Let’s say your day begins with a beautiful, bright day. You feel as if you had a decent night of sleep only to wake up to a terrible headache. For many working adults who balance career, family and self-care, this is terribly common when you read across each of the dimensions of wellness. You typically will process stress, a full schedule and manipulators like too much screen time as the culprits for this experience. However, another monster that is less recognized can be hiding on your shoulders. That monster is your pillow. Throughout this article, we will review the connections between sleep, pillow selection, and migraines, supported by research and ideas regarding your pillow.
How Does Sleep Influence Migraine Onset?
Sleep and migraines are intricately linked, affecting millions of individuals. One of the most common triggers to happen for all migraineurs (the group of people that have migraines) is the quality of sleep or disturbances of the quality of sleep. Studies show that migraineurs often have changed sleep architecture, including the amount of REM (rapid eye movement) sleep and stages of non-REM, and changes in sleep architecture can modulate attack frequency and intensity [1]. Further, migraines can disrupt sleep, which means pain disrupts sleep, and poor sleep increases pain sensitivity, leading to some sort of circular relationship that enhances the complexity of the surface-level sleep situation. The bidirectionality in the original model reinforces the need to improve and maintain sleep health, as it is a significant and effective modality in the prevention of migraines.
What Are Common Sleep-Related Migraine Triggers?
Research has introduced a few specific sleep-related conditions that trigger migraines. Understanding these triggers can help migraine sufferers:
- Inconsistent Sleep Schedules: Having inconsistent bed times and time woke interferes with the body’s internal clock (circadian rhythm). Even inconsistent times influences the brain’s regulation of hormones and neurotransmitters, which can lead to migraine attacks [2].
- Sleep Deprivation: Long-term lack of adequate sleep, no matter the reason, can hypersensitize the nervous system, which decreases the threshold for migraines that can begin [2].
- Oversleeping: In contradiction, sleeping too much (like on weekends or during extended vacations) can trigger a migraine. The idea of a “weekend headache” may be attributed to changes to the sleep-wake cycle and possibly regulation of neurotransmitters. Interestingly, it is also important to note, that people can get more than enough sleep, but be more tired due to “poor quality” sleep [2].
- Poor Sleep Quality: waking frequently during the night, taking long periods of time to fall asleep, and waking up fatigued [2]. When sleep has been fragmented, the brain will have missed a lot of the restorative stages of sleep and the brain will not have properly restored itself to maintain neurological balance.
Multiple additional conditions also have documented association and support for increased frequency of migraines, including by sleep disorders like sleep apneas, restless leg syndrome, and other sleeping disorders [1,2].
Can a Pillow Really Cause Migraines?
Yes. Although it is frequently overlooked, your pillow is very important in determining the quality of your sleep and your ability of support your cervical spine while resting. An improper pillow can lead to misalignment of the head and neck resulting in muscle strain and irritation to the nerves all of which have been shown in studies to contribute to tension type headaches and migraines [3]. The height of your pillow, whether it is firmer or soft and the material it is made of all affect positioning of your head and neck. Over time an incorrect pillow may result in chronic strain to the muscles and joints, worsening migraine symptoms.
How Does Poor Neck Alignment Lead to Headaches?
Correct alignment of the neck provides the natural curvature of the cervical spine; alignment not only helps to evenly distribute weight, but it also decreases muscle fatigue. Not getting cervical spine curvature support means that the neck can be bent improperly and unnaturally in the forward, backward, or side position for hours. This position creates strain on muscles and ligaments in the neck, which could cause surrounding inflammation, as well as irritate the sensitive nerves that lie in close proximity to the cervical spine. Consequently, the body could develop tension-type headaches, or migraines, from both (1) referred pain pathways and (2) sensitization of pain related to pain receptors in the neck and head area. [4]
What Role Does Muscle Strain from Improper Pillow Support Play?
