Sleeping positions that may affect neck and shoulder pain

How Your Sleeping Position May Affect Neck and Shoulder Pain

By Michel Bourgeois, Licensed Massage Therapist

Updated September 2026 · General educational information

Neck and shoulder discomfort can be influenced by muscle tension, daily posture, and the position you maintain while sleeping. Because you spend many hours in bed, small changes to your pillow and sleeping posture may make a noticeable difference in how you feel in the morning.

A Good Night’s Sleep

Sleep gives your body time to recover, but your neck muscles cannot relax comfortably if your head remains bent or rotated for hours. You may go to bed feeling fine and wake with stiffness even when you did nothing unusual the previous day. Your sleeping posture, pillow height, mattress, and arm position may all contribute.

The main goal is neutral alignment: your head should feel supported without being pushed far forward, far backward, tilted toward one shoulder, or forced into a prolonged rotation.

Positions That May Aggravate Symptoms

Person sleeping with both arms raised above the shoulders
Arms held overhead for a long time may aggravate shoulder or arm symptoms.

Sleeping With Your Arms Overhead

Keeping an arm above shoulder level for a long period may place tension on the shoulder and compress sensitive tissues. Some people wake with temporary tingling or numbness. Try lowering the arm and supporting it beside your body. Persistent numbness, tingling, or weakness should be assessed by a healthcare professional.

Person sleeping on the stomach with the head turned
Stomach sleeping usually requires the head to remain turned.

Sleeping on Your Stomach

Stomach sleeping usually keeps your neck rotated to one side for an extended time. For some people, that sustained position can increase morning stiffness, pressure on your jaw or aggravate existing neck and shoulder discomfort. If this position repeatedly causes symptoms, gradually try side or back sleeping instead.

Person sleeping with the head resting toward the shoulder and arm
Avoid trapping the arm or letting the head collapse toward one shoulder.

Resting on the Shoulder or Arm

When the head drops toward one shoulder or an arm is trapped under the body, the neck remains side-bent and the arm may be compressed. Reposition the pillow so it supports the space between your head and shoulder, and keep the lower arm in a comfortable position in front of you.

What Happened Between Bedtime and Morning?

A position that feels comfortable for a few minutes may become irritating after several hours. A pillow that is too high can push your neck forward when you lie on your back. A pillow that is too low—or one that collapses too much—can allow your head to tilt when you lie on your side. The right height depends on your sleeping position, body proportions, and mattress firmness.

Pillow Positions to Avoid

A pillow that is too thick keeping the neck flexed forward
Figure A: A pillow that is too thick may keep the neck flexed forward throughout the night.
If the pillow does not match the 
            space between the head and shoulder, the neck may remain tilted
Figure B: If the pillow does not match the space between the head and shoulder, the neck may remain tilted.

When sleeping on your back, stacking two large pillows often pushes the chin toward the chest. When sleeping on your side, a pillow that is too high or too low can angle the head away from the rest of the spine.

More Supportive Options

For back sleeping, use enough
             support to maintain the neck’s natural curve without pushing the head forward
Figure C: For back sleeping, use enough support to maintain the neck’s natural curve without pushing the head forward.
For back sleeping, use enough
             support to maintain the neck’s natural curve without pushing the head forward
Figure D: For side sleeping, choose a height that keeps the head and neck aligned with the torso.

Why Stomach Sleeping Can Be Challenging

Stomach sleeping normally requires the head to turn to one side, creating a prolonged, uneven position through the neck. Some people tolerate it, but others notice stiffness, headaches, jaw discomfort, or shoulder tension. If it is difficult to change, try starting on your side with a body pillow in front of you to discourage rolling forward.

How to Choose a Supportive Pillow

A pillow does not need to be expensive or carry the word “orthopedic” to work well. What matters is whether it comfortably supports your head and neck in your usual sleeping position.

  • Back sleepers: generally need a lower profile with support under the neck.
  • Side sleepers: generally need enough height to fill the space between the shoulder and head.
  • Combination sleepers: may prefer adjustable fill or a contoured design.
  • Consider your shoulder width, body size, and how deeply you sink into the mattress.
  • Whenever possible, choose a pillow with a trial period or practical return policy.

Let’s Recap

  • Try sleeping on your back or side if those positions feel comfortable.
  • Choose a pillow height that keeps your head and neck neutral.
  • Avoid keeping an arm trapped under you or raised overhead for long periods.
  • If stomach sleeping repeatedly aggravates your neck, transition gradually to another position.
  • Give a new setup several nights, but stop if it clearly worsens your symptoms.

Sources and Further Reading

I hope you find this information helpful.

Thank you for reading,

Michel Bourgeois
Licensed Massage Therapist

This article is provided for educational purposes only and does not constitute medical advice, a diagnosis, or treatment.