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It has always been frustrating for me to wake in the middle of the night with back or neck irritation and pain . Many times I’ll suggest a medium hard bed and sleeping on your side since studies have shown most people prefer a medium hard surface and the side position is better for back support. Sleep positions, our tossing and turning on this medium hard surface and in a side lying position can either reduce our symptoms or increase pain. The surface you sleep on is all important but just as important are the positions you lie in. A better position in the side lying posture might be to straighten the legs to where the knees and legs only have a slight bend and the back neck and head have a more normal posture as if you are standing. Now from your low back to the top of your head your posture looks as if you are standing and looking straight ahead. In the normal spine or an individual as seen from the side the normal curves are readily seen. When scientists analyse data, they are careful to observe that because one thing is associated, or correlated, with another thing — that doesn’t automatically prove that one caused the other. British scientists have found a significant association with common sleeping pill use and increased risk of cancer and death in a group of more than 10,000 people studied over a five-year period. The risk of cancer among people taking the most sleeping pills was 35% higher than those who didn’t use medication for sleep. It may be wise to think about other proven ways to ward off insomnia rather than taking that convenient little tablet.
Seems like common sense that if you regularly get good and tired from exertion and you’re not too wound up from stress, getting to sleep shouldn’t be much of a problem. And here’s a replacement Rx: invest in your sleep with the best natural mattress you can find. Pillow supports and our need for an adequate rest for the head and neck changes with age and injury.
This neutral position doesn’t matter to a bony hard head but makes a world of difference for our very flexible neck and shoulders.
There are 7 neck vetebra and 3 joints on the bottom of each of the 7 vertebra and 3 on the top of each 7 vertebra. These 42 joints need comfort just like the muscles do but how about all these other structures in the neck. Good gracious no wonder there is so much need for comfortable support and the incredible variety of bed pillows promising this support and comfort and I haven’t even started talking about the shoulders. As I theorized and finally concluded that pillows, to be adequate for most users, for most positions we sleep in, had to be designed differently than what is seen now.
Unless an exacting upward support exists to counter act this downward force of gravity, structures and their ability to compensate will be taxed to their limits and irritation occurs. Each and every segment, and there supporting anatomical components has to be supported very well. Lying on one’s back is not recommended by most health care and sleep specialists due to the risk of developing sleep apnea. If you do sleep on your back use pillows under your knees and take most of the fill from the middle compartment of your Totillow Pillow. I recommend that the fill volume and pillow position be adjusted so that the back of the head will comfortable rest on the bed itself. This better ergonomic position has the ears and head back and centered over the shoulders with the nose centered over the sternum. The side compartments on the pillow are not altered as is the center compartment fill is so the two side compartments encase the head like ear muffs.

Not everyone can have their head back on the bed as I suggest since many of us already have their head in forward posture in relation to the shoulders.
If your normal head position is forward when standing and has been that way for awhile you may want to add fill so that in the lying on the back position of the head would be similar to the posture you have during the day.
The posture I recommend if you want to sleep on your back that may be kinder to you regarding sleep apnea development is the position called Back and Side Sleep Posture Position, Part 4. Simple do’s and don’ts may help you find a comfortable position while sleeping on your stomach. It doesn’t happen often, thank goodness, but many of my patients tell me they have this problem. Medium hard surfaces appear to help people get to a deeper sleep and help them stay asleep longer.
Both the firmness of the bed as well as the shape and position of the pillow you use can make a very big difference for overall comfort and deep sleep. Those who took benzodiazepines (such as Valium), non-benzodiazepines (such as Ambien), barbituates, or sedative antihistamines (over-the-counter products such as Sominex or Z-Quil) were significantly more likely to develop cancer, or to die.
For example, although there is debate about the timing of exercise for the best sleep, in general, the more exercise you get, the less insomnia will trouble you. Moderate exercise before bed is a good idea, plus a more intense workout earlier in the day. But since we’ve become a more sedentary (and stressed) society, we have to make moving our bodies and calming our minds conscious, planned priorities. Next time you reach for a sleeping pill, ask yourself what it might feel like to lie down tomorrow night with “positive fatigue” — that pleasant, glowing tiredness you feel when your body’s been as active as your mind. Once you’re ready for bed, a comfortable, supportive mattress will help lull you to dreamland. I only found out later that this special design had to be combined with special use and posture considerations. At its core a bed pillow holds the head up, keeping it from falling to the side, falling back or front. Gravity while sleeping on your back influences the soft palate and with normal breathing the soft palate can fall closing the airway enough to cause snoring. Two of the best ways to decrease your chances of developing this disease is to loose weight and sleep on your side. In this way the fill that is left can be gathered with the pillow fabric itself and placed under the cervical spine. The neck curvature is  supported by the pillow and the head is back, lying on the bed in an improved ergonomic position.
This might be the ideal ergonomic position when sleeping on your side, back or stomach and side combined position.
We have grown accustomed to this position and to force the head back to the bed might just cause more problems then it is worth.
Have someone take a photo from the side of your head and neck while standing and another photo form the side while lying down on your back with the altered fill pillow. Many have found this position naturally and have been falling asleep in this one position for many years. I mean, really slept well, waking with new life and mentally, emotionally, physically ready for the day. The first, snoring, proceeds by many years and may predict and help develop second, sleep apnea.
I have recommended sleeping on one’s stomach to help low back pain to patients I see in the clinic. Not only is it my task to help them with their daily pain, improve their function etc but to help them reduce some of these same symptoms when they sleep.

I would avoid sleeping on your back as research has shown that back sleepers eventually have more problems with snoring and sleep apnea. I explain and ask them why anyone would like to duplicate the same postures they assumed at work while they are trying to sleep and of course the spine does have those special normal curves. His story of his painful neck for many years and years of poor sleep and how the very first night he slept 6 hours straight. The effect was significant even with relatively low use, even just 18 doses a year, the researchers found. A customized pillow adjusted by you and for you makes it easier to restore yourself with natural sleep, instead of the medicated kind.
Normally this pillow rest keeps us from tilting up or down, side to side or rotating left or right.
As I sleep on my side, each segment and other structures in my neck  must compensate for the downward pressure of  gravity. What irritation continues to grow we toss and turn constantly, consistently loosing needed sleep. My ideal bed pillow helped is all of this in any posture I choose as long as  I kept ergonomics in mind.
Snoring may increase over time causing more closure of the airways leading to less oxygen and increased likelihood of developing sleep apnea. I originally used this stomach side lying position with good results for some of my patients that had low back pain or mild sciatic pain. Snoring, especially when sleeping on your back, stretches the soft palate and the tongue, through gravity, moves backward reducing the air passageway. I would suggest a different position if your hips and knees are bent and if your back is bent forward. There is so much that can be done to relieve pain and help muscles relax with good posture awareness when awake and as we sleep. That means to consider the news along with other variables — one reassuring fact being that the overall numbers of deaths in each group were quite small.
The theory is that if the the loft and support is just right our head will rest in a neutral position. All my vertebra and muscles and joints and all those other tissues had to be supported in my way by me so I can sleep with my neck in comfort. Younger bodies can sleep most anywhere, not only do boomers have their routine before bed but, to have healthy deep sleep, many require different shaped bed pillows for comfort and support in the side sleeping position. In the image below I am not sure about the Axis of Hypochondria but they have the rest of the information correct. When we sleep and choose to lie in different postures  how do we maintain this neutral position?
Believe it or not it’s all about the mental, emotional and physical parts that need to rest. When if we find that position, for many of us, it doesn’t last long and we move again and the search continues.

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