Quality sleep is vital for good health and to pick the perfect pillow is vital for good sleep. An ill-fitting pillow can be considered a “sleep thief”. It stops you from sleeping soundly and waking up feeling refreshed. It can also contribute to headaches, neck, shoulder and arm pain, pins and needles and numbness.
The correct pillow largely depends on which type of sleeper you are (ie tummy, side or back) and the size of your body. But no matter what your sleeping style is, the pillow should keep its shape (even when you move) so that it should not need to be “fluffed” too often. (NB See “Hack your sleep position- wake up less creaky” for more insight into sleeping positions).
Our neck curves slightly forward (known as a lordosis) to sustain the weight of the head when you are in an upright position. So it’s important to maintain this slight curve or your “neutral alignment” when in a resting position. See picture below.
Basically, your head should not be pushed too far forward or tilt backwards. Ideally it should sit squarely on your shoulders. Think of a similar position to how you would look when standing up with good alignment. If the pillow is too high when sleeping sideways or on your back, your neck will be bent abnormally forward or to the side. This can potentially cause muscle strain on the back of the neck and shoulders. Similarly, if your head is pushed forward it can also obstruct breathing and encourage snoring. Which can hinder your sleep and usually your partners! Conversely, if the height of the pillow is too low, the neck muscles can also be strained.
To make finding your perfect pillow less of a pain in the neck go through the steps below.
Step 1: Identify your preferred sleeping position
If you are a stomach sleeper, whilst not an ideal sleeping position in itself because the head is turned on the neck, a soft, flat pillow is best. It will give support without raising the head and neck too far, allowing your neck to stay more aligned with your spine. Synthetic, wool, feathers and down are good pillow options when you need to select a low pillow.
Side sleepers benefit from a pillow that is higher at the neck and lower at the head. When lying on one’s side, a pillow should support the head and neck so the spine maintains a straight and natural horizontal line. A thicker pillow is needed for sleeping on the side compared to sleeping on your back. There should be no gap between the pillow and your neck so choose a firm-ish type of pillow that will conform to the shape of your neck. Memory foam or latex may suit.
Back sleepers generally benefit from a thinner pillow that has extra loft (filling) in the bottom third to help cradle the neck. When lying on the back, a pillow should support the natural curvature, or lordosis, of the cervical spine, with adequate support under the head, neck, and shoulders. Pillow height should be lower than for side sleepers. This design will stop your head from being thrown too far forward. Memory foam is a good option here as it moulds to the shape of your head and neck.
Mixed sleepers find themselves in different positions all through the night. The best option here is a soft, medium thickness pillow that gives you neck support. A feather and down, or wool pillow might work best.
Step 2: Choose your pillow filling
Feather and down: sourced from the inner plumage of geese or ducks. Be aware that there is a difference between a down pillow and a feather pillow. Down is very soft and light and is usually located underneath the harder, stronger feathers which protect the bird from the elements. A feather pillow therefore will likely be harder and there is a chance that some of the feather quills will be present, especially in cheaper feather pillows. Often this type of pillow is sold as a combination. A higher percentage of down means a softer pillow that can be moulded and fluffed to your favourite shape. Generally this will also be a more expensive pillow. These pillows can also often be filled according to your preference. More firmness or loft, suits side sleepers while less loft is better for back and stomach sleepers.
Feather and down pillows can last up to 10 years. They are resilient and breathable because they are made of a natural material. Although there is no scientific evidence that down or feather pillows exacerbate allergies or asthma, some people prefer to avoid them even for ethical reasons.
Memory foam: these pillows are made of NASA designed, visco-elastic polyurethane. They come in all shapes and sizes and provide good support. These pillows are useful if you have neck, jaw or shoulder pain as they mould to the contours of your head and neck. Restless sleepers will find them uncomfortable however, as they take a bit of time to mould to your shape. This material can make you feel hot, as it doesn’t “breathe” (so may not be suitable for women approaching or during menopause for example!) They also have a lifespan of 5-10 years.
