Many people experience neck pain the moment they wake up. If that sounds familiar, your sleep position, pillow, and mattress are all worth a closer look. While the causes of neck pain are varied and not always within your control, there are simple things you can do to lower your risk – and your sleeping position is a great place to start. Here are the best and worst sleeping positions for neck pain.

The Worst Sleeping Position for Neck Pain

Without a doubt, sleeping on your stomach is the worst position for both acute and chronic neck pain. To breathe, you have to twist your head and neck to one side, which puts significant pressure on the nerves exiting your neck. Stomach sleeping also misaligns the shoulders, which can create its own problems – and trigger points in the shoulders are a common, often-overlooked source of neck pain.

If you do sleep on your side, lie on the side that isn’t painful, draw your legs gently toward your chest, place a pillow between your knees, and make sure your pillow isn’t propping your head up too high.

The Best Sleeping Position for Neck Pain

If you suffer from neck pain, the key is keeping your neck supported through the night, which usually means sleeping on your back or your side with the right pillow. Much like finding the right pair of shoes, the right pillow makes a real difference. If you sleep on your back, choose a pillow that supports your neck without lifting your head too high (which creates forward head posture). An orthopedic or cervical roll pillow is a good option. If you sleep on your side, again, avoid a pillow that’s too tall.

A few more tips for back and side sleepers:

A feather pillow conforms easily to the shape of the neck, but it collapses over time and should be replaced about once a year.
A memory-foam pillow that contours to your head and neck is another good choice. (A chiropractor’s office can often help you find a properly fitted cervical pillow.)
Avoid a pillow that’s too high or stiff, which keeps the neck flexed all night and leads to morning pain and stiffness.
If you sleep on your side, keep your spine straight by using a pillow that sits higher under your neck than under your head.
When traveling or reclining to watch TV, a horseshoe-shaped pillow supports the neck and keeps your head from dropping to one side – just make sure it isn’t so large that it pushes your head forward.

Neck Pain Beyond Sleeping Position

Research suggests that not only sleep position but sleep itself plays a role in musculoskeletal pain. In one study, researchers compared musculoskeletal pain in 4,140 healthy men and women with and without sleeping problems – difficulty falling asleep, trouble staying asleep, early waking, and non-restorative sleep. People who reported moderate to severe problems in at least three of those four categories were significantly more likely to develop chronic musculoskeletal pain a year later than those who slept well.

One likely explanation is that poor sleep disrupts the muscle relaxation and healing that normally happen overnight. It’s also well established that pain disrupts sleep, creating a vicious cycle in which pain and poor sleep feed each other. If you’ve adjusted your pillow and position and your neck pain persists – or if it stems from an injury or a chronic condition like arthritis – it’s worth getting checked by a qualified healthcare professional.