My pillow was the reason for my morning tension headaches — a chiropractor explains why

A woman sat up in bed with white sheets next to window with hand on her head as she is waking up with a headache. — (Image credit: Getty Images)

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Morning headaches are not exactly my ideal way of starting the day, but they often come uninvited. While they can have various causes, I recently found out that my plush, soft pillow could be the real culprit.

"If you notice that your headaches start or worsen after sleeping, or improve when you change pillows, that’s a strong indicator that your pillow may be a contributing factor," says Dr. Dustin DebRoy, manager of chiropractic education and relations at The Joint Chiropractic.

Key takeaways: At a glance

The wrong pillow can cause headaches: Uneven pillow support can lead to tension headaches.
Your sleep posture matters: Proper neck and spinal alignment is crucial for good sleep quality.
Three key reasons: Sustained muscle tension, joint compression and resultant poor sleep are three causes of tension headaches.
Finding the 'one': Choosing a pillow depends on your sleep position, not its look and feel.
Replacing is key: Changing your pillow every 1-2 years is important to maintain proper support.

How my pillow was causing my headaches

From undue stress on my neck muscles to poor sleep, here are three ways my marshmallow soft pillow was triggering morning tension headaches...

1. Muscle strain

Woman rubs neck as she has neck pain — (Image credit: Getty Images)

Research shows that muscle tension is one of the common causes of tension headaches. So when my head sank to the bottom of my ultra-soft pillow, my neck muscles were immediately placed under pressure.

"The neck muscles must find a supported neutral position to fully relax. If a pillow creates a distortion to the neck, the muscles will respond by tightening up," says Dr. Sherry McAllister, president of The Foundation of Chiropractic Progress.

This is to protect the neck and head from further injury due to uneven support, activating the nervous system to respond to the distortion.

Sustained muscle tightness or tension will reduce the blood flow to the neck and head, increasing the likelihood of developing headaches — which is something I learnt the hard way.

2. Joint compression

The image shows a dark haired woman wearing a stripy shirt sitting on the edge of a bed and holding her head in her hands — (Image credit: Getty Images)

A pillow that's too flat or too high for you can severely affect your sleep posture. It either pushes your neck and head too far forward or drops them back too much, and this can be bad news for your joints.

"Using a pillow that does not properly support your neck can place the cervical joints in a compressed position for extended periods of time," says Dr. DebRoy.

Over time, this can lead to irritation, stiffness, and discomfort that may contribute to headaches. For me, my super soft pillow meant my neck dropped too low and my sleep posture was compromised.

3. Poor sleep

A woman lies in bed tired with her eyes closed and her arm over her face. — (Image credit: Getty Images)

Not only can muscle tension and joint compression caused by the wrong pillow cause discomfort, it can also lead to sleep deprivation. Unfortunately, studies show that several nights of poor sleep can lead to an increase in headaches.

"Poor sleep can increase muscle tension, reduce the body’s ability to recover, and heighten sensitivity to pain, all of which contribute to headache development," says Dr DebRoy.

The pillow I need instead

Analyzing the above factors, I learned that a plush soft pillow is not the answer to quality sleep for me — proper support is.

According to Dr. Ron Miller, Doctor of Physical Therapy at Pursuit Physical Therapy, an adjustable medium-loft pillow would suit me best as an average-sized combination sleeper (side and back).

"What works best is a medium loft pillow with adaptive fill, ones that keep the neck neutral on the back and fills in the shoulder gap on your side. Having adjustable fill pillows is best so you can customize the height," he explains.

A young woman side sleeps in the fetal position using a supportive high-loft pillow. — (Image credit: Future)

"I will recommend frequently testing it to see whether the nose stays aligned with the sternum (the long flat bone at the center of the chest) and when lying on your side," he adds.

But if you're not totally sure about your sleep needs, our guide to choosing a pillow based on your sleep position can help.

However, replacing your pillows at the right time is also crucial to avoid these annoying headaches.

"Often it is not noticed by the naked eye that the pillow has lost its prime," Dr McAllister points out. The general advice is to replace your pillows every 1-2 years.

One way to find out if you're due a new pillow is the easy 30-second test to find out if your pillow is still supportive.

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PPA accredited journalist Becky covers all things sleep-related, from mattress and pillow reviews to reporting on the latest sleep science. Becky loves exploring the intricacies of sleep and its effects on skincare, mental wellbeing, and work performance. When not writing about sleep, Becky can be seen reading in cozy bookshops or learning about global food culture.