Sleeping with Neck Pain: What Your Pillow Might Be Doing Wrong

There’s nothing worse than going to bed hoping for rest, only to wake up with a stiff or sore neck. Sound familiar? You’re not alone. Morning neck pain is a common complaint—and more often than not, your pillow could be playing a bigger role than you think.

At Physio Performance, we see a lot of people who feel fine during the day but wake up feeling like they’ve slept in a headlock. The good news? A few simple changes can make a big difference to how your neck feels each morning.

Let’s break down how your pillow—and the way you sleep—might be affecting your neck.

Why Does Neck Pain Happen During Sleep?

While you're sleeping, your body is meant to be resting and recovering. But if your head and neck aren't properly supported, your muscles stay tense instead of relaxing. Over time, this can lead to tightness, discomfort, and even inflammation.

The problem often comes down to one thing: alignment. If your head is tilted too far in any direction for several hours (which is exactly what happens when you sleep), your neck muscles can strain and your joints can become irritated.

And once that morning stiffness sets in, it can be hard to shake off.

Your Pillow: Friend or Foe?

Most people don’t give their pillow much thought—until it starts causing issues. But your pillow plays a huge role in maintaining neutral neck alignment while you sleep.

Here are a few common pillow problems we come across at Physio Performance:

1. Too High or Too Flat

If your pillow is too thick, your neck bends unnaturally upward. Too flat? It drops downward. In both cases, your muscles and joints are stretched in awkward ways for hours on end.

The result? You wake up with stiffness, aches, and that all-too-familiar need to stretch your neck as soon as you sit up.

2. Too Soft or Too Firm

Soft pillows can collapse during the night, offering little to no support. On the flip side, overly firm pillows might push your head up too much or feel rigid under your neck.

The sweet spot lies in a pillow that gently supports the natural curve of your neck without forcing it into a new shape.

3. Wrong Shape for Your Sleeping Position

The best pillow for you also depends on how you sleep:

• Back sleepers need a thinner pillow with a gentle neck curve.

• Side sleepers need a thicker, firmer pillow to fill the space between their shoulder and ear.

• Stomach sleepers (we hate to say it) are in the trickiest position—this posture twists the neck for hours and often leads to pain. If you’re a stomach sleeper, it’s worth trying to transition to your side or back.

Signs Your Pillow Might Be Causing Problems

Not sure if your pillow is the culprit? Here are a few red flags:

• You wake up with neck pain or stiffness that wasn’t there the night before

• You constantly fluff or fold your pillow to feel more comfortable

• You get headaches that seem to start in the morning and ease throughout the day

• Your shoulders or upper back feel tight after a night’s sleep

What Can You Do?

Here’s where we can help. At Physio Performance, we regularly assess sleep habits as part of our neck pain management. Because if you’re spending 6–8 hours in an unhelpful position each night, no amount of stretching during the day will undo it.

Our approach includes:

• Neck mobility and strength assessments to understand how your body is functioning

• Advice on pillow selection based on your sleep position and body type

• Targeted exercises to reduce stiffness and strengthen postural muscles

• Education on ideal sleep positioning to prevent future flare-ups

We don’t sell pillows—but we do help you choose one that suits you.

The Bottom Line

Neck pain doesn’t always start during the day. Sometimes, the root of the issue is right under your head while you sleep. If your mornings are starting with discomfort or tension, it’s worth looking at your pillow, your posture, and how your body is being supported through the night.

And if you’re not sure where to start, we’re here to help.

Book a session with Physio Performance today and let’s make your mornings more comfortable—starting tonight.