Choosing the Perfect Pillow

With neck pain a common symptom of migraine and disturbed sleep a common migraine trigger, it isn't surprising that most migraineurs appear to be on a never-ending search for the perfect pillow. Though I cannot recommend the perfect pillow to solve everyone's woes, here's what I've learned over the years from doctors, chiropractors, massage therapists and physical therapists.

Basically, you want to have the same good posture when you're sleeping as when you're standing up. Which means that the first and most important consideration when choosing a pillow is the primary position in which you sleep.

If you sleep on your back, your neck should be supported and your head shouldn't be raised too high. A soft or thin pillow works well for back sleepers. One that has support for your neck, like a molded memory foam pillow achieves this goal. A cervical pillow, which is a round tube of a pillow that only goes under your neck works well, too. You can test out neck support by rolling up a towel and sleeping on that to see how it feels. This isn't the ideal solution as it flattens out throughout the night, but is a good way to try it before spending money on yet another pillow.

Side sleepers need a pillow that will fill the space from their shoulder to their head, keeping the neck at the proper alignment. The filling needs to be of medium to firm density to hold up your head all night. If you're at a store that doesn't have a place to test pillows lying down, you can stand against the wall and tuck the pillow between your head and the wall. Just remember that your shoulder compresses some when you lie on it. It is helpful to bring someone shopping with you to tell you if your neck looks like it is aligned properly.

As far as I can tell, stomach sleepers are out of luck. Unless you sleep with your face in the cradle of a massage table, there's no way to sleep on your stomach without wrenching your neck.

Once you've decided on density, pillow material is an individual choice. There's no one best material -- what matters is find one that's comfortable for you. If you are sensitive to odors, be sure to smell pillows, especially those made of synthetic material, before buying one. Many stores do not accept returns on pillows for hygienic reasons.

I know many a migraineur with a pillow graveyard in their guest rooms. I'm one of them: water-filled, down, synthetic down, buckwheat, latex, wool, memory foam, fiberfill, microbeads…. I've spent a small fortune trying them all. I continually return to lumpy synthetic fiberfill for side sleeping and use a cervical roll when sleeping on my back. It is not ideal, butis the best I've come up with.

Have you found a wonderful pillow that allows you to sleep well and wake up without neck pain? Please share!

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