Photo/Illutration A study showed a health risk of using multiple pillows and stacked towels at bedtime.

Sleeping on a high pillow, a practice common among hair-conscious shoguns and geisha, increases the risk of stroke because of the way the neck bends during slumber, Japanese researchers found.

The research team from the National Cerebral and Cardiovascular Center named the ailment “shogun pillow syndrome” in a paper that was recently published online in an international journal of medicine.

The researchers studied cases of spontaneous vertebral artery dissection (sVAD), a rupture of a blood vessel in the back of the neck that causes a stroke, with patients’ sleeping habits.

Overall, sVAD causes about 2 percent of strokes. But among people aged 15 to 45, including those in their prime working years, the ratio rises to 10 percent.

Nearly 20 percent of these stroke patients die or are left with permanent disabilities.

The research team studied 53 people between 45 and 56 years old who were diagnosed with sVAD at the center between 2018 and 2023.

This group was compared with 53 people who were hospitalized for strokes or cerebral hemorrhages from other causes during the same period.

Specifically, the study focused on their gender, age and the heights of their pillows.

Based on the opinions of bedding manufacturers and industry experts, the team defined pillows that are 12 cm or higher as “high” and those 15 cm or higher as “extraordinarily high.”

The study results showed that 18, or 34 percent, of the patients with sVAD used pillows 12 cm or higher, compared with eight, or 15 percent, of the comparison subjects.

In addition, nine, or 17 percent, of the sVAD patients used pillows 15 cm or higher, while the figure was just one, or 1.9 percent, among the non-sVAD patients.

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The research team noted that some of the patients who had appeared at very low risk of stroke used pillows that were 17 to 19 cm high.

The higher the pillow, the more likely the patient was to develop sVAD, they said.

The study concluded that a high pillow increases neck flexion, the lowering of the chin toward the chest. This position could also damage blood vessels if the neck turns during sleep.

“There are quite a few people who use buckwheat pillows with low rebound pillows or towels on top of them,” said Tomotaka Tanaka, a neurosurgeon at the center and a member of the team. “It is advisable to refrain from using pillows that are more than 15 cm high because even if the pillow is soft, it causes severe neck flexion.”

The team in the research paper touched upon the background of the use of high pillows in the country.

“In Japan, between the 17th and 19th centuries, pillows as high as 12-16 cm, called ‘shogun pillows,’ were widely used to maintain the traditional laborious hairstyle among shogun, samurai (warriors) and geisha,” the report said.

The team also said people back in those days may have been aware of the connection between high-pillow usage and strokes.

“Several essays published in the mid-19th century indicate that it was widely believed that ‘a high pillow of approximately 12 cm is comfortable for living; however, a low pillow of approximately 9 cm is better for longevity,’” the report said.

The paper can be read at: (https://journals.sagepub.com/doi/10.1177/23969873231226029)

 

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