Neck pain is one of the most disabling and common musculoskeletal conditions globally. Also, having a sore, stiff, or painful neck can make it difficult to sleep.

Read on to learn about the best positions for sleeping with neck discomfort or pain, and other ways to seek relief. This article also talks about ways to help prevent neck pain and when to contact a doctor.

Back of woman as she lies in bed on a pillow trying to sleep with neck painShare on Pinterest
Image credit: Lumina Images/Getty Images

Improper cervical spine posture, particularly during sleep, can cause several health problems. Seven vertebrae make up the cervical spine, the neck region of the spinal column.

Conditions associated with poor cervical sleeping posture include:

  • neck pain and stiffness
  • shoulder blade or arm pain
  • low quality sleep, which can lead to reduced cognitive functioning and mood while increasing physical discomfort
  • headaches

Sleeping in a position that avoids putting pressure on the neck or shoulders can usually help reduce neck pain and improve sleep. Research also says that to reduce excess pressure and pain, the spine should be in a neutral position or similar to how it is when upright.

According to a 2017 study, when someone with neck pain is lying down to sleep, they should try the following:

  • Back sleepers: Sleeping on the back is one of the best sleeping positions for people with neck pain. It is important to try to maintain normal spinal curvature when lying flat on the back. Sleeping with both hands by the sides or on the chest may also reduce morning pain and stiffness.
  • Side sleepers: Sleeping on the side is another good sleeping position for people with neck pain. Aligning the neck and abdomen regions of the spine can help reduce pressure on the cervical facet joint, stabilizing the neck and allowing it to move freely.
  • Stomach sleepers: Avoid sleeping on the stomach to reduce prolonged strain on the neck in one direction. If a person must sleep on their stomach, they can use a very thin pillow to prop up the forehead and create a more natural angle for the neck.

However, switching up one’s regular sleeping position can be tricky. Most people establish their preferred sleeping positions early in childhood.

Many people also think they sleep in one position, but they spend more time in other positions than they are aware. Some people may go to bed in one position and wake up in a completely different one.

People who have a difficult time controlling or changing their sleeping position can use supportive structures, such as soft props or pillows, to make it easier to stay in a desired position. For example, to avoid rolling over, a person can put a firm, raised pillow behind the back.

Using pillows to support the arms while sleeping on the side or back may also help reduce neck strain and pain. A person can also try placing a pillow between their knees if they are sleeping on their side, or under them if they are sleeping on their back, to reduce spinal strain or pressure.

Using pillows and mattresses specially designed for people with neck pain or discomfort can often help reduce neck pain and make it easier to sleep.

When it comes to picking a pillow for neck pain, the most important feature is that it fully supports the neck.

According to the American Sleep Association, feather or memory foam pillows offer excellent support.

A 2019 study found that using a viscoelastic polyurethane memory foam pillow while undergoing chiropractic treatment was more effective at reducing neck pain than chiropractic treatment alone.

The design of cervical pillows helps reduce neck strain and pain. People with neck pain should also pick thin, low profile pillows that do not elevate the head too much.

Other considerations depend on what position a person tends to sleep in.

Back sleepers

People sleeping on their back should make sure their pillow does not tilt their head forward but that the head and neck are relaxed. They may consider getting a pillow specifically for back sleepers.

Side sleepers

People who sleep on their side should pick pillows that are thick enough to keep the head and neck in line but not so thick that they tilt the head up or down.

When a person is sleeping on their side, their pillow should only fill the empty space between the mattress and the ear. Side sleepers may also benefit from a cervical pillow, which cradles the head and neck.

They may consider getting a pillow specifically for people with neck pain.

People with neck pain may wish to look for a mattress that offers full support to the entire spinal column without any sagging or pressure points.

It is also important to pick a mattress that is large enough to allow a person to move freely while they sleep.

A firm mattress may also be best for people with neck pain. However, they should make sure not to choose a mattress that is so firm it creates hard pressure points, especially at the hips or shoulders.

Learn more about how to pick the right mattress here.

In most cases, a person can relieve or reduce their neck pain with home remedies, such as:

  • taking over-the-counter pain medications or muscle relaxants
  • applying cold packs or ice wrapped in a cloth for 5–20 minutes three times per day
  • applying a heated bag or hot water bottle wrapped in cloth for 20 minutes two to three times per day
  • avoiding engaging in activities that put excessive strain or pressure on the neck, such as vigorous exercise or sports
  • doing gentle neck exercises
  • consulting a physical therapist
  • doing light exercise, such as yoga, swimming, or tai chi

Not all causes of neck pain are preventable, but many are.

Here are a few ways to help prevent neck pain and a few habits to avoid.

What to do

  • Sit upright with the shoulders rolled back and neck slightly back.
  • Stretch the neck regularly.
  • Exercise regularly to maintain flexibility and reduce stiffness.
  • Always wear a helmet while riding a bicycle or motorized vehicle where the head is exposed.
  • Wear a seat belt in a moving car.
  • Wear suitable protective headgear during exercise and sports.
  • Place the computer screen arm’s length away at a height where the top of the screen is at eye level.
  • Hold mobile or music devices at eye level when looking at them.

What to avoid

  • Avoid limiting movement too much, which may cause stiffness.
  • Do not sit or stand in the same position for too long.
  • Avoid twisting the neck while sleeping.
  • Do not sleep on the stomach.
  • Do not dive into shallow water or water of an unknown depth.
  • Avoid cradling a phone between the ear and neck.

A person should seek guidance from a doctor whenever neck pain becomes chronic or severe or interferes with sleep or daily activities.

A person should also consult a doctor if their neck pain:

  • does not improve with basic care
  • lasts longer than 1 week
  • occurs for no clear reason
  • occurs after injury, including a blow to the head or neck

Other symptoms to watch for

A person should talk with a doctor if they have neck pain with one or more of the following symptoms:

  • arm pain, especially if it is shooting down one arm
  • unsteady gait while walking
  • muscle spasm or weakness in the legs
  • loss of muscle tone in arms, hands, or both
  • dropping items or loss of hand dexterity
  • numbness, tingling, or weakness in the hands and upper extremities
  • fever or headache
  • neck stiffness that makes it difficult to touch the chin to the chest
  • loss of coordination in the legs, arms, hands, or fingers

If symptoms are severe or progress quickly, a person should seek emergency care from a doctor or neurologist.

About 20–70% of people in the United States experience neck pain during their lifetime. This can reduce sleep quality and cause a wide range of negative health consequences.

People with neck pain may benefit from sleeping on a fully supportive, firm mattress and using a supportive pillow.

Some pillows specially designed for neck pain, such as a cervical pillow, may also help reduce symptoms.

A person should speak with a doctor about neck pain if it is severe or unexplained, interferes with daily life or sleep, does not respond to basic treatment, lasts longer than 1 week, or comes with other concerning symptoms.