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White pillows and blankets unmade on a bed.

Sleep series: Pillows


Dr. Justin Sullivan, PT, OCS, CFMT

“If you’re not sleeping, you’re not healing”

I say this a lot.  When we sleep our bodies switch over from ‘go’ to ‘recovery’.  That is — if you let it.  This short article is a part of a series where I will be discussing some of the most important components of sleep.  Today, that topic is Pillows.

What to buy:

I’ll try to keep this short and sweet.  The type of pillow you need to be directly under your head is white down (not feathers).  I said down. Not down alternative, not ‘orthopedic,’ not foam, and definitely not filled with water or goo or anything else.  This does not change if you are a side, stomach or back sleeper, although the way you use it may change.  I’ll explain in a minute.  First, lets answer the most common response: “I have allergies.”  Thats OK!  You still want down…just zip it up in an allergen cover.  The pillow that I have found to be the greatest value can be found at Bed Bath & Beyond in-store.

Why Down?:

White down provides the best, most adaptable support without pushing back.  To understand what ‘pushing back’ means, push your finger into your foam pillow, then relax your finger.  See how it pushes back?  This means that the muscles in your neck are fighting that push-back all night, which does not allow for full relaxation.  Relaxation = recovery and repair.  Down alternative has inconsistent properties at best.  I won’t get into the water or goo.

When to use foam pillows:

If you are ONLY a back or stomach sleeper you can skip this section —your head only needs down.  Side sleepers: listen up.  Depending on how broad your shoulders are and how heavy your noggin is, down may not be enough and you may need more underneath.  If you’re a giant and a back sleeper, you may need this also.  To find out how thick that underneath layer needs to be, start by using a thin foam pillow and add a bath towel underneath.  Add layers until your head and neck can be supported in a straight, neutral position.

Switching positions, mattresses or pillows can take time to adjust.  Keep this in mind and experiment with variations. Next up in this series is POSITION HACKS.


Dr. Justin Sullivan, PT, DPT, OCS, CSCS, SFB, SFG


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