As a Chiropractor in Madrid "How are you sleeping?" is one of the first questions I ask people who come to see me. You spend a third of your life in bed and if you are are in a bad position or one that puts stress on your body, it can worsen or cause painful back problems, headaches, stiff or painful neck and other associated problems.

The answer is not always easy and is different for different people. For example if you sleep face up then a thin pillow that doesn't cause your neck to be excessively bent with your chin touching your chest is advisable. If you are someone who sleeps on their side then generally a low pillow would make things worse for neck problems and headaches. Because of this you need to find a pillow specifically for you.

This concept can also be used for mattresses. When you sleep on a very soft mattress on your side it places a lot of strain on the joints and muscles of your back. Recent research (June 2010) from Oklahoma State University discovered that medium firm mattresses was the best for people suffering with back pain.

Replacing a Mattress doesn't have to be an expensive choice. These days Mattress covers are inexpensive and may be a way to stiffen or soften a Mattress that is causing or maintaining your back problem. In research published in the 2009 Journal of Chiropractic Medicine, 60 participants with back pain who changed their mattresses to a medium firm mattress had a big improvment in terms of their back pain and the quality of their sleep. Another 2002 study from the same University discovered similar outcomes but perhaps surprisingly Women and less heavy people had better outcomes.

My three biggest suggestions for improving your sleep are as follows:

• The worst position for sleeping is face down, if you can change this it will make a big difference.
• The second recommendation is more for back pain, putting pillows between the knees if you sleep on your side or pillows under your knees if you sleep on your back. This will remove a lot of the stress on your back.
• Thirdly use a pillow that keeps you neck in a normal position (not bent in any direction).

Any activity that we do daily can have good and bad impacts on the health of our body. I highly recommend that you examine your mattress, bedding and how you are sleeping if you are having issues with back pain or neck pain. It may not be the complete answer but often its a big contributing factor.