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Barry Wahner, DC — 4931 Wissahickon Ave (near Rte 1), Philadelphia, PA 19144 — 215.842.2227

Pillow Talk
Pillows have a limited life and should be replaced regularly. If your pillow no longer feels comfortable or is lumpy, replace it. The average life for different pillow types is:

  • Foam pillows only last 6 months to 2 years
  • Fiber filled pillows last 3-5 years
  • High quality feather pillows can last up to 7 years

Sleeping without a pillow is okay for some back sleepers. To see if you are that person, try this test:

  • Stand with your back against a wall, heels against the wall.
  • Stand as straight as comfortable.
  • Now measure the space between the back of your head and the wall.

Unless your head is very close to the wall, you will need a pillow when you sleep. Your pillow should be just thick enough to fill this gap while you sleep.



Bed Time

Do you look forward to going to bed? Are you comfortable while sleeping? Do you wake up feeling rested and pain free? If the answers are “no”, “No” and “NO”, you are definitely NOT alone!

Difficulty sleeping is surely frustrating but may lead to much more than that. Problems with comfort during and after sleeping mean you have too much stress and strain on your body while in bed. It means you can’t rest and recover properly and leads to a large list of potential health issues (stress, high blood pressure, obesity, diabetes, depression are but a few).

So if sleeping comfortably is a problem, can it be solved? Yes! But it may take some money or effort to fix. Even so, it is a good investment.

In theory, you should sleep for 25% to 30% of your daily life. That is a lot of time and if that time is spent in a poor posture, or with poor equipment or environment that is time spent stressing and straining your body.

Imagine this: Would you enjoy sitting on a lumpy chair with no back support in a hot room with truck traffic driving by while watching a movie? Of course not! It would be uncomfortable, annoying and frustrating. So why try to sleep for 8 hours with any one of those issues. Yet, many people try to do just that – sleep on a poor mattress, with their head propped up on a couple of pillows with the T.V. on and a fan blowing on them.

How do you do it right? By first knowing how it is done wrong. Study the Sleep Stress Worksheet and note each specific point that relates to your current sleep habits:


Sleep Stress Worksheet

  1. Not in bed – Do you sleep on one of the following?
    • Couch
    • Floor
    • Air mattress
    • Chair/recliner
    • Other?
  2. Poor mattress – Is your mattress:
    • Too soft
    • Too hard
    • Too small or too short
    • Too Hot (a problem with memory foam mattress)
  3. Wrong pillow support – How do you describe your pillow?
    • Too high
    • Too low
    • Too old
    • Not supportiveNo pillow


  1. Poor sleep environment – is your bedroom:
    • Too hot
    • Air or fan blowing directly on you
    • Too bright
    • Too noisy

Posture – in which position do you sleep?

  1. Stomach sleeper
    • Head twisted to side
    • Arm under head
    • One leg bent at hip and rotated out to side
  2. Side sleeper
    • Hips twisted
    • Shoulder pressure
    • Head poorly supported
  3. Back sleeper
    • Propped up on too many pillows

To enjoy better sleep, take your list of issues from the sleep stress worksheet and fix or improve those issues. While you may not be able to fix them all – at least not immediately – you can certainly correct many of them.

Do you find yourself falling asleep on the couch or a recliner? Commit to going to bed a little earlier, or at the first signs of fatigue. Have a consistent bed time and follow it. On those evenings you find yourself drifting off, go to bed early. Falling asleep crunched up in a recliner then waking after a couple of hours to finally go to bed disrupts your sleep and adds stress to your body.

Does your mattress feel squishy? Can you see a “valley” where you sleep on your mattress? Can you feel any springs? Is the mattress more than 10 or 15 years old? It is time to go shopping!

Do you wrestle with your pillow – shape it, scrunch it, punch it – and still your neck is uncomfortable? Does your neck feel unsupported? Is your head out of alignment from your spine? Is your pillow more than a few years old? Retire that pillow from neck duty (you will be able to use it in other ways you will learn later) and get a new pillow. Keep your pillow in good shape by replacing it when it does not feel good or it’s time has expired (see Pillow Talk sidebar).


For environment problems, make some changes to create a darker, quieter bedroom. Darker paint colors and room darkening blinds will help. If your room is too loud, new windows, heavier draperies and carpeting will do the trick. You could also buy “white noise” machines which create background sound that cancels out other noises. Or go low tech and get a set of ear plugs – they really work!

A surprising source of problems is a fan blowing directly on you. The constant stimulation of air moving across the skin chills the area, irritates the underlying muscles and the nerve system leading to spasms and inflammation which causes you to wake with pain and stiffness. You can have a fan or air conditioner in the room, but have the air moving indirectly around you. You will still be cooled down, but will not create irritation. Is there a ceiling fan above your bed? Reverse the fan direction so it pulls the air upward. This pulls cooler air up and circulates it making the room more comfortable.

Sleep Postures
Sleep postures – here is the one area you can fix that won’t cost you money. The bad news – sleep postures are dictated by habits and habits take commitment to change.

In what posture should you sleep?
On your back:
This is the best position in which to sleep. Your back, neck and shoulders are well supported in this posture with the least amount of stress placed on your joints.
Keep your head supported on a pillow but not too many. You want your neck and head in line with your shoulders and spine.

You can use a pillow (or pillows) under your knees or thighs to keep the hips and knees bent. This reduces pressure on the lower spine joints and muscles. People with low back pain often find this to be the most comfortable position to sleep. Using pillows this way also reduces pressure on the knees and hips so if you have problems in those joints give this a try.

On your side:
This is also a good position but will place more stress on your hips and shoulders. You may need some additional pillows to help you in this position.

Side posture generally requires a thicker pillow or more pillow volume under your head to hold your head straight. Too little pillow volume and your head drops down, too much and your head is pushed up; both of which are bad.

To help keep your spine aligned in side posture sleeping try one of the following:

  • Put a pillow between your knees to keep your hips lined up
  • Hug a pillow in your arms to keep your shoulders balanced
  • Use a body pillow to lean against as you can both hug it and have it between your knees.

On your stomach:
This position is to be avoided. It contorts your spine and other joints and places significant stress on your body. When on your stomach your head is twisted to the side(damaging the neck), your low back and belly drops down (compresses the low back joints) and you generally rotate one hip out and bend the leg up to try to open up the low back joints but as a consequence twist the spine, and compact the hip.

Many people that use this position feel they can’t sleep in any other posture. The stomach sleeper likes to have pressure on their chest as it feels secure. Sleeping on the back or side leaves them feeling vulnerable. To help be more comfortable they can try to use a body pillow and hug it too them. This gives them the feeling of pressure they desire and if used while side sleeping will prevent them from rolling onto the stomach.

Even if you are an inveterate stomach sleeper, you CAN make the change to a better posture. Side posture is the easier transition. When going to bed decide to sleep in a different posture, and use pillows to help prevent rolling over. If you wake up on your stomach, just simply roll over. Don’t stress about it, just keep changing to your new position when you catch yourself on your stomach. The combination of committing to the new position, using pillows and having a good mattress and pillow can help you make the transition.

Sleep and proper rest is vital to good health. We often just accept poor sleep as unavoidable but often it can be improved. Work on your “bed time” for better sleep. Get good quality “equipment”, improve your “environment” and use relaxing postures. Your sleep quality will be enhanced, you will get better rest and you will have fewer aches and pains. The time and effort you put into your bed time will pay off with improved health and quality of life.

Dr. Barry Wahner
April 2012



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