Pillow Talk: How To Pick The Right Pillow For You.

By Dr. Alissa Dimos, CACCP Precision Chiropractic, Bedford, NH

Okay, let’s start from square one. At the end of the day, your pillow’s most important job is to support you in your go-to sleeping position, all night long. And when I say, “support,” I don’t just mean that it feels soft and cozy. The right pillow should keep your head, neck, and spine, all in neutral alignment, and support the natural curvature of your spine (if you don’t have a good curve at this time but are working towards it, than MORE reason for a good pillow.) Keeping a neutral spine not only alleviates neck pain, it also relieves pressure throughout your entire body.

Before we can dive into which pillow is going to be best for those who experience neck pain, or for those who are looking to take care of their posture while they sleep (to help prevent neck pain occurring in the first place), we first need to understand the basic feelings, causes and types of neck pain some people may suffer from.
There are three main types of neck pain that you may experience:
1. Acute neck pain – neck pain that has been occurring for three days or less, so is a very new episode of pain.
2. Sub-acute neck pain – neck pain that has been occurring for 1 – 3 weeks.
3. Chronic neck pain – neck pain that has been occurring for over a month. This type of pain can be happening constantly or on and off daily throughout the month (or longer).

Pro Tip: If you’re not exactly sure how to tell if your spine is in neutral alignment, check to make sure your ears are in line with your shoulders, and your chin is in line with your sternum.

Now, here’s the tricky part: each sleeping position requires a different type of pillow in order to maintain healthy posture (I know, I know.)

But before I tell you exactly what each style of sleeper should look for, don’t forget about the fun part of pillow shopping! Once you’ve covered your body’s needs, and you’ve found a pillow that supports a neutral spine, you can dive into all the little details that satisfy your wants. There are, after all, hundreds of pillows out there, so you might as well find the one that’s perfectly suited to you.

You see, your sleeping position is just one reflection of your slumber habits, and there’s a lot more to consider when you’re on the hunt for your perfect pillow. For example, hot sleepers, memory foam fans, eco-friendly folks, and latex lovers are all likely to want specific types of pillows in order to accommodate their personal preferences. Remember: your pillow should always support a healthy posture, but it should also be compatible with your whole self.

So, before we unpack all of this, here is a super helpful picture to help you see where we are headed:

In order to maintain healthy posture, back sleepers need what I refer to as a “happy medium pillow,” meaning it’s got a medium loft, and a medium firmness. Additionally, back sleepers might find that pillows filled with materials that conform to pressure (like memory foam, for example), are particularly beneficial.
You might now be wondering, “But why do back sleepers need a pillow with medium loft and firmness?” Well, I’m glad you asked. Let’s take a closer look:
• Medium Loft — A medium loft is going to help relieve pressure in your neck and shoulders by providing a nice, cushy buffer between you and your mattress. If your pillow is too lofty, your head will be craned upwards (ouch, my neck!). If it’s not lofty enough, you’re pretty much lying flat on your mattress (well this isn’t comfortable.)
• Medium Firmness — A medium firmness will keep your head supported enough to be aligned with the spine, and ensure that the pillow won’t flatten over the course of the night. If your pillow is too soft, it’s likely to lose its shape under the weight of your head.

To keep a neutral spine and healthy posture, side sleepers need a pillow with a high loft, and firmer support. Side sleepers might also find that fluffable materials like Kapok, or shapeable materials like down, are particularly useful for the lateral position. Here’s why:
• High Loft — Most importantly, a pillow with a taller profile is going to prop your head up so that it’s in neutral alignment with your spine. Additionally, a lofty pillow will relieve pressure in your shoulder, and make sure that it’s not bearing the brunt of your body’s weight. If you ever feel like your shoulder is deeply digging into your mattress, your pillow might not be lofty enough.
• Firm Support — Pillows with a medium firm or firm level of support will serve to keep your head and neck in line with your spine throughout the night. If your pillow is too soft, your head will gradually sink down over the course of your slumber, throwing your spine out of neutral alignment (hello, stiff neck).
• Fluffy & Shapeable — Firmer pillows can take some getting used to, so I suggest searching for fluffable materials like Kapok, down, or down-alternatives. These materials are pretty soft on their own, so make sure your pillow is amply stuffed, and the loft is high. But finding a pillow that can be fluffed into a higher loft is often beneficial for side sleepers with broader shoulders (yes, I’m talking to most of the men here.) Also, pillows that are easily shaped allow you to reach one arm beneath the pillow in a cozy embrace, which is a go-to move for many side sleepers.

When it comes to stomach sleeping, finding the perfect pillow can be a little tricky. In fact, I try to encourage all of my patients to avoid the prone position altogether, as it tends to position the upper cervical spine at end-range rotation or extension. Essentially, this means you’re at greater risk of straining your neck, and putting pressure on your lower back or abdomen. (1) (Yes, there is research on this!)
If you’re not going to stop sleeping on your stomach, let’s check out proper pillow support:
• Low Loft — In order to maintain neutral spine alignment, stomach sleepers need a pillow with low loft (two inches or shorter). If your pillow’s loft is even slightly too high, your head will be craned upwards, and your whole posture will be thrown out of whack. Remember: your pillow should support the natural C curve of your spine. It’s nearly impossible to maintain the cervical lordosis in this position however.
• Soft Support — Pillows with soft support are going to provide a cushy buffer between you and your mattress, but also ensure that your head is not too propped up. The firmer the pillow, the more likely it is for your neck to be lifted out of alignment with your spine (and that’s when the soreness sets in).
• Compressible Fill — Pillows filled with feathers or down alternatives are ideal for stomach sleepers. Why? Well, those materials are easily compressed into a super low loft. They are also very shapeable, which lends itself well to stomach sleepers who like to embrace the underside of the pillow rather than lie with their arms at their side. Finding a pillow with an adjustable fill is also a bonus, as you can decrease the loft as much as you need.

What can I say, folks? Yes, there is a seemingly endless ocean of pillows out there, but that can be a good thing (if you know what to look for). And hey, now you know what to look for! Just remember that keeping a healthy sleeping posture is the most important thing, and once you’ve done that, you can explore all the other things you want your pillow to do. So, go forth, sleep well, and if you ever feel lost in the wide world of bedding, remember these pro tips.

Precision Chiropractic
116 S River Rd Unit F
Bedford, NH 03110-6734