DEAR DOCTOR K:

Most nights I fall asleep feeling fine. But I wake up in the morning with a literal pain in my neck. What can I do?

DEAR READER:

Without even realizing it, you may be putting stress and strain on your neck muscles at night. But there are steps you can take to prevent neck pain, even as you sleep.

If your neck could talk, what position would it tell you it wanted to be in while you slept? I can't tell you the answer from personal experience. But I think I know. It would say, "Please don't bend your head upward or sideways. Let it fall straight back a little."

If you don't use a pillow, try using one: You need one to give your neck muscles support. Specifically, use a pillow that supports the natural curve of your neck. If you sleep on your back, choose a rounded pillow directly under your neck, with a flatter pillow under your head. You can achieve this by tucking a small neck roll into the pillowcase of a flatter, softer pillow. Or use a pillow that has a built-in neck support with an indentation for the head.

Another option is a traditionally shaped pillow with "memory foam" that molds to the curve of your head and neck. Even better, some memory foam pillows are made especially for the neck. A larger hump of pillow is in front. That supports your neck and encourages your head to fall backward. A smaller hump of pillow is in back. When you're lying on your back, your head fits in the dip between the humps. I use one of these, and it works great.

If you sleep on your back, avoid pillows that are too high or stiff. These will keep your neck flexed overnight and can cause morning pain and stiffness.

If you sleep on your side, use a pillow that is higher under your neck than your head. The double-humped pillow works just as well for side-sleepers as back-sleepers.

If you tend to sleep on your stomach, you probably wouldn't want to hear your neck's views about that. Since it's unwise to sleep with your face buried in a pillow, given the need to breathe, you've got to twist your head. If you've been a lifelong stomach sleeper, it might be tough to switch sleeping positions now. Still, start the night sleeping in a well-supported back or side position.

Finally, reconsider reading in bed, which is tough on the neck. We have a lot more information on preventing neck pain in our Special Health Report, "Neck and Shoulder Pain." You can find out more about it at my website.

If it seems like an extravagance to buy a specially shaped, memory foam pillow, consider these two points. First, a good night's sleep is really important for your health. Second, we spend a third of our lives sleeping. Why skimp on how you live a third of your life?

(Dr. Komaroff is a physician and professor at Harvard Medical School. Go to his website to send questions and get additional information: www.AskDoctorK.com.)

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