P108 Effects of different pillow designs on promoting sleep quality and spinal alignment by reducing neck pain, waking symptoms, neck disability in adults: a systematic review and meta-analysis

INTRODUCTION: Poor sleep quality is more prevalent in patients with neck pain than in the control without neck pain. The effectiveness of using different pillows in the management of neck pain, waking symptoms and sleep quality is inconclusive. OBJECTIVES: To identify the randomized controlled trials assessing the effect of different types of pillows on sleep quality, spinal alignment, neck pain, waking symptoms and neck disability. METHODS: A systematic review was conducted by searching CINAHL Complete, Cochrane Library, EMBASE, Medline, Pubmed and Psychinfo databases from inception to September 2020. Two reviewers independently assessed the articles and evaluated the methodological quality using the Physiotherapy Evidence Database (PEDro) scale. RESULTS: Thirty-five articles fulfilled the inclusion criteria of the study. There were nine high-quality studies involving 555 participants. The meta-analysis revealed significant differences favouring the use of rubber pillows to reduce neck pain [standardized mean difference (SMD: -0.263; P < 0.001). Moreover, favourable outcomes by using rubber and spring pillows were found in waking pain (SMD: -0.228; P < 0.001), neck disability (SMD: -0.506; P = 0.020) and pillow satisfaction (SMD: 1.144; P < 0.001). However, pillow designs did not influence sleep quality (SMD = 0.047; P = 0.703) or spinal alignment at side-lying position (SMD=0.049; P=0.280) in patients with chronic neck pain. DISCUSSION: The use of spring and rubber pillows shows positive effects on reducing neck pain and disability. Although pillow designs do not change the sleep quality, waking symptoms can be reduced with positive pillow satisfaction in patients with chronic neck pain.