One of the factors that can contribute to the development of migraines related to the use of a pillow is muscle strain. Specifically, if the pillow is too high, this forces the neck into an extended position, and if the pillow is too low, the neck is in flexion. In both instances, the neck and shoulder muscles are contracting in order to keep the head in a specific position for probably 6 to 8 hours throughout the night [5]. Eventually, after their obligations are over the contracted muscles be come fatigued and will result in a development of trigger points in the neck and shoulder muscles. Trigger points are hyperirritable spots that will often radiate pain to the head and temples. Chronic muscle tension is a common underlying mechanism for many of the headaches and migraines.
Which Sleeping Postures Worsen Pain?
Certain sleeping positions inherently increase neck strain and can worsen migraines:
- Stomach Sleeping: Sleeping on your stomach places your neck in a rotated position for long periods of time, leading to muscle imbalance and nerve compression. [5]
- Side Sleeping without Proper Pillow Support: If your pillow is too thin or thick, and your neck bends, muscles can be subjected to asymmetrical pressure. [3]
- Back Sleeping:When back sleeping, it is typically the best sleeping position to maintain proper spinal alignment. The trick is to have a pillow that supports the natural curve of your cervical spine. Having too thick, or slim, of a pillow while back sleeping could still create discomfort while back sleeping[4].
Adopting optimal sleeping positions paired with the right pillow can significantly reduce strain and decrease headache frequency.
What Are the Signs Your Pillow Might Be the Problem?
Identifying that your pillow is a migraine trigger involves watching for specific symptoms:
- Morning Headaches: Waking up with headaches that are isolated around the neck or base of your skull is a pretty good indicator that your pillow is not managing your head correctly [3].
- Stiff Neck and Shoulder Pain: If you have a morning stiff neck or some shoulder pain, this may indicate you have muscle tension from the sleep posture in which you placed your spine [5].
- Increased Sleep Quality In a Different Pillow: If it’s apparent sleeping on a different pillow (such as in a hotel or even a friend’s house) resulted in less frequent percentages of headaches, it is likely, that your normal pillow is part of the issue [3].
- Increased Percentage/Severity of Migraine: If you observe the frequency or severity of migraines worsening for no apparent reason, and notice it coinciding with nights you’re utilizing your pillow, you might like to try a different pillow [3].
How Do Different Types of Pillows Affect Migraines?
Pillows vary widely in how they support the neck and head, and some are better suited for migraine sufferers:
- Memory Foam Pillows: These mold to the shape of your head and neck, providing consistent, customized support that maintains spinal alignment throughout the night [6]. They help reduce pressure points and muscle tension.
- Cervical or Orthopedic Pillows: Designed with a contoured shape to maintain the natural curve of the cervical spine, these pillows alleviate pressure on nerves and muscles, reducing headaches and improving comfort [7].
- Feather and Down Pillows: Though soft and comfortable, they often lack firm support, potentially causing the neck to bend unnaturally during sleep and increasing muscle strain [3].
- Adjustable Pillows: These pillows allow you to add or remove filling to adjust height and firmness, enabling you to tailor support to your specific needs. They can be especially helpful for those prone to migraines [3].
- Latex Pillows: Known for their durability and moderate firmness, latex pillows provide good support with some bounce, which can help keep the cervical spine aligned [6].
How Can You Choose the Right Pillow for Migraine Relief?
Choosing the right pillow involves considering several personal factors:
- Sleep Position:
- Back Sleepers: Benefit from thinner pillows that maintain the natural curve of the neck without pushing the head forward [4].
- Side Sleepers: Need thicker, firmer pillows that fill the gap between the neck and mattress to keep the spine straight [3].
- Stomach Sleepers: Ideally should transition to back or side sleeping, but if not, need very thin, soft pillows or none at all to minimize neck rotation [5].
- Pillow Material: Memory foam and latex are recommended for their supportive and pressure-relieving properties [6].
- Adjustability: Pillows with adjustable filling allow you to customize height and firmness as your needs change or based on seasons [3].
- Trial Periods and Return Policies: Many companies offer sleep trials, allowing you to test the pillow for several weeks before deciding. This helps ensure the pillow suits your unique needs [3].
