
Is there a proper way to lay on a pillow? The answer is yes! Keep reading to make sure you are using your pillow correctly!
There are seven cervical vertebrae in your neck. When lying down, it is critical that every single vertebra be supported. For the vertebrae to be completely supported, two things need to happen:
- Your neck pillow needs to be the correct height
- Your neck pillow needs to be in the correct position
Height of a neck pillow
The correct way to lay on a pillow has a lot to do with the pillow height. If the pillow is the wrong height, it can cause your neck and upper back to hurt. The pillow should be high enough and dense enough to support your head and neck fully.

How do you know if your pillow is fully supporting your head and neck? When lying down, you should be able to draw a straight line from the center of your forehead, through your nose, chin, and sternum. If your pillow is too high or too low, your neck will be resting at an angle.

When you sleep with your neck at an angle, it puts stress on your neck muscles, ligaments, and joints. This can lead to or exacerbate temporomandibular joint dysfunction (TMD) and neck pain. It can also cause headaches or migraines.
Position of a neck pillow
The correct way to lay on a pillow also has to do with the position of the pillow. If the pillow is too far away from your shoulder, the lower cervical vertebrae are not supported. This means that while you sleep, gravity pulls on the unsupported vertebrae and muscles.

Sleeping like this causes your neck muscles and joints to bend. This can mean waking up with neck stiffness and pain. Sleeping in this position consistently can lead to even more serious neck issues.

The pillow should also be deep enough to hold your entire head. You do not want any part of your head hanging off the top of the pillow. If it does hang off, gravity pulls down on your head which can lead to neck pain and stiffness.
The proper way to lay on a pillow is to place a pillow that holds your entire head, right up against your shoulder. There should be no space between your shoulder and your pillow. This ensures each cervical vertebra is supported.
Correct way to lay on a pillow
Once the pillow height, density, and position are correct, it’s time to lie down. When you lie down, do not put your arm under your pillow. You want to avoid lying on your arm or hand in any way.
If you feel like you need to lie on your arm it can be a tell-tale sign that your pillow is not supportive enough. People often find this position comfortable because their arm offers their head additional support. However, the additional support needs to come from a pillow, not your arm.
Sleeping on your arm can lead to TMJ issues. Your jaw is a delicate joint and sleeping on a hard surface like your fist or arm puts too much strain on this tiny joint. Sleeping like this also gives an unbalanced amount of support to the joints in your neck and can lead to stiffness and pain when you wake up in the morning.
Additionally, it can lead to shoulder and arm pain. Your shoulder was not designed to hold your head and neck up all night. Or to be compressed all night. Let your pillow do its job, don’t pass it off to your arm!

When you lie down on your pillow, your shoulder and elbow should be resting at a 90 degree angle on the outside of your pillow. The pillow should be supporting each of your neck vertebra and holding your head so your neck is straight and not angled.
The correct way to lay on a pillow for back sleepers
Back sleepers follow the same pillow positioning principles as side sleepers. A back sleeper should position their pillow up against their shoulders to fully support their neck. When the pillow is pulled up against the shoulders, it supports the natural curve in the neck. The pillow should be high enough and dense enough so your chin rests perpendicular to the bed. Your chin should not be angled up or down.
Contoured neck wedge pillow
A contoured neck wedge pillow is an excellent pillow option for side and back sleepers. It fully supports the vertebrae in your upper spine and supports the entire weight of your head. It matches the natural contour found in your neck and provides the maximum amount of comfort and support.
Learning the proper way to lay on a pillow is a crucial step on the journey to sleeping comfortably!
-Hillary Blare, Doctor of Physical Therapy