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How To Sleep with a Stiff Neck

Written by Kristen Hamlin

Trying to sleep with a stiff neck is, well, literally a pain in the neck. Just when you think you’ve found a comfortable position, your neck starts to ache again and you need to shift and start the process all over. This continues until morning, when you finally get out of bed, still tired, even more sore, and completely unprepared to tackle your day.

A stiff and painful neck, no matter the cause, disrupts your sleep. Although some causes of a stiff neck, such as illness or injury, require medical intervention for relief, often a few adjustments to your sleep routine and the right pillow can help you get some rest.

Why Does Your Neck Hurt?

A sore neck can occur for any number of reasons. Temporary neck pain that only lasts for a few days or so is usually due to strained muscles. You might hear someone say that they “slept funny,” meaning that they slept in an awkward position that put strain on their neck. Working at a desk with your head bent down, watching television or reading in a position that strains your neck, and even grinding your teeth from stress can also cause temporary neck pain.

Sometimes, though, the cause of neck pain is something more serious, such as osteoarthritis or compressed nerves. As we age, the cartilage between vertebrae can deteriorate, often causing bone spurs to form. These bone spurs are spiny growths on the vertebrae, which can compress the nerves of the neck and cause pain. Herniated discs can also contribute to neck pain.

An injury to the neck, such as whiplash, might cause temporary or chronic neck pain. The least common, but perhaps most serious cause of neck pain is a disease like cancer or spinal meningitis. Again, these conditions are rare, and will likely have severe symptoms in addition to neck pain, such as numbness and tingling in the extremities.

Whatever the source of your neck pain, it can make getting comfortable for a good night’s sleep feel next to impossible.

Reducing Neck Pain Before Bed

Getting a good night’s rest with a stiff neck starts before you even get into bed. Taking care of your neck all day can prevent the pain before it starts — or keep it from getting worse. Assuming that your pain isn’t due to an injury or illness, making some small adjustments to your daily routine and habits can go a long way toward preventing pain. These include:

  • Practicing good posture. Stand up straight with your head over your shoulders, chest out, and stomach tucked in. Avoid slouching in your chair.
  • Taking breaks. Sitting with your head bent to look at your phone, read, work on a puzzle or needlework, or any other activity can cause your neck to feel tight. Take breaks and lift your head up, or prop your book or phone up at eye level so you won’t have to bend your neck.
  • Stretching. Throughout the day, take quick stretch breaks where you move your neck and torso in different directions to keep the joint loose.

In fact, also stretching before bed is another good way to alleviate a stiff neck and sleep better. Stretching while focusing on your breath can help you relax and release tension, reducing pain and helping improve your overall sleep quality. To alleviate the pain of a stiff neck, doctors from the Cleveland Clinic recommend a few simple stretches, including:

  • Rolling your shoulders down and back 10 times.
  • Squeezing your shoulder blades together 10 times.
  • Pushing your head backwards into your hands and holding for 30 seconds.
  • Bringing your ear to your shoulder 10 times on each side.

However you decide to stretch before bed, it’s important to stretch gently and don’t overextend yourself. Remember that you’re trying to relax, not get in a workout. Stretching too vigorously or jerking your head around can increase irritation and inflammation, making the pain even worse.

Although stretching can prevent and alleviate a stiff neck, there’s more you can do to sleep well with a stiff neck.

  • Use ice or heat. If you have an injury, ice it for the first 48 hours, and then use heat. Don’t fall asleep with an ice or heat pack, though, as it can injure your skin. 
  • Take an over-the-counter pain reliever.
  • Massage the sore area gently. A visit to a professional massage therapist can provide relief as well.
  • Use a soft neck collar temporarily, with your doctor’s approval. A neck collar can provide support, but prolonged use can actually increase weakness and pain.

The Key to a Good Night’s Sleep: Your Pillow

To prevent developing neck pain from sleeping, alignment is important. Supporting your neck with the right pillow, and supporting your lower back, hips, or knees with a pillow (the right spot depends on your sleeping position) helps keep you aligned and prevents the awkward positions that lead to pain.

If you already have a stiff neck, though, sleeping in the right position with adequate support can help you drift off without any trouble. That’s where choosing the right size, shape, and type of pillow for your preferred sleeping position and body type comes in.

According to Harvard Medical School, the best sleeping positions when you have a stiff neck are either on your back or side. Again, supporting your neck and head with the right pillow can make all the difference. If you sleep on your side, the pillow should naturally fit into the space between your head and neck for support. If you sleep on your back, choose a cervical pillow designed for extra neck support with a rounded edge to go under your neck with a flatter spot for sleeping. In a pinch, you can put a neck pillow or rolled up towel inside your pillowcase to add the extra support to your regular pillow.

Doctors often recommend high-quality, firm feather pillows for patients with stiff necks, as the feathers easily conform to your head and neck and provide plenty of support. Another option, if you’re allergic to feathers or don’t want to have to replace your pillow every year or two, is a memory foam pillow. Although more firm than a feather or down alternative pillow, memory foam will also conform to your head for plenty of support and alignment. Regardless of filling type, sleeping on a pillow that’s too soft will increase your pain, so choose a fairly firm pillow.

You may have heard that sleeping without a pillow is the best option if you have a stiff neck or consistently wake up with neck pain. That advice only applies if you sleep on your stomach, which you should absolutely not do if you have neck pain. Sleeping on your stomach causes you to arch your back and turn your neck to one side, which can lead to pain and stiffness, so if you have neck pain, it’s better to sleep on your side or back — and with a pillow.

Beyond Filling: Size and Loft

Your sleeping position and the filling in your pillow can make a big difference in how supportive and comfortable it is when you have a stiff neck, but the best pillow for neck pain also depends on your body size and the type of mattress you sleep on. In general, to reduce neck pain you should avoid pillows with a high loft (thickness) to keep your neck from flexing all night. Instead, opt for either a low (3 inches or less) or medium (3-5 inches) loft pillow for the most comfort.

A few other factors can influence your pillow choice as well, though. For example, if you sleep on a memory foam or latex mattress that provides a lot of sink, you may prefer a low loft pillow since there isn’t as much space between your neck and the mattress. If you sleep on a hybrid or innerspring mattress that doesn’t sink down as much, you may prefer a pillow with more loft for adequate support.

Your body size can also influence which pillow is most comfortable as well. Heavier individuals (those above 230 pounds) are likely to sink down into their mattress, regardless of its type,  more than someone lighter. This extra sinkage could mean they prefer a lower loft pillow, even if they have an innerspring mattress. By the same token, if you have wide shoulders and sleep on your side, you may want a slightly thicker pillow, as there will be more space between your neck and the mattress.

Ultimately, the best pillow for neck pain is the one that provides plenty of support for your neck and head, so your body stays aligned and your muscles can fully relax while you are sleeping. If you only occasionally experience neck pain, investing in a pillow with adjustable loft may be the best option, as you can add and remove filling as necessary for the perfect level of support.

Additional Resources

Need more insight into getting the best night’s sleep you can? Follow the links below to learn more: