Back Clinic Sleep Hygiene Chiropractic Team. The ideal sleep environment is cool, quiet, and dark. However, research has shown that continuous sleep can be interrupted by uncomfortable room temperature, light, and noises. Proper sleep hygiene specialists may also recommend selecting a comfortable mattress, pillows, and bedding and moving or hiding a visible clock. This prevents the sleeper from focusing on time passing while trying to fall asleep. Dr. Alex Jimenez describes sleep hygiene as a variety of habits that are often necessary to achieve a proper quality of sleep to rise with full daytime alertness.
Sleep is essential for an individual’s mental and physical health and well-being because it is important in the body’s natural healing and repairing functions. Therefore, the most important sleeping measure is to maintain regular sleeping patterns. According to Dr. Jimenez, heavy meals before bed, caffeine or alcohol before bed, and even improper sleeping postures accompanied by pain and discomfort can be frequent poor sleep hygiene practices that can interfere with the sleep quality of many individuals. Sleep and hygiene articles can help provide useful insight towards improving sleep and overall health.
Getting healthy sleep can be difficult when dealing with back problems or recovering from surgery. It can be difficult, if not impossible, to get and stay comfortable long enough to sleep on a regular flat mattress. It is worth considering an adjustable bed as an alternative. Because of their lifestyle and health benefits, these beds are growing in popularity to meet an individual’s spine, posture, and sleeping needs.
Adjustable Bed
An adjustable bed can raise and lower a mattress’s orientation to different angles, allowing the upper body to rest at a slight incline, such as 30 to 45 degrees, with support under the knees as they bend at a slight angle. The body can feel better in an inclined or semi-upright position rather than lying flat. Individuals with back or neck problems or joint conditions like shoulder arthritis have reported feeling better in this position.
Features
The number of adjustments varies from model to model. Available features include:
Adjustable firmness for the low back/lumbar area.
Adjustments may be made by remote control.
Some offer massage options.
Zero gravity – NASA invented the zero gravity position to reduce pressure on astronauts during takeoff. In this position, the head and knees are raised above the heart, making the body feel weightless.
Adjustable beds are sold in single, queen, and king sizes.
Split queen and king sizes allow the settings to be customized for each side of the bed.
Benefits
Snoring
Over 90 million Americans snore during sleep.
The main cause of snoring is the blockage of the windpipe while sleeping, which can be caused by several factors, but most commonly by the weight of the neck on the windpipe, preventing the individual from breathing properly.
An adjustable bed allows for an inclined position, decreasing the pressure on the windpipe, reducing snoring, and allowing for a more relaxing sleep.
Asthma
Asthma can disrupt healthy sleep and make breathing difficult at night.
COPD and chronic lung conditions can worsen over time, impacting sleep quality.
Lying flat often irritates these lung conditions.
Sleeping with the head and feet in a raised position makes breathing easier.
Posture
Unhealthy posture causes soreness, stiffness, tightness, headaches, and other health issues.
Adjustable beds provide postural support to the spine and can improve posture and increase overall health.
Back Problems
80% of individuals deal with various back issues and symptoms.
Adjustable beds provide support and alignment to the spine by allowing the mattress to conform to the body’s contours.
This can prevent sciatica, enabling the nerves to relax and rest without added body pressure.
For those with sciatica, pain can be alleviated by using a raised leg position to take the stress off the nerves and increase circulation.
Lowering the bed up and down can help stretch the back.
Digestion
An adjustable bed can help with digestion issues.
An inclined position prevents indigestion and acid reflux and helps the body process food more efficiently.
A six-inch raise is recommended to increase digestion.
Individuals who go to bed on a full stomach should raise the incline as there is more digestive activity.
Inflammation, Swelling, and Injury Recovery
When dealing with neuromusculoskeletal injuries, doctors often recommend elevating the injured part of the body to speed up recovery.
An adjustable bed lifts or raises the mattress and elevates the limbs while maintaining a neutral/natural sleeping position.
Pregnancy
Physical and hormonal changes during pregnancy can cause back discomfort symptoms, sciatica, circulation issues, and swelling.
Pregnant women can use the zero gravity position to reduce swelling, alleviate back pain, and improve circulation.
This position also makes back sleeping safer for the mom and baby.
Individuals should research all the styles and features available to find what works for them.
