Pillows 101: Choosing the Best Pillow for Your Sleeping Position and Comfort

Sleeping Positions 

There are three main sleeping positions—on the back, on the stomach, and on the side. The pillow is important in each sleeping position since each position needs a different level of the neck and head support.

•  On back: Those who sleep on their backs need a pillow that will support the head, neck, shoulders, and spine. Your cervical spine has a natural curve and the pillow should conform to that curve for maximum support and relaxation.  
• On the side: If you sleep on either of your sides, use a pillow that supports your head in line with your neck.  Make sure that your shoulders are square so that you’re not collapsing into the bottom shoulder. The pillow should fill the spaces between your ear and mattress. If your head or neck is tilted, and is not aligned with the rest of the spine and leads to neck or back pain.  
• On stomach: This sleeping position is not recommended because it puts too much pressure on the spine, especially during the corrective stage of your care.   If you like sleeping on your stomach, instead try side sleeping with a pillow tucked into your belly.  This can be a regular pillow or a body pillow like this one.

Types of Pillow Fillers 

The fillers used in the pillow determine its firmness. These play an important role as they perform functions like taking shape as per weight distribution, heat exchange between body and pillow material, and temperature monitoring. Here are some popular filler options. 

Recommended: 

• Cotton and wool pillows: cotton and wool pillows offer natural, hypoallergenic options that are breathable and moisture-wicking. However, they tend to deform quickly and typically last only 1-2 years.
• Feather and down pillows: Feather and down pillows, with a lifespan of 5-10 years, provide softness and excellent temperature regulation but may trigger allergies and require frequent fluffing.   These pillows are soft, easy to shape or mold onto your head and neck.  
• Natural Latex pillows: Natural latex pillows, lasting 10-20 years, are durable and resistant to dust mites and mold, but can be heavy and expensive.
• Buckwheat pillows: Buckwheat pillows, lasting 5-10 years with replaceable husks, offer high adjustability and air circulation, though they can be noisy when shifting and some sleepers find that the kernels are just too hard to be comfortable.

Not Recommended:

• Polyester pillows: While inexpensive and hypoallergenic, have a short lifespan of 6 months to 2 years and can become lumpy over time.
• Memory foam pillows: Memory foam pillows, lasting 2-3 years, conform too well to the head and neckand may not maintain proper spinal alignment throughout the night due to slow recovery.

Dr. Flick’s Favorite Pillows

For side sleepers:  Pillow Cube

For back and side sleepers:  Therapeutica Sleeping Pillow which has several sizes to accomodates smaller or larger framed individuals.  Also consider a feather pillow like this one.  Feather pillows that are soft enough to be “rolled” under the neck or folded in half for extra support while you’re on your side.  See example video here.

Additional Recommendations for a Healthy Spine

Reading in bed:  

Consider a large wedge pillow like this one and pile pillows high enough on your lap to support your book at a comfortable level for your neck (avoid extended periods of looking down).  You might also try mirrored glasses like these to keep your neck in a neutral position while reading in bed.

For children:

A very lightweight down or cotton pillow that doesn’t cause your child’s head to be pushed forward while they sleep.

Pillow FAQs

How often should I replace my pillow?

Pillows should generally be replaced every 1 to 2 years, depending on the material and usage. Over time, pillows lose their shape and support, which can lead to discomfort and poor sleep quality. Signs that it’s time to replace your pillow include lumps, excessive flatness, or waking up with neck pain.

Can the wrong pillow cause neck pain?

Yes, using the wrong pillow can cause neck pain. A pillow that is too high or too low can misalign your spine, leading to strain and discomfort. It’s important to choose a pillow that keeps your head and neck in a neutral position, aligned with your spine, to avoid neck pain.

Are expensive pillows worth the investment?

Expensive pillows can be worth the investment if they provide better support, durability, and comfort. High-quality materials like latex and down often last longer and offer better support than cheaper alternatives. However, it’s important to find a pillow that suits your specific needs and sleeping position, regardless of the price. Dr. Flick’s favorite pillow is a cheap feather pillow which she replaces every few years. So, while an expensive pillow may last you longer, it’s not necessary for good spinal health.

If you found this post helpful or need more support, we’re happy to help!