Getting a good night’s sleep is essential for people living with migraine. But that may be easier said than done, especially if your pillow makes sleeping harder.

“I feel like my pillow may be causing me to get headaches,” one MyMigraineTeam member said. Another replied, “When a headache wakes me in the middle of the night, it’s usually my pillow.”

Keep reading to discover how sleep, migraine, and pillows are all connected — and whether any specific pillows can help ease migraine attacks.

How Are Sleep and Migraine Connected?

Sleep and migraine have a bidirectional relationship. This means that sleep can affect migraine, and migraine can affect sleep.

Sleep Quality and Migraine

Many people who experience migraine attacks have a hard time falling asleep or staying asleep. Others wake up in the morning with a migraine headache to start their day. Any of these events can affect the quality of the sleep you’re able to get.

Not sleeping well can also be a trigger for a migraine attack. Researchers have found that poor sleep quality is a risk factor for developing migraine. Newer research suggests that sleep problems may be a feature of migraine disease itself, and not just as the result of having a migraine attack.

The Role of Neck Pain

Neck pain is common among people who experience migraine attacks. A review of clinical studies showed that 77 percent of people with migraine also have neck pain (compared to 23 percent of people without migraine).

Neck and shoulder muscle tension can sometimes trigger a migraine attack or make an existing migraine pain feel more intense. If a pillow can help to reduce neck pain, it may be able to reduce one potential trigger for a migraine attack.

Does Sleep Position Matter?

Sleep position can affect how well your body is able to rest during the night. If you have joint pain, acid reflux, or sleep apnea, your sleep position likely affects your ability to get a good night’s sleep. This, in turn, can affect your migraine symptoms.

Can a Migraine Pillow Help?

Since sleep matters for people who experience migraine symptoms, anything that can improve sleep quality can potentially help with migraine management. Pillows are a key part of your bed setup that could help or hurt your sleep. Research has found that pillow selection can affect neck pain and sleep quality, two things that are related to migraine symptoms.

What Is a Migraine Pillow?

A migraine pillow is designed to address factors that may contribute to migraine attacks. Key features include:

• Adequate support for your head and neck to maintain neutral alignment of your spine
• A good loft (pillow height) based on your sleeping position
• Not having an odor, as smells can be a migraine trigger (you’ll also need to clean or replace your pillow often enough so it doesn’t develop a smell)
• Temperature regulation or cooling properties to prevent overheating, since heat can also trigger a migraine attack
• Adjustable firmness, which can help when you need something firmer or softer at different times

Pillow Material Options

Another factor to consider is the material of the pillow. One research study compared polyester, foam, feather, and latex pillows in relation to symptoms like neck stiffness, headache, and arm pain. The latex pillow had the best results when it came to improving headache and arm pain upon waking.

MyMigraineTeam members have found success with a wide range of pillow materials. “What makes sleeping more comfortable for me involves using large memory foam pillows,” one member said. Another replied, “I use a buckwheat pillow (nonallergenic and good neck support).”

A migraine pillow will likely incorporate several features, versus a general sleep-supportive pillow, cervical pillow, or cervical roll that may only focus on one area. You may need to experiment with different styles and materials to find which one is right for you.

Who May Benefit From a Pillow Change?

Are you thinking it might be time to change pillows? There are a few reasons you might want to think about switching your pillow setup.

People With Neck Pain or Stiffness

If you wake up and feel like it’s hard to move your head and neck around, it might be partially due to your nighttime sleep setup. A supportive pillow can help put your neck in a more neutral position and reduce some of the stress on your joints that can lead to pain and stiffness.

People With Poor Sleep Quality

Poor sleep quality can fuel migraine symptoms. If your smartwatch is telling you your sleep quality needs help, or if you often wake up just knowing it was a rough night of sleep, a pillow change might be just what you need.

Finding a comfortable pillow can make it easier to fall asleep and get a good night of rest. By putting your body in a more comfortable position, a new pillow might help reduce the number of times you wake up at night.

People Who Wake Up With a Morning Migraine

In the study examining pillow types, the latex pillow resulted in fewer morning migraine headaches compared to the other pillows in the study. This could mean the pillow you sleep on at night plays a role in how your head feels in the morning.

How To Choose the Right Pillow

When you walk down the pillow aisle at any department store, it can feel like there are endless options. As you begin your search for a new pillow, it’s important to take sleep posture into consideration.

Pillow Considerations for Back Sleepers

When you lie on your back, your spine has less pressure on it than when you’re in other positions, largely due to neck alignment. Placing a moderately lofted pillow (3 to 5 inches) under your head can prevent your head from tipping back and overextending your spine.

Some people might also find it comfortable to have a contoured pillow that adds a bit of extra cervical support while still supporting the head.

Pillow Considerations for Side Sleepers

When you lie on your side, your head is farther away from the bed when it’s in a neutral alignment. Side sleepers will need a slightly higher lofted pillow (4 to 6 inches) to support the head in this position.

Pillow Considerations for Stomach Sleepers

Stomach sleeping is a tough position for the neck. Having your head turned to one side all night puts a lot of stress on the joints and muscles.

If you’re a stomach sleeper, you’ll want a very low-profile pillow (less than 3 inches) or possibly even no pillow.

Other Pillow Considerations

Your mattress firmness will also affect the type of pillow you need. If your mattress is soft, you’re going to sink farther down into it. This will bring your head and neck closer to the mattress, so you won’t need as high of a loft in your pillow.

If your mattress is pretty firm, it will hold you higher above the mattress. You’ll need a higher lofted pillow to support your head and neck.

It might take a bit of trial and error to figure out which pillow type is right for your sleeping position and current mattress setup. Some mattress stores might let you test the pillow out while it’s still in the package to get a feel for it.

Pillows and Migraine

Unfortunately, a new pillow isn’t going to be a magic fix for your migraine attacks. What it might do is help to reduce potential migraine triggers like neck strain and poor sleep quality.

While a migraine pillow won’t be a replacement for any migraine treatment you’re currently on, it could be a nice addition to your symptom management program. If you have any specific questions or concerns regarding your treatment or what sleep changes might be right for you, consult your healthcare team.

Join the Conversation

On MyMigraineTeam, people share their experiences with migraine, get advice, and find support from others who understand.

What types of pillows have made a difference in your migraine symptoms? Let others know in the comments below.