Most people think about their pillow only when it is time to sleep. After a knock to the head, though, the way your head rests overnight can be worth a note. No one can tell you from a single night what it means. What you can do is write down what you notice, so the examiner has something specific to work with.
This is general education, not a diagnosis. It is written for readers in the St. Louis metro who are deciding whether to get examined this week. If your symptoms are getting worse, or you notice confusion, repeated vomiting, unusual drowsiness, weakness, or trouble speaking, do not wait for a log. Seek medical care or emergency services right away.
Why the pillow matters to your notes
Your neck and upper back carry the weight of your head for hours each night. Many people settle into a few habitual positions while they sleep, often without remembering them in the morning. A pillow that is too high, too flat, or too firm can keep the head tipped or turned in one direction for a long stretch. That is one reason some people wake with a sense of stiffness or a headache that is hard to place. A written record gives the examiner context, and it costs nothing to keep.
The point of the notes is not to find a single cause. It is to show patterns. If you wake with the same ache most mornings, or only on certain nights, that pattern is useful information. If nothing changes from one night to the next, that is useful too.
What to write down each morning
Keep a small notebook or a note on your phone beside the bed. Each morning, write the date and answer a few plain questions. Which side did you mostly sleep on? How many pillows did you use, and were there none, one, or a stack? Was the pillow flat, medium, or high when you lay down? When you woke, was your head turned, tipped back, or pushed forward?
Also note how long you stayed in the same position before you moved. Many people change position several times in a night without knowing it. If you can recall it, write down whether you woke during the night, and roughly what time it was. Keep each answer short. A line is enough.
Simple things to check in your bedroom
Look at the pillow itself. Fold it in half and see whether it still lifts your head, or whether it has flattened into a thin layer. Lie down as you normally do and notice whether your shoulders reach the mattress while your head rests on the pillow, or whether the head sits up in the air with nothing under it. Write down whether you use a body pillow, a pillow under the knees, or a pillow tucked against your back.
Describe the mattress in plain words: soft, firm, or sagging on one side. Do not change everything at once. If you swap a pillow or move a mattress, write the date you did it in your log. That way the examiner can see whether anything shifted during the week before your visit, and when.
The first hour after waking
Pay attention to the first hour after you get up. Did the head ache start while you were still lying down, or only after you stood? Did turning your head to the left or to the right feel tight or pinched? Did the ache ease once you got up and moved around, or did it stay the same? Write short answers. A note like tight when I turn left, eased after tea is far more useful to an examiner than a note that says bad morning.
If you notice dizziness, nausea, or a change in how you see or speak during that first hour, add it to the log with the time. Those details matter more than the pillow itself, and they are worth raising with a clinician as soon as you can.
What to bring to the visit
Bring the notes for the week before your appointment. Include a short list of the pillows and mattress you use, and a line for every change you made. If you know the date of your fall or knock, write it at the top of the first page. If you do not know the exact date, write your best estimate and say that it is an estimate. Honesty about uncertainty helps more than a confident guess.
Note any sleep aids, over-the-counter products, or home remedies you used during the week, with the dates. Be clear in the log that these were not a replacement for an exam. Bring the notebook or a printout, and keep the original so you can add to it if the examiner asks follow-up questions.
When to stop waiting
A pillow log will not settle the question of a head injury, and it will not replace an examination. Get checked promptly if your headaches are getting worse, if you have new confusion, slurred speech, unequal pupils, numbness, weakness, repeated vomiting, or if someone wakes you and you are hard to rouse. Those signs need care now, not a notebook. Call emergency services for them.
Your night notes are one small piece of the picture. Keep them plain, keep them dated, and let the examiner read them alongside everything else you have written down. A clear record made in ordinary words is often the most helpful thing a patient can bring into the room.