Clients come into my massage clinic frequently complaining that they have woken up with neck pain. One likely cause is their pillow, either too big or too flat. Back and side sleeping positions are the best for spine alignment, however the pillow height and firmness make a difference. One quick test, if you fold your pillow in two and it doesn't bounce back to it’s original form, then it is time to purchase a new pillow! Pancake flat pillows do not provide enough support, your neck muscles will tense up while you sleep to compensate. On the other end of the spectrum, a big extra firm pillow may exacerbate a head forward posture and irritate the nerves in your upper back/neck. If you notice you are waking up with neck pain and headaches, massage therapy can help relax the muscles and improve ease of motion of the spine. Hopefully you can find the perfect pillow for your restorative sleeps!