Getting a good night’s sleep

Let’s get the maths out of the way at the beginning of this piece. The average adult will spend an average of 8 hours asleep per night (of course this figure can vary wildly depending on the individual) which is the equivalent of 33% of the 24 hour cycle. Spread this over a 90 year lifespan and you are looking at 30 years tucked up in bed! This is a great deal of time to spend on one activity so you better get it right!

When looking at this length of time it is well worth putting some thought and effort into your bedding and sleeping environment. Ensuring the correct mattress, pillow, duvet, bed sheets, lighting, sound proofing and temperature is just as essential as adjusting your car seat or getting your TV to sofa viewing angle just right! We see so many patients who report poor or unpredictable sleeping patterns. Many patients will also report waking up with pain during the night or in the mornings but will not seek to make any changes to their situation or habits.

So, how to choose what is right for you? Often this can be a game of trial and error. No one mattress is perfect for you and for me. Everyone prefers a different room temperature and not everyone will enjoy listening to sounds of the rain-forest while sleeping! But, there are some general rules that you can apply to your choices.


Generally when selecting a mattress firmer is usually better. This is especially true in the case of low back pain. A nice way to test whether a mattress is good for you or not is to make three marks along your spine. The first mark at the very base of the spine, the second between the shoulder blades and the third at the base of the neck. Now lay down on your chosen mattress on your side with a pillow rested under your head. Have a friend, colleague or significant other take a picture from behind. When looking at the picture you should see that the three marks form a nice straight line with little to no deviation. Any deviation would suggest the mattress is either too hard or too soft.


When laying on your side it should also be noted that the neck should be in a neutral position and not bent or rotated to either side. A curved pillow can help to cradle the head and take undue stress from the neck. If you regularly wake up with neck pain then its worth considering this simple and cost effective change. Also, pay attention to your sleeping position. Many patients with neck pain sleep on their stomachs with their neck twisted to one side – this will unsurprisingly result in neck pain! If this is a sleeping habit you have adopted then its time to change it! I once had a patient who sewed a tennis ball onto the front of their pyjama top so that they would no longer be able to lay on their front during the night- this tactic worked very well indeed!

Always look at the SPAM acronym when choosing a pillow:

Sleep Preference- what position do you sleep in? Back, side or stomach? A side sleeper needs the higher pillow to support the space between the neck and shoulder, while a back sleeper needs to reduce the height of the pillow to allow the neck to be neutral. A stomach sleeper is always advised not to sleep in this position but when it is hard to break this habit, the lower the pillow the better.

Anatomy- side sleepers need higher pillows to close the space between the shoulder and neck. Always look at the size of your body, and try out the pillow before buying, often a person with larger shoulders will need a higher pillow compared to someone with narrow shoulders.

Material- Goose Feather? Memory Foam or soft polyester? It is usually best to invest a Memory foam pillow that won’t loose its shape and follows the contours of the neck. But regardless of the material all pillows have the lifespan similar to a shoe (after all you use it 8 hours a day!)- about 1 to 2 years, then you will need to get a replacement.

Other environmental factors:

The duvet you choose obviously needs to reflect the environment you are in. It has been shown that most (again not all!) people sleep better in cooler temperatures – around 18 degrees C has been documented as the optimum.

Ensuring a dark, quiet and peaceful environment when going to sleep is vitally important for obvious reasons. If you have noisy neighbours then invest in some ear plugs or noise cancelling headphones to help block out any background noise. 

Bed time habits can be very important. Try to keep your bed as a place to rest NOT work, watch TV or eat dinner. If you are regularly performing brain stimulating activities in the bedroom then your brain will start to associate bed time with work time and it will become very difficult for you to switch off. Are you using your phone in bed or receiving notifications all night long? Time to turn off the phone or move it to another room, and switch back to a conventional alarm clock.

Finally- make sure your room in dark. Excessive light can play a very large role in poor sleeping patterns. Our bodies require the dark in order to begin production of Melatonin which in turn helps us fall asleep. Consider black out curtains if you are disturbed by outside light before or during your sleep.

If you are struggling with sleep then come and see us for some advice and look at some suitable pillows for you at Physio Savvy!

Sweet Dreams! 🙂


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Simon Fayers

Simon Fayers

Senior Physiotherapist at Physio Savvy
Simon graduated from the University of Hertfordshire and after having experienced the NHS during three years of clinical placement, opted to continue his career abroad. He made the move to Iceland where he worked within two private clinics treating a wide variety of conditions from sports injuries to severe neurological disability. After a successful stint in Iceland, he decided to relocate to Oslo where he worked within a multi-disciplinary clinic. Now, Simon he is currently in Malaysia as the first to bring Positional Release Technique into the country.
Simon Fayers

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Posted in Musculoskeletal Disorders.