Helping Your Patients Rest Assured With a New Pillow

In our current environment, where life seems to rush along at an increasingly fast pace, the value of proper sleep habits seems to diminish at the same speed. We start our day with too much caffeine and end it with too little sleep. The natural consequence of this is insomnia and other sleep problems. Chiropractors have all likely seen their fair share of patients with stiff necks, shoulders or backs due to "sleeping funny." This can be a double whammy, as an uncomfortable pillow may not only exacerbate existing sleeping problems, but can undo all the good done by an adjustment.

In an effort to help patients have a more restful night, you might be considering offering pillows. To help you determine how best to approach offering therapeutic pillows to patients, Dynamic Chiropractic PracticeINSIGHTS went to vendor experts to get their opinions on ways to help patients rest easy and wake up refreshed.

(Editor's Note: Obviously, an expert allied with a particular company will tend to be biased to that company's products. Therefore, in this series, Dynamic Chiropractic PracticeINSIGHTS provides comments that reflect a consensus on the general characteristics that make for a good product in order that you may make an informed decision as you do your research into a particular product or service.)

Approaching the Issue

The truth is that for many patients, their current pillow may be so familiar to them that they have no idea how much better they might feel with a new one that will properly support them. As Lisa Lounsbrough, with Pivotal Health Solutions, located in Watertown, SD, noted, "Keep in mind that if they [patients] have been sleeping on an old filled or flattened-out pillow, a more supportive pillow may take several nights to get used to as the body readjusts to correct alignment. They should begin getting adjusted by their doctor prior to using their new orthopedic pillow."

Kent Greenawalt, president and CEO of Roanoke, Virginia-based Foot Levelers agreed that it may take some time for a patient to get used to a new pillow. As he explained, "A pillow with proper corrective support may initially feel less comfortable than 'old squishy,' but the benefits of improved sleep posture by way of a properly supported cervical pillow will reveal themselves to the patient in due course."

So then the question becomes: how do you convince your patients that it is time to get rid of those trusty old nighttime friends in favor of a better night's sleep? Sarah Nagel of Core Products International, based in Osceola, Wisc., provided some suggestions for making and maintaining the connection when it comes to offering your patients proper orthotic pillows:

• Focus on fewer, high-quality products
• Demonstrate the product during your treatment
• Generate patient trust and loyalty by asking patients about total wellness
• Offer product alternatives that maintain your treatment at home

Drs. Louis E. Bisogni and Richard Coopersmith, both of whom use products from Bioposture, agreed with Nagel, also stressing the importance of including sleep analysis as part of any initial health exam: "A chiropractor, when recording a patient's initial history and physical, should ask the patient about his or her sleep patterns. Often patients are very willing to discuss their sleep habits and concerns. It is important for the chiropractor to identify any health problems during the early stages of patient care. This is now an important component of clinical recommendations that potentiate the benefits of the treatment provided to patients. Patients consider chiropractors as health care professionals who understand the value of sleep."

No Two Patients are the Same

Patients also come in all shapes and sizes. While this may seem evident to the chiropractor when doing an adjustment, the same adage holds true for helping them select a proper pillow. Charles Halley, DC, with Heavenly Pillow and Mattress in Tampa, Fla., explained that the patient's height will determine the best contour pillow to suit their needs: "The average person will take a 4 12-inch thick pillow; that is usually somebody from 5'6" to 5'11". Taller people will take a 5-inch pillow and people shorter than 5'6" will take a 4-inch pillow. This is all based on your height being relative to the width of your shoulders. This is not always true but it does hold 90 percent of the time."

[pb]A Matter of Gravity

While your patients may not understand why a proper pillow is so important, you know that it can help treat a wide range of conditions. Leslie Edwards of Therapeutica, based in Ontario, Canada, explains that two of the biggest culprits for many of these conditions are immobility and gravity. This becomes important when trying to explain things in terms patients will understand. She explained, "A good portion of our day is spent immobile. If you add the hours you spend sleeping, sitting at the office, travelling to work, sitting at mealtimes and in front of a television or computer, you will get a number of between 20 and 22 hours per day. Immobility is not in itself bad, everyone needs to physically rest. The issue is that our backs were designed to support the survival of an active individual. Twenty hours a day of immobility was never in the plan. Gravity bears down on us 24 hours a day whether we are mobile or immobile. Damage is caused by the cumulative stress from incorrectly positioning our backs during the many hours we are immobile."

Of course, your patients will want to know exactly what conditions might be helped by trading in their favorite pillow for a brand new one. As Sarah Nagel explained, "There are many conditions a proper orthopedic pillow can help resolve, but the first consideration is ensuring that the patient can have a restful and good night's sleep. Proper and adequate sleep will help restore energy and allow a body to heal naturally. Conditions that may be helped or improved by use of an orthopedic pillow include; general neck pain/stiffness, sleep apnea, snoring, whiplash, breathing difficulty, acid reflux, blood circulation issues, as well as back pain, shoulder injuries, sciatica, tension headaches and more."

The Value of Good Sleep

This all comes down to helping the patient understand the need for a pillow that provides the proper support. As Leslie Edwards noted, "Your sleep environment is essential to quality sleep. Some of these things can be easily addressed; the amount of light, noise and temperature in your room. Your mattress and pillow play a vital role in the quantity and quality of sleep you achieve. The patient needs to be educated to understand this value. A pillow that offers no support to the neck or upper back is an impediment to quality sleep."

Asking the Right Questions

Our experts recommend discussing sleep habits with patients before recommending a proper pillow. Below are some simple, yes-or-no questions you can ask patients to help determine which is the best pillow for their needs.

• Do you feel pain or stiffness in your neck, back, arm or shoulder when you wake up?
• Do you get frequent tension headaches?
• Do you suffer from arthritis?
• Have you been in a whiplash accident, or have you had any prior injuries to your neck, shoulder or back?
• Do you weigh more than is recommended for your height and build?
• Do your hands or arms frequently 'fall asleep' during the night?
• Do you toss and turn throughout the night, trying to get comfortable?
• Do you clench or grind your teeth while sleeping?
• Do you snore loudly on a regular basis?"

A "yes" to any of these questions may indicate the need for a proper support pillow.