Patients with acute neck injuries are always complaining that sleeping has become almost too painful to tolerate. I cannot over emphasize how important sleep is to a patient in pain. I always say, rest is an essential component for repair. I have found that the ideal position for getting those necessary Z's when your neck is killing you is on your back with a rolled up towel placed in the curve of your neck and no pillow underneath your head.
Patients with persistent or chronic neck pain always ask me if there is an ideal pillow I recommend. I find it is very difficult to recommend a single pillow as each individual has different needs. There are also so many pillow options available with different materials, varying thickness, and densities. I suggest trying out as many pillows as you can in order to find the one that is most comfortable for you.
The underlying principal in avoiding a painful night is maintaining a neutral spine. This means that the head should be properly aligned on the torso. If you are predominately a side sleeper, usually a thicker pillow or a greater number of pillows would be required to achieve a neutral spine. If you are a back sleeper, usually a thinner pillow or fewer pillows are best. If you are a stomach sleeper, good luck! A stomach sleeper spends the night with their head turned to one side or the other; this can lead to shortening of certain muscles and strain on the joints and ligaments of the neck resulting in pain. If sleeping on your stomach is the only way you can count sheep (and I'm including myself in this category) I find it is best to tuck a pillow underneath the shoulder you look towards. This angles your body slightly and will minimize how far you have to twist your neck while sleeping. It's not ideal, but just like in parenting, "there's the right way to do things, and then there's the way it works for you." Sweet dreams!