Latex: a renewable and biodegradable product made from the sap of rubber trees. These pillows are durable, lasting for 5-10 years and are good for allergy sufferers as they are dust mite and mould resistant. They tend to be cooler than memory foam and come in all shapes, profiles and densities. Some use shredded material while others are made of solid cores. They do not offer as much “give” as a memory foam pillow and can be quite heavy and expensive.
Cotton and wool: breathable fibres that are soft and hypoallergenic. Not very mouldable though.
Polyester: the most common pillow type. Offers comfort to all types of sleepers as these pillows can be low to high in profile, soft and fluffy to somewhat firm. The amount of support depends on the amount of filling. These pillows do tend to form lumps quickly and need replacing more frequently than other materials.
Step 3: “Test” different pillows
Personal preference is a major part of any pillow choice. If the pillow feels comfortable, it’s easier to fall asleep and stay asleep.
Lie down on the pillow (if you can!) especially if you are purchasing in a mattress or bedding showroom or even a Physiotherapy practice. Also ask about trial periods and money back guarantees and return policies. At Ikea, for example, you have the option to return your pillow if you are not happy with it (conditions do apply).
Maybe go online and read reviews for different pillows before going shopping, especially if you are thinking of buying a specialty or “branded” pillow.
Remember, there are no government standards for the terms soft, medium, or firm in pillows. Also, the best pillow for you may not be the most expensive one. So do try different pillows in different price ranges. The pillow’s surface can be one source of comfort. A cool, smooth-feeling pillowcase is perfect for some, while warm surfaces, such as flannelette, are best for others.
Step 4: Caring for your pillow
Consider a pillow protector – relatively inexpensive and can be easily washed. This will help to extend the life of your pillow, especially if you have chosen a more expensive option. This will also keep it fresh and clean, away from moisture, oils and staining.
Otherwise, check the label on the pillow and to see whether it is machine washable and how frequently it can be washed.
Every 6 months it is a good idea to test your pillow. Put your pillow on a flat surface and fold it in half. If it bounces back to its original shape when you let go, your pillow is in good shape. If it stays folded, it is time to replace it.
Pillows and travel
Now whilst we may not be doing any international trips in the near future (except maybe to New Zealand) don’t underestimate how much better you will sleep with your own pillow. Whether you are staying in a hotel or with friends sometimes it is worthwhile to take your pillow with you.
Otherwise, if you are in a hotel, besides using the lounge cushion with a pillowcase on it, consider asking the concierge for extra pillows. Swap out their standard pillows with firmer ones if they are available and that’s what you need. Some hotels even have pillow menus- all you have to do is ask. The fancier the hotel you are staying in the more options they will have. The hotel will also be happy that you get a good nights sleep (and rate them well!).
Think wedge pillows to elevate the upper body if you suffer from reflux. Wedge pillows also recreate the recliner position in bed.
Travel pillows– Small U-shaped pillows designed for travel. They prevent the head from bending too far to one side or another while sitting up in a car or airplane. The takes on some of the work that would normally be done by the muscles to keep the head up. Those needing to save space may wish to buy an inflatable travel pillow.
See Therapeutic Pillow AustraliaSleep apnea pillow– designed for use with a CPAP mask.
In fact there are many many websites and companies dedicated to producing and selling specific pillows for specific issues. It just takes a bit of googling and research and checking of return policies.
Need a simple pillow “hack” when you have neck pain or are on holidays with a really dodgy pillow?
Roll a standard sized towel into a sausage shape and insert inside the pillow case, along one edge, to create a support for your neck. Vary the size of the towel “sausage” to suit and even tape into place if necessary.
Now if you do happen to pick the perfect pillow, my suggestion would be to go back out and buy another one. To keep in reserve. Quite often, if you look after your pillow and it does last for a couple of years, when it is time to replace it, odds are that your favourite will no longer be available!