Ten Benefits
References
Ancuelle, Victor, et al. “Effects of an adapted mattress in musculoskeletal pain and sleep quality in institutionalized elders.” Sleep science (Sao Paulo, Brazil) vol. 8,3 (2015): 115-20. doi:10.1016/j.slsci.2015.08.004
Söderback, I, and A Lassfolk. “The usefulness of four methods of assessing the benefits of electrically adjustable beds in relation to their costs.” International journal of technology assessment in health care vol. 9,4 (1993): 573-80. doi:10.1017/s0266462300005493
Tetley, M. “Instinctive sleeping and resting postures: an anthropological and zoological approach to the treatment of low back and joint pain.” BMJ (Clinical research ed.) vol. 321,7276 (2000): 1616-8. doi:10.1136/bmj.321.7276.1616
Verhaert, Vincent, et al. “Ergonomics in bed design: the effect of spinal alignment on sleep parameters.” Ergonomics vol. 54,2 (2011): 169-78. doi:10.1080/00140139.2010.538725
Sciatica Sleep: Poor sleep can leave the body feeling off and unable to function. Not getting the proper amount of sleep can decrease health, decrease work or school productivity, and cause burnout. If it becomes chronic, it can have serious side effects on the brain and body that include:
When sleeping, certain positions/postures can place added pressure on the spine, irritating the nerve. The best sleeping positions maintain the spine’s natural curve and are different for everybody. For example, many individuals sleep on their side. They do not start sleeping this way, but they end up on their side and wake up in pain to find their sciatica flaring up. Other individuals can turn on a specific side, and the symptoms fade or go away.
Positions
The best sleeping position for one individual may not be the best for another. A lot of this depends on the placement of the injury/pinching that can affect how certain sleep positions work, causing no symptoms, while other sleep postures generate all kinds of symptoms, especially pain. Individuals are recommended to sleep in the position that works for them, provided with the correct posture.
Side Sleepers
Side sleepers are recommended to place a pillow between their knees for healthy sleep and pain avoidance results.
A pillow between the legs helps to prevent twisting.
A firm pillow will work or a soft pillow folded in half.
It is also recommended to consider a small pillow under the waist to maintain the alignment between the ribs, hips, and the spine.
Back Sleepers
Back sleepers can benefit from a pillow under the knees to maintain a neutral curve of the spine.
This keeps the legs slightly elevated helping prevent the legs from tilting the pelvis and pulling the spine out of a neutral position.
Individuals that sleep on their back but end up on their side, are recommended to use a large pillow or body pillow placed on the side they turn on to prevent this.
Stomach Sleeping Not Recommended
Sciatic pain can become worse with sleeping on the stomach.
Sleeping on the stomach can collapse the spine and the pelvis as there is no support underneath. This causes damage to the nerves, increasing symptoms and pain levels.
Try to avoid sleeping on the stomach until the sciatic nerve has healed or try to train the body to sleep on the side or back.
Non-Surgical Spinal Decompression Can Help Sciatica Sleep Symptoms
Non-surgical spinal decompression therapy relieves pressure on the sciatic nerve, spine, and surrounding muscles by pulling/stretching them in small increments. The decompression creates negative pressure within the discs that floods the area with an abundance of nutrients to activate and expedite the healing response.
The chiropractic physical therapy team uses motorized medical equipment with sensors linked to a computer-aided system to perform the procedure.
The equipment is designed to adjust the pull force accordingly to prevent muscle resistance.
The adjustable table also allows the spine to be stretched at different angles to target all areas of the back.
Relieves Pressure On The Sciatic Nerve
Decompression stretches the nerve out and increases the space around the impinged and inflamed nerve.
Pain Relief
Decompression relieves tension in tight, spasming, or injured muscles.
Stimulates the nervous system to release the body’s natural pain killers.
Spinal tissue healing from fluids, cells, and other substances that enter the damaged tissue.
Restores Disc and Joint Alignment
Decompression realigns the joints and discs, preventing pain, inflammation, mobility/flexibility problems, and dysfunction.
Encourages Sleep
There are toxins in the body, decompression causes these toxins to be expelled.
This causes exhaustion because the body needs time to adjust after expelling the negative energy.
After a short time, energy levels will return.
The decompression relaxes the entire body which allows for more restful sleep.
DRX9000
References
Kim, Shin Hyung et al. “Risk factors associated with clinical insomnia in chronic low back pain: a retrospective analysis in a university hospital in Korea.” The Korean journal of pain vol. 28,2 (2015): 137-43. doi:10.3344/kjp.2015.28.2.137
Radwan, Ahmed, et al. “Effect of different mattress designs on promoting sleep quality, pain reduction, and spinal alignment in adults with or without back pain; a systematic review of controlled trials.” Sleep health vol. 1,4 (2015): 257-267. doi:10.1016/j.sleh.2015.08.001
Santilli, Valter, et al. “Chiropractic manipulation in the treatment of acute back pain and sciatica with disc protrusion: a randomized, double-blind clinical trial of active and simulated spinal manipulations.” The spine journal: official journal of the North American Spine Society vol. 6,2 (2006): 131-7. doi:10.1016/j.spinee.2005.08.001
Healthy sleep plays a vital role in the body’s overall health, as it ensures muscle growth, recovery, and illness prevention. This is especially true for home D.I. Yers’ fitness enthusiasts, weekend warriors, athletes, and physically active individuals. When sleeping, the body goes into recovery mode, releasing hormones and other chemicals to repair and restore muscle. A healthy night’s sleep provides the rest the mind and body need to perform at optimal levels.
Healthy Sleep
Sleep is vital for recovering from workouts. This could be construction work, exercise, gardening, sports, landscaping, any activity that uses bodyweight or works against some form of resistance. The muscles cannot repair themselves properly without proper sleep. Sleep aids the muscles in releasing protein-building amino acids, helping them grow in size and strength.
Growth hormone is released during non-REM sleep that stimulates tissue growth and repairs muscle.
During REM or rapid eye movement sleep, blood pressure drops, breathing slows and deepens, the brain relaxes, and blood supply to the muscles increases, feeding them oxygen and nutrients.
Unhealthy Sleep
Sleep maintains the muscles’ sharpness, coordination, function, and muscle movement patterns that improve physical performance. The body needs to sleep for at least 7 hours a night for muscles to grow properly. Not getting healthy sleep decreases protein synthesis activity and increases the activity of degradation that leads to muscle loss.
Less Sleep Leads To Eating More
Hormonal changes occur when the body sleeps less, causing individuals to feel hungry more often, increasing the amount of food taken in because after eating, the body does not feel full right away, so the individual continues to eat. Without sleep, the body decreases the production of a hormone that indicates when the body is full and activates a hormone that causes hunger. Insufficient sleep also lowers the body’s sensitivity to insulin. Because of this, the muscle fuel glycogen is not adequately replenished. Without the regular restoration of glycogen, individuals have less energy, insulin sensitivity decreases, increasing the risk of diabetes.
Physical Health
Unhealthy sleep also impacts overall physical health. Individuals that do not get healthy sleep have an increased risk of developing:
Sugar raises blood sugar, which triggers the pancreas to release insulin, fueling the cells causing overstimulation.
Eliminating sugar after dinner can help the body fall asleep.
References
Dattilo, M et al. “Sleep and muscle recovery: endocrinological and molecular basis for a new and promising hypothesis.” Medical hypotheses vol. 77,2 (2011): 220-2. doi:10.1016/j.mehy.2011.04.017
Morselli, Lisa et al. “Role of sleep duration in the regulation of glucose metabolism and appetite.” Best practice & research. Clinical endocrinology & metabolism vol. 24,5 (2010): 687-702. doi:10.1016/j.beem.2010.07.005
Murray, Bob, and Christine Rosenbloom. “Fundamentals of glycogen metabolism for coaches and athletes.” Nutrition reviews vol. 76,4 (2018): 243-259. doi:10.1093/nutrit/nuy001
Sleeping with a bulging disc can be challenging for the body to achieve the proper rest. And sleeping in an awkward position can add stress to the spine, making the bulge worse, which can cause tingling, numbness, pain, and digestive problems. This can disrupt the sleep cycle and prevent proper healing of the spinal injury.
Sleeping With a Bulging Disc
When sleeping, most back pain occurs in the lumbar or lower back, in one of two places where the spine meets the pelvis. Around 95% of lower back herniations happen in the L4-L5 spinal segment or the L5-S1 Lumbosacral joint. Any back pain can turn into a vicious cycle of:
Sleeping with a bulging disc requires maintaining the ears, shoulders, and hips aligned to keep the spine aligned.
Sleeping on The Back
Back sleeping done correctly is the best way to sleep for the spine’s health. The important thing is to ensure the entire back is supported when sleeping. If there is a gap or space between the mattress and the back, the weight and gravity force the spine to lower in an unnatural way to fill the space. This can cause back muscle soreness, injury, and sciatica. A thin pillow, blanket, or towel can be used to fill the space, giving the spine the support it needs. Back sleepers can also benefit from a pillow or two under the knees to elevate the legs and help maintain the natural curve of the pine.
Sleeping on The Side
Side sleepers can try pulling the legs up toward the chest, and placing a pillow between the knees can provide relief when sleeping with a bulging disc. Pulling the legs up in the fetal position can relieve pressure on the discs. It is recommended to switch sides to keep the spine balanced. This helps maintain hip alignment, which helps keep the spine in a neutral position.
Sleeping On The Stomach
It is recommended to avoid sleeping on the stomach. This pulls the spine down into an unnatural curve that can cause and exacerbate back pain. For individuals that naturally stomach sleep, it is recommended to place a pillow under the hips and lower abdomen to prevent unnatural spinal positioning.
Chiropractic Relief
Utilizing the right sleeping position can provide pain relief and thorough rest. However, sleeping with a herniated disc is far from what is needed to get back to a normal healthy sleeping pattern. This depends on the location of the bulging disc, severity, and cause. A chiropractor can:
Help the individual develop an optimal sleeping routine and positioning.
Body Composition
Sleep and Growth Hormone In Children
Growth, in all ages, is primarily controlled by growth hormone. The hormone is regulated by the hypothalamus and pituitarygland which plays an important role in sleep. Growth hormone has been found:
It peaks during the beginning of deep sleep.
There are multiple smaller peaks during the other stages of sleep.
Those who have a delay at the beginning of deep sleep have delayed rises in growth hormone levels.
For children to grow they need to have proper levels of growth hormone. This means they need to have the proper amount of sleep for proper body composition. Research has found that increased levels of sleep resulted in less overall fat mass and a reduced percentage of body fat allowing their bodies to grow.
References
Al Qaraghli MI, De Jesus O. Lumbar Disc Herniation. [Updated 2021 Aug 30]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK560878/
Desouzart, Gustavo et al. ‘Effects of Sleeping Position on Back Pain in Physically Active Seniors: A Controlled Pilot Study. 1 Jan. 2016: 235 – 240.
Kose, Gulsah et al. “The Effect of Low Back Pain on Daily Activities and Sleep Quality in Patients With Lumbar Disc Herniation: A Pilot Study.” The Journal of neuroscience nursing: Journal of the American Association of Neuroscience Nurses vol. 51,4 (2019): 184-189. doi:10.1097/JNN.0000000000000446
Sener, Sevgi, and Ozkan Guler. “Self-reported data on sleep quality and psychologic characteristics in patients with myofascial pain and disc displacement versus asymptomatic controls.” The International Journal of prosthodontics vol. 25,4 (2012): 348-52.
Individuals talk about how they don’t sleep much because they have so much to do and can operate/function on only 5 or 6 hours of sleep and are surprised when they develop serious health problems and mental health issues. However, inadequate sleep is a big deal. Depriving the body and mind of proper sleep leads to all kinds of health problems that include:
Chiropractors focus on whole-body health, are specialists in the musculoskeletal system, and take a multifaceted approach to treat fatigue and inadequate sleep. They can help with sleep problems and other health factors by bringing the body back into alignment/balance, improving circulation, nerve energy flow, and nervous system function. This includes chiropractic adjustments and therapeutic massage.
Spinal Adjustments
Misalignment of the cervical spine could be contributing to issues breathing and getting into a deep sleep.
Spinal realignment can help with better sleep.
Posture Analysis and Sleep Positions
Posture is a significant part of optimal health, especially when breathing correctly.
A chiropractor can analyze and correct any posture misalignments.
They can also advise how best to sleep, so the airway does not become obstructed during the night.
Health Factors
A recommendation for fatigue and inadequate sleep is to lose weight if overweight or obese.
A trained nutritionist or health coach can help develop healthy eating and lifestyle habits.
Less Stress and Plenty of Sleep
The combination of spinal adjustments and therapeutic massage can generate significant benefits to help keep the body healthy. Chiropractic adjustments have been found to release stress-reducing hormones like oxytocinand neurotensin. And therapeutic massage has been shown to improve inadequate sleep patterns, as well as:
Jamison, Jennifer R. “Insomnia: does chiropractic help?.” Journal of manipulative and physiological therapeutics vol. 28,3 (2005): 179-86. doi:10.1016/j.jmpt.2005.02.013
Jehan, Shazia et al. “Obstructive Sleep Apnea and Obesity: Implications for Public Health.” Sleep medicine and disorders: international journal vol. 1,4 (2017): 00019.
Kashani, Fahimeh, and Parisa Kashani. “The effect of massage therapy on the quality of sleep in breast cancer patients.” Iranian journal of nursing and midwifery research vol. 19,2 (2014): 113-8.
Kingston, Jana et al. “A review of the literature on chiropractic and insomnia.” Journal of chiropractic medicine vol. 9,3 (2010): 121-6. doi:10.1016/j.jcm.2010.03.003
Chiropractic Reset: Traveling is not an easy adjustment as it disrupts the body’s internal clock. When flying even just 3 hours, the body can start to experience symptoms like:
Fatigue
Confusion
Insomnia
Joint and muscle pain
Stiffness
Stomach problems
Nausea
Hunger
Bad mood
Not only is the flight a physical challenge, but so are the long lines, backed-up traffic, lost luggage, etc. All take a toll on the mind and body; a chiropractic reset can help restore the body’s balance and energy levels.
Jet Lag
Jet lag happens when the brain region known as the hypothalamus or center that controls sleep cycles, appetite, and temperature conflicts with travel changes. A survey from international flight attendants found that despite being used to long air travel:
90% had fatigue over the first five days.
94% had a lack of energy/motivation.
93% had broken sleep.
70% had ear, nose, or throat issues.
Scientists have estimated that it takes a full day to recover for every hour of time difference. The direction traveled can affect how intense the symptoms are since it’s easier for the body to delay its internal clock than speed it up. Traveling east is more difficult on the body compared to traveling west.
Ways To Limit The Effects
Workout
Get a thorough physical workout the day before you fly.
It doesn’t matter; it can be an hour on an elliptical machine, a mile jog, or a vigorous swim.
The objective is to get the lymph system moving to help prevent edema in the legs, hands and flush toxins from the body.
Take a Walk Every Hour
Try and get up at least once an hour for long trips and every half hour for shorter ones.
If possible, try to get a flight that gets to your destination in the evening.
Then, stay up until 10 pm local time.
If you have to take a nap, set the alarm not to surpass two hours.
Avoid caffeine and alcohol
You don’t have to go without alcohol or caffeine, but they should be cut out a few hours before sleeping.
Both can affect the ability to fall asleep, stay asleep, and the quality of sleep.
Change sleep patterns beforehand
In the week leading up to the trip, start adjusting sleep time and wake time to get closer to the new time zone.
This way, upon arrival, the body is basically adjusted.
Skip the big meal
To help the digestive system, try not to eat a massive meal upon arrival.
Allow body functions like sleep and digestion to adjust to the changes.
Bask in the sun
Daylight has a significant effect on the body’s clock.
Get outside to wake up the brain to help the body and mind adjust to the daytime hours.
Melatonin
This is a hormone in the body that helps control the circadian rhythm.
Melatonin is dependent on the amount of light the body is exposed to.
When there’s light, melatonin release is stopped.
When dark, melatonin release is stimulated.
It is recommended not to take melatonin before leaving, or it will make the jet lag worse.
Wait until landing in the new time zone to supplement one hour before regular sleep time at the new location.
Continue for three nights or until the body has adjusted.
Pycnogenol
Pycnogenol has been studied for its effect of reducing jet lag symptoms.
It reduces cerebral and joint swelling, which leads to fewer short-term memory problems, fatigue, and cardiac issues.
It has been shown to decrease deep vein thrombosis and superficial vein thrombosis, typical side effects of long flights.
Recommendations are to take three times a day for up to five days maximum of seven days after landing.
Chiropractic Reset
Chiropractic reset adjustments the day before and especially after the flight can restore balance to the nervous system and the body. This will help reset sleeping and waking patterns after the stress of flying.
Body Composition
Metabolic Syndrome
Metabolic syndrome is a name for a set of symptoms and conditions that revolve around cardiovascular health.
Obesity and a high amount of visceral fat are significant risk factors for being diagnosed with metabolic syndrome.
Body composition analysis can be thought of as a tool for understanding the approach to preventing the onset of metabolic syndrome. Knowing how to identify the risks can support individuals in making informed decisions on their healthcare journey.
References
Belcaro, G et al. “Jet-lag: prevention with Pycnogenol. Preliminary report: evaluation in healthy individuals and hypertensive patients.” Minerva cardioangiologica vol. 56,5 Suppl (2008): 3-9.
Janse van Rensburg, Dina C Christa et al. “How to manage travel fatigue and jet lag in athletes? A systematic review of interventions.” British journal of sports medicine vol. 54,16 (2020): 960-968. doi:10.1136/bjsports-2019-101635
Straub, WF et al. “The effect of chiropractic care on jet lag of Finnish junior elite athletes.” Journal of manipulative and physiological therapeutics vol. 24,3 (2001): 191-8.
Zerón-Rugerio, María Fernanda et al. “Eating Jet Lag: A Marker of the Variability in Meal Timing and Its Association with Body Mass Index.” Nutrients vol. 11,12 2980. 6 Dec. 2019, doi:10.3390/nu11122980
Many individuals do not realize the importance of the type of pillow they use for sleep. Sleeping on the wrong pillow is the perfect set-up for neck, shoulder, and back pain. Here are a few chiropractic tips on what to know about picking the best pillow. Knowing which is the right pillow for you can be the key to proper sleep and waking up pain-free.
Importance of Pillows
Neck and shoulder pain can be a nightmare, especially when the body cannot get decent rest. The right pillow/s can help with neck and back pain symptoms and recover from injuries quicker. When the head is in an awkward position for sleep duration, this causes neck, shoulder, and headache problems. The importance of finding the right pillow follows a set of guidelines.
Shape
The shape of the pillow has a definitive role in the cervical/neck’s curvature.
Posture
Sleep posture is important in preventing neck, shoulder, and back musculoskeletal pain.
Sleep quality
Craniocervical pressures and cervical spine alignment are height-specific. Any changes can affect an individual’s sleep quality.
Height
Cervical alignment can become significantly impacted by the shape and height of the pillow.
Pillow Comfort Importance
Trying to find the right pillow will require trial and error. The basics to consider include:
One sign that it’s time for a new pillow is waking up with pain.
Age of current pillows. The recommendation is they should be replaced every year or two. This depends on the stuffing/material used as different types wear down quicker.
If problems are getting comfortable and being able to fall asleep.
Constantly readjusting or fluffing the pillow/s.
The pillow has become lumpy or lost its shape.
It is flat with no cervical support or, too high placing the head in a forward tilt.
This is an online quiz along with a personalized process in their stores.
The process helps choose a pillow based on individual support preferences and sleep position for the best spinal alignment.
Customizable or adjustable pillows are another option. These pillows allow the individual to change the amount of filling to fit their needs.
Research, personal preference, and advice from a doctor and or chiropractor will help find the pillow that is right for you.
A third of an individual’s life is spent in bed. Make it as comfortable as possible.
Body Health
Sleep Body Composition Importance
Not getting enough sleep makes it difficult to gain muscle.
Not getting enough sleep means that the body experiences less short wave sleep, affecting the body’s ability to secrete Growth Hormone and develop muscle.
Testosterone is negatively affected by lack of sleep.
Not enough sleep increases cortisol levels, impairing muscle development.
Not getting enough sleep makes it difficult to lose fat.
Irregular sleep throws off the body’s ghrelin/leptin cycles, causing hunger.
Not getting enough sleep has been linked to eating more.
Not getting enough sleep can cause reductions in the body’s Basal Metabolic Rate, reducing total energy output.
“Effect of pillow height on the biomechanics of the head-neck complex: investigation of the craniocervical pressure and cervical spine alignment.” PeerJ. August 2016. pubmed.ncbi.nlm.nih.gov/27635354/
“Improving the quality of sleep with an optimal pillow: a randomized, comparative study.” Tohoku Journal of Experimental Medicine. July 2014. pubmed.ncbi.nlm.nih.gov/25008402/
“The effects of pillow designs on neck pain, waking symptoms, neck disability, sleep quality and spinal alignment in adults: A systematic review and meta-analysis.” Clinical Biomechanics. May 2021. pubmed.ncbi.nlm.nih.gov/33895703/
Okamoto-Mizuno, Kazue, and Koh Mizuno. “Effects of thermal environment on sleep and circadian rhythm.” Journal of physiological anthropology vol. 31,1 14. 31 May. 2012, doi:10.1186/1880-6805-31-14
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