What Pillow is Right for YOU? Part 1

Do you often wake up with a stiff neck or headache? Do you toss and turn at night trying to get comfortable? Your pillow may be the culprit. A pillow that provides comfortable support is crucial for a good night’s sleep and depending on what position you sleep in, can determine what type of pillow you need. There are down feather, contoured memory foam, shredded memory foam, down alternative, cotton, millet, buckwheat (and more) filled pillows. With so many options out there, it can be daunting to figure out where to start. As a physical therapist, who treats patients suffering from neck pain and headaches, I often see patients using the wrong type of pillow for their sleep position. It is easier to get the right type of pillow(s) than to change what position you sleep in. Even if you move around during the night, think about what position you tend to fall asleep in and wake up in. Here are a few pointers to get you started on selecting the right pillow for you!

    • Side Sleepers: People who are side sleepers need the most supportive type of pillow. Their pillows should be thick and firm. When you squeeze the pillow, you should meet firm resistance that doesn’t give way after a few moments of pressure. The pillow should fill the space between the ear and the shoulder when you are lying on your side. I often see these types of sleepers using multiple pillows stacked on top of each other. This may work for the person who doesn’t move too much in their sleep, but for those that move, having one firm pillow is often more successful because it will not fall away as the person moves around in their sleep. These types of sleepers often use additional pillows to support their arms and legs to reduce neck, low back and hip pain. A trick that I share with my patients is to stop using 4+ pillows at night that end up on the floor by morning. Instead, switch to 2 – one supportive pillow for the head and one firm body pillow. When you hug the body pillow with your arm and leg, it is less likely to end up on the floor. My current favorite recommendation for body pillows is using one that has a shredded memory foam filling and a zipper. Most of the time you will need to order additional memory foam and add it to your body pillow to make it firm enough to give your body support all night.
    • Back Sleepers: People who sleep on their back need a thinner pillow than side sleepers. Often, they will enjoy have a small contour to the pillow to support the neck but be weary of pre contoured pillows. A 6 1/2 foot person will need a different amount of contour than a petite 5 foot person. I typically recommend that back sleepers get a softer pillow and place a small towel roll (created with a hand towel) between the pillow and pillowcase. You can roll the towel up more to create a larger curve or unroll it for a smaller curve. The curvature should fill the gap between your neck and the pillow. It should never “push” your neck into a curve as this will create a stiff neck by morning! Many times, patients with low back pain will enjoy have a firm pillow under their knees to take pressure off the low back while they sleep.
    • Stomach Sleepers: In an ideal world, stomach sleepers would not use any pillows. If you must use a pillow, find the flattest pillow possible. This position does tend to create the most issues with neck pain in the morning. For my patients that are chronically waking up with intense neck pain, I will have them try using a body pillow with less support/filling than body pillows used by side sleepers. This will allow stomach sleepers to sleep partially on their stomach and partially on their side so that their neck is not fully turned to one side all night long.

I hope this post got you thinking and gave you some ideas on where to start when searching for your perfect pillow. Stayed tuned for Part 2 of this post where I will talk more about specific types of pillows.


Dr. Etheredge is a physical therapist who specializes in treating patients with headaches, neck pain and dizziness. Many of her patients have multiple diagnoses and complex needs. Dr. Etheredge is certified and dry needling and has been using this modality for years to assist her patients in achieving their goals. Learn more about Dr. Etheredge here .