Effect of pillow height on the biomechanics of the head-neck complex: investigation of the cranio-cervical pressure and cervical spine alignment

Abstract

BackgroundWhile appropriate pillow height is crucial to maintaining the quality of sleep and overall health, there are no universal, evidence-based guidelines for pillow design or selection. We aimed to evaluate the effect of pillow height on cranio-cervical pressure and cervical spine alignment.MethodsTen healthy subjects (five males) aged 26 ± 3.6 years were recruited. The average height, weight, and neck length were 167 ± 9.3 cm, 59.6 ± 11.9 kg, and 12.9 ± 1.2 cm respectively. The subjects lay on pillows of four different heights (H0, 110 mm; H1, 130 mm; H2, 150 mm; and H3, 170 mm). The cranio-cervical pressure distribution over the pillow was recorded; the peak and average pressures for each pillow height were compared by one-way ANOVA with repeated measures. Cervical spine alignment was studied using a finite element model constructed based on data from the Visible Human Project. The coordinate of the center of each cervical vertebra were predicted for each pillow height. Three spine alignment parameters (cervical angle, lordosis distance and kyphosis distance) were identified.ResultsThe average cranial pressure at pillow height H3 was approximately 30% higher than that at H0, and significantly different from those at H1 and H2 (p < 0.05). The average cervical pressure at pillow height H0 was 65% lower than that at H3, and significantly different from those at H1 and H2 (p < 0.05). The peak cervical pressures at pillow heights H2 and H3 were significantly different from that at H0 (p < 0.05). With respect to cervical spine alignment, raising pillow height from H0 to H3 caused an increase of 66.4% and 25.1% in cervical angle and lordosis distance, respectively, and a reduction of 43.4% in kyphosis distance.DiscussionPillow height elevation significantly increased the average and peak pressures of the cranial and cervical regions, and increased the extension and lordosis of the cervical spine. The cranio-cervical pressures and cervical spine alignment were height-specific, and they were believed to reflect quality of sleep. Our results provide a quantitative and objective evaluation of the effect of pillow height on the biomechanics of the head-neck complex, and have application in pillow design and selection.

A Survey of Koreans on Sleep Habits and Sleeping Symptoms Relating to Pillow Comfort and Support

“…Participants were asked to respond to a questionnaire ( Table 1) that consisted of 32 questions designed to assess the sleep habits, sleeping symptoms, comfort and support characteristics of pillows, as well as perceptions of pillow suitability. We developed the questions about sleep habits (average sleep latency, bedtime, wake-up time, sleep duration, number of tosses and turns or waking events and sleeping position during the preceding month) and symptoms (snoring or coughing, breathing and sleepiness during waking hours) based on the Korean version of the Pittsburgh Sleep Quality Index (PSQI-K) and questions about pillow-related factors (support, comfort, fatigue, height and shape) from existing pillow studies [17][18][19][20][21][22][23][24][25][26][27]. Table 1.…”

“…Previous studies have been conducted on pillow design elements (materials, shape, contour), and pain caused by various pillow types [17][18][19][20][21][22][23][24][25][26][27]. Gordon and Grimmer-Somers [21] reported that latex materials can reduce headache and shoulder pain.…”

“…Cai and Chen [25] analyzed participant's actual sleeping positions and suggested that a pillow with a high side height could improve sleep quality. Ren et al [26] studied the importance of proper pillow height; as the height of a pillow increased, the average and highest pressure on the head and cervical spine also increased. Liu et al [27] proposed a new pillow design with a proper combination of head, neck and shoulder support to improve sleep quality.…”

Karakteristik Fisis Keempukan Bantal Berbahan Dasar Kapuk Randu

“…Bantal yang nyaman dipengaruhi oleh keempukan, ketinggian [7,8], bentuk [9,10], kemampuan menopang kepala untuk mempertahankan keselarasan tulang belakang, dan mengurangi suhu pengguna bantal [11].…”

<p>The Role of Head Elevation in Treatment of Vitreous Haemorrhage</p>

“…2 However, there are many disadvantages of elevated head position, such as inability to sleep due to uncomfortable position, neck discomfort, and daytime somnolence. 10 To the best of our knowledge, there has been no experimental study showing the benefits of an elevated head position in clearance of VH. The results of previous studies regarding this issue remain controversial and insufficient.…”