Got them are some of the principles of sleeping and what kind of pillow to choose if you have neck pain, I want to go over one study and kind of breezed over a couple more studies that show some of the latest evidence for neck pillows and what they can do for you. So the first study I want to look at is this one done in Italy. This is published in 2017. In Well, I’m not going to try to pronounce the journal name, but this study is the effectiveness of a new cervical pillow on pain and sleep quality in recreational athletes with chronic mechanical neck pain. And what they did in this study, they wanted to look at neck pain, disability, as well as neck pain levels. And kind of a new approach for this study is they wanted to look at heart rate variability because they wanted heart rate variability as is a an indicator of sleep quality. So in the introduction to the study they they mentioned that stress and musculoskeletal discomfort are considered as the major causes of lack of sleep. Although improper pre sleep postures can aggravate pain, the use of an appropriate pillow can relieve neck pain, improving the quality of sleep. And they go on to say recent Reacher’s recent research on the effects of different pillow types and shapes for in subjects with chronic mechanical neck pain, found that soft pillows that supported the cervical lordosis the curving your neck, and pillows with sleeping neck support provided effective relief of neck pain, improving the quality of sleep. It’s known that heart rate variability the heart rate is modulated by the combined The effects of the sympathetic nervous system and the parasympathetic nervous system. The sympathetic nervous system is your fight or flight system. It ramps up heart rate feeds blood into the muscles but shunts blood away from the digestive system. So this is your fight or flight system. The parasympathetic nervous system is your rest and digest system where the heart slows down, you have less of the cortisol stress hormone, and more blood is brought back into your digestive system to to kind of restore your health after you have to use your sympathetic nervous system to run away from something. And so the dynamic balance between the sympathetic nervous system and the parasympathetic nervous nervous system can be measured at the heart, in the sinoatrial node. And so what people can do is people can use heart rate variability as an indicator of your of your overall level of stress, and therefore your whole systemic biological health. So they measured heart rate variability in this study. heart rate variability gives you information about the autonomic nervous system function. And it has been shown to vary across the sleep wake cycle. So, a greater level of disability is associated with lower heart rate variability. So if your heart rate beat by beat is too consistent over time, that’s not good. You need to have some variability as an indicator of a healthy heart. So get a greater level of disability is associated with a lower heart rate variability, not good. So what they did is they had these subjects Athletes mean age of 40 years. They had them use their normal pillow for a week, and they measured heart rate variability. They measured the ear temperature at the tympanic membrane as well as neck pain, disability and neck neck scores overall. So for the first week they use their normal pillow. The second week they use this new kind of pillow. This pillow is called a DM two pillow. It’s Italian made. But when I read through this study, I tried to research where I could find that one of these pillows. did a Google search for DMT cervical pillow. I did a Google search for the iPhone thermal memory, face changing material pillow could not find this pillow out of Milan, Italy. That there are other pillows out there with the same shape. The unique parts of this pillow is the shape that comes in. So your head rests on this larger part. And the rest of the pillow is going to cradle your, your, your head while your neck is over the large part. And you can use this pillow on your back or on your side. And so the unique The unique thing about this pillow is that this face changing material that he uses, actually keeps your your head cool at night. Which sounds pretty good to me. It’s gonna minimize heat peeks as your temperature fluctuates throughout the night. Gonna keep your head cool. It’s they say it’s gonna cool down your brain too. So they measure this in this study by measuring the temperature of the eardrum. Since I couldn’t find that particular pillow, I did a Google search of other pillows and I knew that that Sleep Number carries a bunch of different pillows and they carry a good selection of neck pillows too. And so I found this one called inbalance pillow with temperature bouncing technology. Other Sleep Number products have this technology called 37.5 which is a cooling technology where they have volcanic ash woven into the fibers of their pillowcases and sheets, which actually does a really good job of cooling you down at night but this one does not have that technology but they just say it’s temperature balancing. So what I gather is that this pillow from Sleep Number, I would choose the contour also has face changing materials that will help you cool off at night. I have not tried this pillow personally. But of course it is $120 I have sampled The the true temps sheets, mattress layer and pillowcases at the seat number store. And there they are remarkably cool to the touch which is which is nice. Although