hours, this muscle becomes angry and uncomfortable.



You also do not want to sleep on too flat of a pillow, as this allows your head to drop backward and this compresses the back/side of the head and neck.




When you go to sleep you want to ensure that you head is line with your body like this:



This will decrease passive stress on the muscle while you are sleeping and can prevent headaches due to neck pain.


If you need to sleep elevated, you want to have your upper back propped up, not just your head. Using a wedge pillow is a great way to keep your head elevated while protecting your neck. This pillow is an inexpensive option to trial to see if this works for you.


wedge pillow for neck pain

If you feel you need more support at the back of your neck, you can roll a towel up and place it inside your pillowcase. This will allow the curve of your neck to rest on the roll while still using your own pillow.


posture and neck pain

Ultimately, reducing the cause of tightness at the upper trapezius will have the most impact on reducing neck pain with headaches. This includes your time spent looking down on technology or a desk, sitting in a slumped position, or sitting for long periods of time doing anything.



However, since we spend many hours in one or two positions when we sleep, these positions can have a more significant impact. For this reason, you want to ensure that you are sleeping as optimally as possible.


If you suffer from neck pain and headaches upon waking or that are worse in the morning, try these tips to get yourself feeling better in no time!


Stay Well & Feel Good,




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Dr. Kim Day-MacDonald, physical therapist

Hi! I am Dr. Kim MacDonald. I am a physical therapist who specializes in empowering my patients to optimize how they move their bodies and improve their ability to do the things they love regardless of age, experience, or capabilities.

My experience in the health care field allows me to teach the tools you need to ensure that you are working safely to improve your pain and maximize your physical potential.

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