Nothing renders a good night’s sleep less effective than awakening only to discover that you have a stiff and painful neck. No matter how well you’ve slept, you’re not going feel refreshed and ready to face the day if you have morning neck pain, and you can’t turn your head without pain.

While this may be attributed to medical conditions such as slipped disks, arthritis, or injuries, there are things that can be done to ensure you are waking up either pain-free or with the least amount of neck pain possible.

According to the Spine Health Institute, waking up with a stiff neck is generally the result of one of three things: A pre-existing illness or injury, sudden movement during sleep which causes neck strain, or the most likely cause—the head and neck settled into an awkward angle during sleep which stretched muscles, ligaments, and joints beyond their comfortable limits. According to recent research, up to 5% of reported neck injuries occur during sleep.

So what kinds of sleeping positions cause these problems and are there changes we can make in our sleeping arrangements that can reduce the risk of waking up with a stiff, sore neck?

Sleep Position Predicament

According to WebMD,16% of Americans report sleeping primarily on their stomachs. Sleeping on the stomach means that, in order to breath, your head will be twisted at a side angle for hours at a time, causing muscle strain. Sleeping in this position means your spine and head will be out of alignment, causing strain that leads to damage. Sleeping this way on a regular basis will cause the damage to accumulate, putting you more at risk for chronic neck problems.

According to doctors, the best sleep positions for preventing neck pain are the side or the back. To further prevent neck pain when side-sleeping, try sleeping with a pillow between the thighs. This helps to keep the spine properly aligned.

Pillow Problem

Most people spend an average of 6 to 10 hours per night with their heads on a pillow. If you aren’t sleeping with a pillow that keeps your head and spine correctly aligned, your muscles and ligaments may be stretched into an unnatural position and then subjected to this for many hours. Your pillow should be supporting your head in a neutral position, meaning it’s aligned with your spine. A pillow that’s too high or fluffy will cause your head and neck to be tilted too far upwards, and a pillow that’s too flat will cause your head and neck to be tilted back, or downwards.

Pillows that work best for keeping the neck properly aligned during sleep are feather pillows, memory foam pillows, or special neck pillows that are specifically designed to support the neck in a proper position.

Avoid choosing a pillow that’s too deep or too stiff as these can result in your neck muscles remaining flexed overnight.

The Neck-Pain Sleep-Problem Cycle

Chronic sleep problems such as insomnia, difficulty falling asleep, staying asleep, early waking and sleep apnea can affect one’s sleeping position and muscle tension during the hours we’re meant to be enjoying rest and recuperation. This can result in waking up with a sore or stiff neck, which in turn may cause another sleepless night which then worsens the problem. This allows a growing cycle of neck pain and sleepless nights which may need to be addressed by professionals. According to a recent study, people who reported sleep problems were significantly more likely to develop chronic pain in the neck and back. 

Gentle stretching and neck massage can increase neck flexibility and loosen tight muscles and ligaments to allow for better sleep and muscle healing.

Your Mattress Matters

Because spinal misalignment is the major cause of neck pain, the pillow isn’t the only culprit contributing to morning neck pain. Sleeping on the wrong mattress can also promote curvature of the spine and neck misalignment resulting in pain. Most doctors recommend choosing a firm mattress as the best mattress for preventing neck and back pain. Firmer mattresses help to keep your back and neck aligned.

For the best possible body alignment, a mattress should be less than ten years old. If your mattress sags in the middle, it’s especially important to replace it. Doctors recommend trying out a new firm mattress by lying flat on the surface before purchasing in order to receive instant feedback on where your pressure points are and which mattress type best allows you to sleep in comfort and support.

Pre-sleep Position is Also Important

Doctors warn us that we should be certain we are properly aligned and supported in bed even before going to sleep. Many people read in bed at night, scroll through social media, or watch television. Horseshoe-shaped pillows are ideal for support while you relax in bed with that novel you’ve been wanting to read or the show you’ve been binge-watching at every opportunity.

When talking on the phone, avoid keeping it tucked between your ear and shoulder. This angle can result in neck strain.

Minimizing Further Neck Pain

Once you’ve had the unpleasant experience of waking up with a stiff neck, it’s important to keep the neck mobile, though it may be painful to consider moving it. There are several motions that can gently stretch the neck muscles to aid in returning mobility. First, extend the neck by gently looking upward while holding the back and shoulders still. Bend your head as far back as you can without increasing pain and hold the position for five seconds. Next, slowly bend the head forward, looking forward while gently lowering the chin to the chest. Hold for five seconds and then return to an upright, neutral position. Finally, gently flex the neck by tipping the head side to side, moving the ear toward the shoulder.

While it isn’t always possible to completely avoid neck pain, as it tends to increase with age and wear and tear, making a few simple changes can minimize the possibility of waking up with a pain in the neck.