Pillow talk

Lumpy and flat, clumpy and warped, crumbly, skinny, and sneezy.

No, they're not the seven dwarves, but they do come close to capturing the seven sins of pillowdom, and they might be why you're waking up with a stiff neck or a headache, or are still exhausted after eight solid hours of shut-eye.

In Portsmouth, N.H., there's a chiropractor who, having witnessed the damage this seemingly standard bedtime accessory can cause, has spent nearly three decades testing and experimenting with more than 150 specimens. Though he's not quite there yet, he's never given up on his quest for perfection.

''Whether they were coming in with back problems or neck problems, stiffness, sleep apnea, numbness in their hands, or complaining that they just can't get comfortable at night, I could see people just weren't getting the kind of support they need for the third of their lives they spend in bed," says Dr. Paul Bacon. ''It's bad enough the abuse we give our bodies during the day, but during the night, when it should be a time of rest and recuperation from the day's stresses, sleeping all wrong just adds insult to injury."

By ''all wrong," Bacon means either sleeping on one's side with a too-flat pillow that scrunches up the shoulders and twists the head out of whack (If you find yourself sleeping with your hand under your pillow, your head and neck are crying out for more support), sleeping on one's back with a too-fat pillow that lifts the head too high and compresses the neck, or the chiropractor's worst nightmare -- sleeping on one's stomach with the head twisted sideways for hours at a time.

Spinal bio-mechanics told Bacon that many a problem begins in the neck, so he knew he had to start there. ''You can't really get the rest you need unless you're in alignment, and you can't get in alignment if your head isn't in a central position," he says. And this, he adds, is only possible for side sleepers whose pillow is thick and dense enough to support their head in line with the center of their torso.

''Everyone's been worrying about the mattress you sleep on when they should be looking at pillows," says Bacon. ''A less-than-ideal mattress won't kill you, but the wrong pillow can destroy your neck."

The damage of sleeping for years on ill-fitting pillows is exacerbated by the sedentary life, says Dr. Jerry McAndrews, an Oklahoma chiropractor who is a spokesman for the American Chiropractic Association. ''Folks who spend their lives in front of the computer and the TV, then sleep on a pillow that gives their tired neck no support, it just spells trouble," he says.

Some of this is, alas, unique to our culture, according to Dr. Scott Bautch of Wausau, Wisc., past president of the association's occupational health committee. Contrast this to the Japanese who tend to have narrower shoulders and be more physically fit. ''It's part of their culture to stretch together in the office every morning," says Bautch. ''With their full range of motion, they're less vulnerable to pillow-related problems."

Brian Cassidy estimates that, between work and home, he puts in five hours a day at the computer. The Nottingham, N.H., man originally sought Bacon out for what he assumed to be lower back issues. But Bacon showed him the problem was actually farther north in his neck. ''I was constantly tossing and turning and scrunching my pillow," says Cassidy. A year later, he's sleeping more soundly on the custom-fitted pillow Bacon ordered for him.

Bacon says we are all back sleepers until age 5 or so. By 8 or 10, as our joints, ligaments, and muscles mature, side sleeping becomes ideal. Sadly, neck problems are increasingly common at a more tender age as sedentary youngsters begin to mirror the lifestyle and aches and pains of their computer- and TV-tethered parents, says Bautch. So much so that a recent study shows 7 percent of American 14-year-olds already have neck or back problems, problems that can, Bautch says, lead to disabilities down the road.

And, though Martha Stewart may be dismayed, couples should not necessarily have matching pillows. The chiropractors point out that humans vary in the distance between shoulder and ear, in the weight of the head, in sleep position, in sensitivities to different materials. So, alas, one pillow doesn't fit all.

''We're each built differently; our sleep patterns are incredibly individualistic," says McAndrews. In fact, he recommends (gulp) switching sides of the bed each month. ''Just like kids carrying their heavy backpack on one shoulder can do irreparable damage to his or her muscles and skeleton, if you sleep on the same side of the bed for years, it can throw your entire system off balance."

Bacon couldn't agree more. ''Sleep is an individual sport. Once you fall asleep, you are alone with your physiology," he says.

Learning exactly what the best pillow is has been Bacon's quest for 30 years. Determined to get as close to the ideal as possible, he made the rounds of orthopedic supply houses to test the newest in therapeutic pillows. He began by calibrating the rates of compression of these pillows with a 10-pound bowling ball, roughly the weight of an adult head. ''It was astounding and discouraging," he says. ''Almost every single one had foam or feathers that broke down quickly and weren't supportive. After a couple of months, even the pricey pillows were essentially useless -- 90 percent of them start breaking down within 90 days."

So Bacon retreated to his basement workroom where, over the years, he's tested a variety of materials to devise a pillow that is flat enough for the back sleeper, but dense and thick enough for the side-sleeper.

Before long he was using his patients for testing, sending them home with pillows he'd picked up or created, specimens filled with buckwheat hulls, air, white goose down, water, memory foam, wool, and sheepskin -- pillows that range from $5 to $150. And he asked them to keep a record of how they felt. He collected so many pillows, in fact, that eventually his wife put her foot down. ''I had pillows in the bedroom, pillows in the attic, pillows everywhere. She finally decided she needed to get those pillows out of the house." Many of his patients got new pillows at that time, he recalls with a chuckle.

Over the years, Bacon found skin-friendly cotton batten and supportive latex to be better than memory foam (too soft in warm weather, too stiff in cold), which he found to be better than buckwheat hulls and white goose down (they disperse too quickly to be of much support).

But his most deflating specimen to date has been the air chamber pillow. ''It's a great idea, because you can adjust the thickness to the individual's size, weight, and sleep patterns with the amount of air you pump into each chamber," Bacon says. Sadly, though, the chambers tend to break with repeated use. ''The darn things just don't hold up. I keep having to send them back." Still, Bacon is ''wagering the air pillow is the pillow of the future . . . once the manufacturer works the bugs out."

Bacon, however, refuses to give up on his quest for pillow perfection. ''What's needed is a pillow that's got a depression in the middle which will support the neck for back sleeping and plenty of thickness on each side for side sleeping," he says. ''And it needs to be adaptable for a variety of bodies."

His current experimental model melds latex with a core of denser foam and layers of cotton batten, covered by sheep skin or wool for added softness and the feel of natural fiber against the skin. ''After all these years and all these pillows," he says, ''I do believe I'm getting close."