as you can see the sheets are $200 and you know that it’s a premium product and they have they don’t mind charging a premium for it. So back to the study I could not find a DMT pillow but there are some alternatives including that Sleep Number. Okay so this pillow keeps it cool. has high breathability resistance to wet aging permanent this deformation and dynamic fatigue of of all of their phones. This is a different kind of foam. Some kind of thermal foam. It is micro encapsulation technology. If you can find it looks like a good pillow. So they have these people sleep with this pillow for another week and they reported the outcomes. On this table one mpds is neck pain disability score and RS is neck neck numerical rating scale on a scale of one to 10. How bad is your neck pain and TC is your tympanic membrane temperature. So the the temperature of the eardrums dropped from 37 degrees roughly to 36. You know what’s one degree Celsius is kind of the big change if you’re measuring body temperature. You don’t want your body temperature to fluctuate too much. Neck disability index dropped from roughly 40 to 40 or 234 which is nice neck numerical rating scale 6.3 to five, which is also kind of nice. I like to see a drop down to like two or three I’d like to see a bigger change. But according to the study they said that is a statistically significant change Alright, so the discussion chronic neck pain major public health problem as I said before in my my classes, the benefits of this DMT pillow are possibly explained by the mechanisms through which the shape of the pillow maintains and appropriate cervical curvature. So it’s putting that curve back in the neck is preserving normal cervical curve stability, which a neck support should do. And it helps with muscle adaptation at muscle activity is reduced, because they’re allowed to relax more. They’re adapting to the appropriate cervical curve, you have not lost that curve and this decreasing neck muscle spasms. The appropriate lordotic curve may reduce intradiscal pressure by changing the distribution of loads between cervical discs, decreasing pain arising from the epiphyseal joints. withdraw the facet joints behind The neck discs. The round shaped portion of the pillow facilitates breathing and avoids narrowing of the airway due to the incorrect position during the sleep. Here’s an illustration of a pillow user on his back and a pillow user on this side. So they say the cooling of the head during the sleep is a relevant, relevant factor to sleep depth. And as demonstrated in several studies. a pillow that influences the heart rate variability suggests that a sympathetic nervous system innovation was less excited using a cool pillow. So the the dry feeling but the cool dry sleep is important for the balance between the sympathetic nervous system and the parasympathetic nervous system, all part of the autonomic nervous system, controlling and coordinating your health so a decrease of low frequency and high frequency ratio, heart rate variability after the use of the pillow represents a shift from sympathetic fight or flight to parasympathetic nerve activities rest and digest. And this is important for sleep because sleep is when your body is sort of at work rebuilding yourself. These changes that are linked to the restorative functions of the parasympathetic nervous system is restorative. So that’s a that’s an interesting study. There’s lots to learn when you read through the study. There’s a couple more just real quick, not not quite as much time as on there. The use of neck support pillows and postural exercises in management of chronic neck pain. So these guys recommend postural exercises, to to support neck pain, to give neck pain relief, but when you do postural exercises, along with neck support pillows, you have an even better result. postural exercises significant Secondly, decreased neck pain questionnaire scores at three weeks and the use of a neck pillow, significantly decreased neck pain questionnaire scores at 12 weeks. So, according to them, postural exercises have a short term benefit and neck support will have a long term benefit because you can keep on using the neck but you might drop out of using exercises for neck relief. And in the last one changes in chronic back pain following the introduction of a viscoelastic, polyurethane foam pillow and or chiropractic treatment of Carpathia Friedman is well known for good results for neck pain, whether it’s from disk pain or facet joint pain or just mechanical neck pain in general. The findings of this study suggest that a viscoelastic polyurethane pillow could be included as an adjunct management tool to chiropractic treatment for chronic neck pain. Groups significantly improved their neck rating scale, numeric rating, pain rating scale, and neck disability index scores. And analysis indicates a significant different difference at post tests between the two groups that Chiropractic and pillow demonstrated and then proved minimum clinically important difference compared to the other groups. So chiropractic treatments does well for neck pain, pillow change, if it’s appropriate, does well for neck pain but the two combined chiropractic care and a neck pillow will give you good results for neck disability index and neck numerical rating scale. So there you have it. This is some of the studies. This one’s comes out of 2019 the other ones 2017 some of the latest evidence based information about pillows, neck supports and neck pain. Hope this helps.