High pillows can cause stroke…? Comedians such as Chidori Nobu are affected! Danger of “Tono Pillow Syndrome” which is common among men in their 40s.

The National Cerebral and Cardiovascular Center’s research team has discovered that “sleeping with the pillow raised” refers to sleeping peacefully and without anxiety, but it is actually a dangerous practice that can lead to “idiopathic vertebral artery dissection,” which is a contributing factor to strokes.

What exactly is “idiopathic vertebral artery dissection”?

Nobu of the comedy duo Chidori was hospitalized in August 2010 at the age of 42 for a right-sided vertebral artery dissection, but in fact, he had also been hospitalized nine years earlier in February 2001 for a left-sided vertebral artery dissection. I was horrified to find out that my left vertebral artery had ruptured if I had left it untreated, “ he revealed on Twitter (now X).

<More than anything else, early detection saved my life! This cerebral artery dissection is a disease that is not well known, so people think it is a migraine or hangover and leave it untreated, and it can be dangerous.

Cha Kato and Diane Yusuke have also suffered from vertebral artery dissection in the past. All of them had good progress and returned to work after a month or so of rest without surgery.

Stroke is the leading cause of bedridden patients in Japan. Stroke is a general term for diseases that cause damage to blood vessels in the brain due to clogging or rupture of blood vessels in the brain. The main types of stroke are cerebral infarction, in which a blood vessel in the brain clogs; cerebral hemorrhage, in which a blood vessel in the brain ruptures; subarachnoid hemorrhage, in which a bump on a blood vessel in the brain, called a brain aneurysm, bursts; and transient ischemic attack, in which a blood vessel in the brain temporarily clogs.

Idiopathic vertebral artery dissection, on the other hand, occurs in the vertebral artery that runs through the bone at the back of the neck, one of the two pairs of arteries that carry blood from the neck to the brain. Idiopathic” means that the cause of the onset of the disease cannot be determined, and as the center’s press release notes, “Although there has been a need to determine the cause of the disease in order to prevent its onset, in about two-thirds of patients the cause was unknown.” Dr. Kimitoshi Sano, a neurosurgeon listed in the Guinness Book of Records for having performed the largest number of operations for subarachnoid hemorrhage in the world, explains as follows.

The wall of the artery has a three-layered structure, from the inside: intima, tunica media, and adventitia. Arterial dissection occurs when a fissure develops between the intima and tunica media, allowing blood to enter and tear the artery. If the dissection exceeds the tunica media muscle layer, the outer membrane alone is unable to support the blood pressure, resulting in hemorrhage and subarachnoid hemorrhage. Arterial dissection can occur in arteries throughout the body, but in the head, dissection of the vertebral artery is most common, probably because movement in the neck is greater than elsewhere.

Typical symptoms are neck pain and severe headaches. However, mild cases may heal spontaneously, believing that it is simply a “sleeping mistake” or “stiff shoulder. Most patients are men in their 40s, but since they are in the prime of their working lives, they often judge it to be due to fatigue, which aggravates the symptoms. The comment “If you don’t usually have headaches but feel pain, go for a checkup,” which Nobu introduced on his X website, is an accurate reminder.

The research team focused on “pillows” as a risk factor for such idiopathic vertebral artery dissection. They noticed that some of the patients were using extremely high pillows. The team then studied the height of pillows at the onset of the disease by classifying about 50 patients and about 50 patients with other diseases. They found that about 40% of the patients in the group who used pillows less than 12 cm high had the disease, while 90% of the patients in the group who used pillows more than 15 cm high had the disease.

The researchers further examined these relationships in detail and found a link between pillow height and the risk of developing the disease. They also found that the harder the pillow, the more pronounced the association.

The vertebral artery runs through a hole in the bone of the cervical vertebrae, so if the pillow is too high, it can bend and pull on the neck, potentially damaging it. That may be what is meant by the pillow having something to do with it.”

The aforementioned Dr. Sano nodded his head in agreement.

In Japan, there is a history of the use of high, hard pillows called “tonoyamakura,” which were used from the 17th to 19th centuries. It is said to have been effective in maintaining the hairstyle of the lord, and despite its name, it seems to have been widely distributed among the general public, often appearing in period dramas.

In fact, several essays from the 1800s mention that there was a popular saying that the pillow should be about 9 cm high to avoid premature death, although a pillow as high as 12 cm would be easier for the hair to stay in place. Apparently, people at that time were also aware of the hidden link between high pillows and strokes.

The research team at the National Cerebral and Cardiovascular Center hoped that the casual sleep habit would be widely recognized as an important risk factor for stroke and that the number of patients suffering from stroke would be reduced, even if only a little.

It has been said that to prevent stroke, it is important to “strive for early detection and management of major risk factors such as hypertension, dyslipidemia, heart disease, and diabetes,” “exercise at least 30 minutes at least five days a week to improve physical inactivity,” “lead a healthy lifestyle, paying attention to stress, smoking, drinking, dehydration, etc. In the future, however, “sleeping on a soft pillow that is not too high” will also be recommended.