- Durability and Hygiene: Choose pillows that retain their shape over time and are easy to clean or have removable covers [3].
What Other Sleep-Related Tips Can Help Prevent Migraines?
Beyond pillow choice, incorporating healthy sleep habits can improve migraine management:
- Maintain a Consistent Sleep Schedule: Go to bed and wake at the same times daily to stabilize your circadian rhythm [2].
- Create a Sleep-Conducive Environment: A dark, quiet, and cool bedroom promotes deep, restorative sleep [2].
- Limit Exposure to Screens Before Bed: Blue light interferes with melatonin secretion, delaying sleep onset [2].
- Practice Relaxation Techniques: Meditation, deep breathing exercises, progressive muscle relaxation, and gentle stretching can reduce stress and muscle tension [2].
- Avoid Caffeine and Heavy Meals Before Bed: These can disrupt sleep quality [2].
- Address Underlying Sleep Disorders: If you suspect sleep apnea, restless legs syndrome, or insomnia, seek professional help, as these can exacerbate migraines [1,2].
When Should You Consult a Doctor?
If you experience routine, severe migraines that greatly affect your daily life or change in your lifestyle has no effect on your symptoms, it is time to contact your healthcare professional. A doctor or neurologist can uncover underlying causes and provide you with specific treatments based on your needs, such as:
- Prescription medications for migraine prevention or relief.
- Physical therapy focusing on posture and neck muscle strengthening.
- Sleep studies to diagnose and treat sleep disorders.
- Behavioral therapies to reduce stress and improve sleep hygiene.
Early intervention improves quality of life and may reduce migraine frequency and intensity over time.
Final Thoughts
Although easily overlooked, the significance of your pillow in how to manage migraines is very important. A supportive pillow offers proper spinal alignment, reduces muscle strain, and improves sleep quality, all of which are factors in migraine occurrence and intensity. While finding the right pillow takes time, the investment means that, in conjunction with good sleep habits, it is an easy, noninvasive measure to reduce migraines. When the right pillow is chosen this allows a migraine sufferer to recuperate back to a restful night and perform at a high level day in and day out.
Frequently Asked Questions:
1. Can the wrong pillow cause migraines?
Yes. An unsupportive pillow can lead to poor neck alignment and muscle strain, which are common migraine triggers.
2. How do I know if my pillow is causing headaches?
Consistently waking up with headaches, neck stiffness, or shoulder pain that improves during the day can indicate your pillow is the culprit.
3. Does sleeping position affect migraine frequency?
Yes. Sleeping positions that strain the neck, like stomach sleeping or unsupported side sleeping, increase migraine risk.
4. How often should I replace my pillow?
Typically every 1 to 2 years, or sooner if the pillow loses shape, support, or becomes uncomfortable.
5. Can a new pillow make migraines worse at first?
Sometimes adjusting to a new pillow causes temporary discomfort. However, if headaches persist beyond an adjustment period, the pillow may not be suitable.
References:
- American Migraine Foundation. (2023). Sleep disorders and migraine. Retrieved from https://americanmigrainefoundation.org/resource-library/sleep-disorders-and-migraine/
- Cleveland Clinic. (2023). Myalgia (muscle pain). Retrieved from https://my.clevelandclinic.org/health/symptoms/myalgia-muscle-pain
- Healthline. (2022). Muscle aches: Causes, treatments, and prevention. Retrieved from https://www.healthline.com/health/muscle-aches
- Mayo Clinic. (2023). Muscle pain: Causes. Retrieved from https://www.mayoclinic.org/symptoms/muscle-pain/basics
- National Center for Complementary and Integrative Health. (2022). Ashwagandha: In depth. National Institutes of Health. Retrieved from https://www.nccih.nih.gov/health/ashwagandha
- National Institute of Neurological Disorders and Stroke. (2023). Cervical spondylosis information page. Retrieved from https://www.ninds.nih.gov/health-information/disorders/cervical-spondylosis
