My back is aching. My neck is killing me. My husband’s snoring kept me up all night. These are just some complaints American’s have when they are desperately seeking Zzzs.

While there are numerous types of pillows with a variety of fills and firmness available, comfort is key. The correct body alignment and positioning, with the help of a pillow, also comes into play, and can relieve soreness and ailments.

“In health, sleep is something that’s difficult for lots of people. So, when we say what is the appropriate position to sleep in, it is tough to say. Because the appropriate position has many different meanings depending on what your condition is,” said Dr. Ryan Szepiela, who specializes in pain management and rehabilitation at ProMedica.

The way you sleep could agitate back pain, sleep apnea or snoring, and gastroesophageal reflux or heartburn.

“Some people recommend back sleeping for back pain, or the side sleeping with a pillow in between your legs and kind of bent up to give your spine appropriate alignment,” he said. The pillow prevents the knees from coming together and helps keep the spine in a neutral position.

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If you have difficulty sleeping on your side then it comes down to the mattress. A common trap people with back pain fall into is thinking the cushiest mattress is the best. The softer mattresses mean your spine fall into it, and our head doesn’t, so it pulls you out of appropriate alignment, he said.

“You don’t need anything as hard as a board, but you need something that has a little bit of give, and also a little bit of firmness,” he said.

Because mattresses can be pricey, he recommends testing it on site and buying it from a place with a liberal return policy. You may find it uncomfortable two to three weeks in.

Many factors go into managing acid reflux, including your before-bed routine and diet. In bed posture is elevation.

“Do not lay flat on your bed because that puts your throat and stomach at the same level. Stomach acid can flow up,” he said.

He recommended elevating your head or sleeping on a wedge pillow that is a little bit thicker. If you can’t sleep with your head elevated, he said to place four to six inch blocks underneath the bed frame to prop up the head side of the bed. Elevating one side of the bed frame allows the esophagus and throat to be higher than the stomach.

When it comes to snorers, it is often a bed mate or spouse who is kept awake and diagnose sleep apnea. The most common is obstructive sleep apnea “caused by a blockage of the airway. Most of the time it is the soft tissue in back of the throat collapse during sleep.”

Sleeping on your back might exacerbate it, he said, as it can place your neck in a flexed position. So, avoid pillows that put you high up or flex your neck.

“There are specific pillows made for sleep apnea that neutrally align the airway or neck, because if you flex down or extend the neck too far you have more or worsening of the narrowing,” he said.

Pharmacies and medical supply stores can provide pillows tailored to one’s own figure, including ProMedica’s Pharmacy Counter. Ready-to-use pillows that some people with the ailment have tried are Temper-Pedic, memory foam, or a light wedge pillow.

Dr. Jerry Dombeck, who owns Team Chiropractic and Massage Therapy in Toledo, said when people complain of neck or back pain after a night’s sleep it could be attributed to numerous things, often something the person did a day or two before; not necessarily how they slept. The resting and laying still allows for the inflammation to set in, and the inflammation is what causes pain. In general, choosing a pillow and a sleeping position is a matter of preference and your body’s natural inclination.

“I don’t have a strong opinion about a best position, because realistically people move when they sleep. They roll. I know I do,” he said.

He noted that everyone’s body is different: “A lot of times it is a matter of trial and error as to what pillow is going to work for you. You want a pillow that is going to be versatile. But if you maintain one or two positions all night long, then maybe a pillow that is more specific will work for you. But I don’t, so I need a pillow that I can manipulate into the shape that I want it.”

He demonstrated with a contour pillow how to keep your neck and spine alignment.

“If you are on your side, you want pressure under your neck and a little less pressure under your head so that when your head falls, your head, nose, and chin are in alignment with the surface you are on. Your head has to be parallel with the surface that you are sleeping on,” he said.

He pointed out that when sleeping on the side, sleep on the back of the shoulder.

For a neutral position when sleeping elevated, the same applies.

“When you are sleeping elevated, if you are sleeping upright a little bit, your head, nose, and chin want to be parallel with the angle you are sleeping at. If you are sleeping flat, your head, nose, and chin want to be perpendicular to the ground,” he said.

Be careful not to put your head into “inflection,” where the chin is pointed down towards the chest. “That is when you cut off air supply and develop sleep apnea.”

He said that pillows, fills, and sleeping position are really a personal thing. There is no right or wrong when it comes to choosing down feather versus a hypoallergenic fill, or foam. But when it comes to correct sleep posture, he suggested a contoured pillow or one with a water bladder.

“That is why you see contour pillows looking like they are hollowed out towards the middle, because that is where your ear goes and that is where your head is cradled. The thicker part is always supporting the neck,” he said.

When sleeping on your stomach, laying your head flat at a 90 degree angle could have you waking up and saying “I slept wrong.”

“You are creating too much rotation on the neck and to maintain that, it puts stress on those joints. To have prolonged stress like that, you are going to wake up with torticollis or wryneck,” Dr. Dombeck said.

With a contoured pillow he demonstrated the correct alignment for sleeping on your stomach, although a longer pillow could work:

“I put my pillow on one side of my chest and on the side of my head so that my body, my torso is actually at 30 to 45 degree angle. That way when my head is to the side, it is only turned at 30 to 40 degrees. Here the head is turned slightly and facing down still, and allows for space to breathe.”

Dr. Dombeck does sell pillows in his office, one of which is the popular water-based pillow, which can be adjusted to soft, medium, or firm, depending on how it is filled.

“It is the same concept of support but it doesn’t matter where your head is on the pillow. The water bladder underneath the pillow will cradle your head no matter where it is on the pillow, for the same kind of support [as a contoured pillow],” he said.

In the end, choosing a pillow and a sleep position is a matter of choice and comfort.

Contact Natalie Trusso Cafarello at: 419-724-6133, or ntrusso@theblade.com, or on Twitter @natalietrusso.

First Published November 8, 2015, 5:00 a.m.