Biomechanical evaluation and structural optimization of a zoned cervical pillow for Chinese women

While cervical pillows promote healthy sleep, evidence-based biomechanical guidelines remain limited. This study utilizes finite-element analysis (FEA) to evaluate the biomechanical effect of pillow material compositions and structural designs on the cranio-cervical complex of Chinese adult women. Based on female anthropometric data, a dual-layer cervical pillow with nine functional zones was designed. An integrated head–neck–pillow model was developed using SolidWorks and Hypermesh. Eight combinations of materials were evaluated, using different hyperelastic polyurethane elastomers for the external comfort layer and internal scaffold. Abaqus/Explicit evaluated the von Mises stress, contact pressure and indentation displacement across supine and lateral sleeping positions. The optimal configuration (BioLux-60-00 external layer and Bonni-45-00 internal scaffold) produced the lowest peak contact pressure in both the supine (21.67 kPa) and lateral (36.01 kPa) positions, with surface displacements of 30.85 and 34.34 mm, respectively. Configurations with pronounced stiffness mismatch exhibited localized pressure concentrations, whereas rigid external layers substantially restricted deformation. Experimental pressure maps showed load–response and spatial concentration patterns broadly consistent with the simulated CPRESS distributions. In conclusion, zoned cervical pillows tailored to Chinese female anthropometry effectively support cervical lordosis, and their performance depends on balancing interface pressure distribution and deformation. Mechanically compatible internal scaffold and external layers enhance support by reducing stress shielding, improving load transmission, and mitigating the risk of ischemia-induced muscle fatigue, while also reducing localized pressure concentration and providing sufficient compliance to accommodate the head–neck contour.