Mattresses & Sleeping Posture

Patients regularly ask for advice on which pillows and mattresses, aid  prevention of the kind problems that may bring them to the clinic seeking assistance for various back , neck discomforts and sleep disorders.

What may be the best position for sleeping is a common question. Presentations in the Practice often are in the form of a “cricked neck” or torticolis, considered by many patients as “a trapped nerve in the neck”. Symptoms may well be in the following form. “When I awoke I tried to lift my head off the pillow and could not move as the pain was awful, or, I cannot turn my head and I have pain travelling down my arm!”  When I turned over in bed and tried to stand up my “low back just went” now I am unable to stand up and I have pain across the low back.”

I will attempt here to address some of these many questions that may help.

First and foremost, Sleep is an absolute necessity, therefore get it any way you can, without quality sleep regularly a host of other ailments are likely to head your way.

Addressing the above presentations it is important to understand why they occur in the first instance, particularly why the following suggestions are presented.


Reducing likelihood of awakening with a stiff neck or trapped nerve like symptoms. This often happens after periods of extreme exhaustion, stress, illness, over exercising, a heavy night’s drinking and very often after reading on the side in a park on hot days or in bed.

My preference is to use a quality feather pillow (with an allergy cover if needed). One pillow is normally adequate, however two with slightly varying density of feathers give better options for varied positions of sleeping. Prior to sleeping I recommend turning the bottom of the pillow up to give a wedge shape which the larger part can be snuggled into the neck when sleeping on our side. This allows the Cervical spine to remain in a neutral position with the rest of the spine.

If sleeping on stomach with one arm up, one down, head to one side one knee up and the other down! Common position for many, the less dense pillow works well tucked under the neck with little that may raise the actual head up. When sleeping on the back I it can be helpful to place the pillow under the head and neck. If this makes the chin tuck in, excellent as this will traction the back of the spine opening the joint spaces. Sadly it may promote snoring.

Anatomical reasons for a neutral or straight spine are worth mentioning. When we sleep with two pillows under the side of the head we effect a tilting upwards of the head and neck. This causes the uppermost muscles attached from the Occiput, Temporal bones ( bones of the cranium/head) and cervical spine to the various ribs and lower vertebrae to slacken. These muscles rely on being in a state of constant tonic contraction. When muscles slacken  spindles within these muscles send signals to the Cerebellal part of the brain to reset the resting tone of the main muscle fibres to a shorter length. Once his happens, these muscles in their new shortened state pull joints closer together. This may irritate the area causing a responsive inflammation causing increased pressure in the area affected. Thus when turning over or getting up there may be sudden impingement of the joints, rotated or leaning neck and elevated shoulder on the shortened side. The inflammation around impinged joints presses on nerves and causing protective postures. These presentations by patients are what an Osteopath is faced with daily and may take between two and as many as four or more sessions to resolve. Hence prevention is better that cure.


Depending upon weight, shoulder and hip size, form medium firm mattresses are recommended, with a softer top layer built in. This enables the hips and shoulders to sink into the soft part without pushing the spine out of position. When this occurs there may be a bowing of the spine downwards causing again a shortening of the upper side muscles and resetting of resting length. This may lead to a lifting of the pelvis and subsequent bacl or leg issues, trapped nerve like symptoms of a sciatic nature. There also be restrictions on the twelfth rib affecting the diaphragm and subsequently breathing difficulties. All of these may not present for some time. It is an interesting coincidence that many patients begiing to share life with a partner have a tendency to sleep facing away from them. This normally means sleeping on the same side regularly. If this is the case and the mattress or pillow are not correct we very well may see you in the clinic at some future stage. Especially those sleeping in rented accommodation.

We are very fortunate to have an arrangement with a designer and producer of Organic bespoke mattresses both for adult beds and baby’s cribs and cots, particularly of use to those with allergy concerns. For more information on mattresses to suit yourself body size weight etc. Please contact for further information.