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Neck Pain When Sleeping

by Jaydee Vykoukal, PT, DPT March 06, 2020 0 Comments

Woman Sleeping

Suffering from neck pain when sleeping is a common issue most of us will face at least once in our lives. How we move throughout each day can cause or aggravate neck pain. Of particular importance is how we sleep, since we spend nearly a third of our lives doing just that. Poor sleeping posture can lead to neck pain, while good posture can prevent and soothe symptoms in the neck. Keep reading to learn how to deal with neck pain when sleeping. 

How Sleeping Wrong May Cause Neck Pain

Sleeping at an awkward ankle or making a sudden movement while sleeping may cause an injury or worsen a preexisting one. A pillow that is too bulky can over-flex the neck and irritate soft tissue of the neck and joints. Whereas no pillow (or too small of a pillow) can overextend the neck and irritate the neck as well. Lastly, having the head turned to one side can lead to imbalances and stiffness in the neck too.

Spending too much time in any one position can ultimately lead to a chronic stiff neck.

Best Sleeping Position for Neck Pain

Sleeping on your back is the ideal sleep position for the entire spine, as it promotes optimized alignment. Keeping the entire spine and neck in the most neutral position possible will minimize the onset of neck pain. If this is not possible or comfortable, the next best option is sleeping on your side. Try to avoid sleeping on your stomach since turning the head to one side can be very aggravating.

The key to using a pillow is to make sure to match the pillow height with your neck position. In other words, make the pillow fit to your neck rather than the neck fit to your pillow. To gain an understanding of what a “neutral” spine is, see our guide on performing whiplash exercises.

Choosing the Right Pillow for Neck Pain

There is no such thing as the perfect pillow. We all vary slightly structurally and will find comfort in different types of pillows. No matter what you choose, it should promote a good neck position and leave you feeling well-rested in the morning. You shouldn’t find yourself waking up consistently with neck or back pain.

Feather Pillow

Traditional feather pillows are an effective option since they are easy to fluff and mold into the position you would like them to be in. Plus, many people find comfort in the innate softness of the material. Just make sure you don’t have an allergy to feathers first.

Orthopedic Pillow

These oddly shaped pillows are designed to ergonomically hold your neck and head in neutral. Typically, each side has slightly different height so that you can adjust it to your neck position depending on whether you’re a back sleeper or a side sleeper. The higher density foam that it’s made of means there is little room for adjusting the overall pillow form.

Cervical Pillow

A cervical pillow is a great option for naturally supporting the head. The built-in concavity in the middle of the pillow provides neck support and comfort. This memory foam pillow is only minimally adjustable from its original shape. 

Sleeping Without a Pillow

There is an ongoing debate as to which type of pillow, or if any type of pillow, is right for the neck. Those that support sleeping without a pillow argue that pillows innately lead to poor postural alignment in addition to issues with proper breathing and skin health. If you sleep on your back no pillow might be a good option to consider.

Ultimately, the choice should come down to the option that you are most comfortable with while maximizing the health of your neck and spine. If you aren’t sure about your posture or what pillow to use, consider signing up for a bout of physical therapy.

Tips for Sleeping with Neck Pain

Neck pain can make it feel impossible to get comfortable when trying to sleep. Here are some quick tips for getting the best rest possible to allow comfort, rest, and healing.

  • Use a travel pillow for sleeping on a plane or train to minimizing those neck-straining head bobs when you take a snooze
  • Consider the alignment of your entire spine when in bed. A stiffer, supportive mattress may be better for this. Plus, using pillows to support the legs can also help align the entire spine from head to toe.
  • Use a heating pad prior to sleep to promote pain relief and relaxation. 
  • Improve overall sleep hygiene to get adequate rest, decrease the risk of further aggravation and promote healing.  These may include tricks like reducing overall caffeine intake, exercising, keeping a consistent schedule, relaxation techniques, and removing all electronics from your bedroom.
  • If you like to read or watch TV in bed prior to sleep, avoid poor posture habits. Do not prop yourself into a poor forward slouched position. Keep your TV or book at eye level to avoid extreme neck postures.

Remedies for Morning Neck Pain

It happens to all of us from time to time. You wake up feeling sore or with a throbbing headache that you weren’t anticipating. Whether it was from sleeping funny or an activity you did the day before, here are some quick remedies to use to get you back on track and feeling better as quickly as possible.

Ice or Heat

Deciding whether to apply an ice pack or heating pad right when you wake up depends on your goals for pain relief. Typically, most people prefer heat to promote relaxation for their stiff and sore neck. However, if you notice heat or swelling in the neck, or you simply prefer ice, this is also a great option. Another great option to alternate a few times throughout your day between the two to get the benefits of both.

Alternating Hot and Cold Therapy, the Ultimate Resource

Pain Medication

When your neck hurts and you need quick relief to focus on your day, sometimes a pain pill can do the trick for short term relief. Typically non-steroidal anti-inflammatories, or NSAIDS such as ibuprofen, are the best option for addressing any inflammation and localized pain. Take them as needed for initial comfort, but proceed with caution since they do come with risk of organ damage.


Whether you self-administer, ask a loved one for a quick neck rub, or you have your massage therapist on speed dial, massage is a great way to relieve neck pain. Self-massage tools can help you reach muscle knots and trigger points or provide a more generalized neck rub (don’t forget the shoulder blades!).

The Most Effective Tools, Tips & Techniques for Self Massage

Neck Stretches

Sometimes, taking a few minutes to stretch the neck can be just enough to break up some muscle tension. It can also help your body get into a better posture for the day to prevent further aggravation. Start with simple moves like bringing one ear to the same shoulder, the chin to the chest, and/or stretching the chest.


Transcutaneous electrical nerve stimulation, or TENS, can provide temporary relief by breaking up pain signals between the neck and brain. With less perceived pain, this can give the neck muscles time to relax and recoup. Try placing the two electrodes on each side of the neck around where the shoulder and neck meet. Talk to a medical professional, such as a doctor, physical therapist, or unit rep if you are not sure how to use a TENS unit.

For more whiplash treatment options, look here.

Treating Neck Pain at Night

Neck pain is a delicate issue due to its connection to the spinal cord, brain, and upper extremity use. If you experience consistent night pain, loss of balance, difficulty breathing, chronic dizziness or changes in vision, or tingling or loss of strength in the neck and arms, contact your doctor immediately to rule out more serious issues with the neck.

Neck pain doesn’t have to be a chronic debilitating issue. By paying attention to your neck posture with sleeping and other activities throughout your day, you can promote the best possible spine health and minimize risk of neck pain.




Jaydee Vykoukal, PT, DPT
Jaydee Vykoukal, PT, DPT

JayDee Vykoukal is a Doctor of Physical Therapy, owner of the healthy habit platform Health Means Wealth, and freelance medical writer. She loves traveling and spending time with her family in nature. Her passion is helping others continue to participate in the activities they love through education and proper exercise.

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