5 tips for choosing a good pillow

If you have read my previous blog post, ‘7 tips for getting a great nights sleep’, hopefully you have tried a few of them and had good results.  Tip 5 in that post was “Have a good bed and a good pillow”. I didn’t go into too much detail on the various types of pillows to use in that post so here it is.  There are many different types of pillows out there and it can be quite daunting choosing the right one.  In this post I want to discuss how your sleeping position can help you choose the best pillow size and then I will discuss how to go about choosing the best pillow for you. 

What pillow is best for you will depend on what position you predominantly sleep in. The obvious question to ask here is, how do you normally sleep?  I say normally, because we all move at night and don’t always have control on what you do whilst asleep, but most people have a preferred position.  The three main sleeping positions are:

1. Stomach sleeping
2. Side sleeping
3. Back sleeping

Of course, there are always some weird mixture of the 3 main types, like half stomach and half side etc.  I don’t think there is one best position to sleep in, everybody will have a position that is better for them.  What I can say is that stomach sleeping is not ideal, especially from a chiropractic point of view.  There are a few reasons I say this.  Firstly, you have to have your neck twisted to one side in order to breathe.  It is not good to do this for hours on end.  Secondly, lying on your stomach can limit rib cage expansion and hence breathing.  You rib cage predominantly expands in an up and out movement.  Lying on your stomach can limit this motion, hence your breathing.

This leaves back and side sleeping as preferred options.  My personal favourite is side sleeping. I have never been able to easily fall asleep on my back.  The aim with choosing a pillow is to try to make sure you have good spinal alignment.  This means that our neck should ideally be in alignment with the rest of your spine. When you think about this, it makes sense that back and side sleepers will need different pillow heights based on our anatomy. The main component of this is the shoulders.  When you are on your side you need to take into account the width of your shoulders to ensure good neck alignment, hence side sleepers may need thicker pillows compared to back sleepers.  Let’s look at each of the main sleeping positions and things to look for when choosing a pillow. 

Back sleepers
As I said earlier, the pillow should support the natural curve of your neck.  It should not be too thick and force your head and neck forwards (or into flexion).  If you have some lower back pain, a useful tip for back sleepers is putting a small pillow under the knees.  This can take the pressure off the lower back.
Side sleepers
When on your side, the pillow should be high enough to support the head and neck so that the neck stays in good alignment with the rest of the spine. If the pillow is to low, your neck will be bent all night and more likely to be sore in the morning. A useful tip for lower back pain sufferers is to place a small pillow between the knees when side sleeping.  Often people will swing the top leg over when side sleeping which can create a twisting or torqueing movement through the spine.  This can aggravate a susceptible back, so the pillow between the knees may help this.
Stomach sleeping
If you do sleep on your stomach, I do recommend trying to change to one of the other positions, but if you have to sleep on your stomach the pillow should be reasonably flat or have no pillow. You don’t want the neck to be twisted and bent backwards (This is not a good position for the neck to be in).  If you are prone to lower back pain, stomach sleeping can put more pressure through the joints in the lower back.

5 Tips for choosing a good pillow
When you look for pillows it can be quite daunting as there are hundreds around.  Do you get one with contours or a flat one?  What height should it be?  What material should it be made of? Do you like a firmer pillow or a softer one? Do you like memory foam or feather pillows? Here are my 5 tips for choosing the best pillow for you:

1. Decide on your main sleeping position. This position will help determine the best pillow height.  The pillow that I sell at my practice (they are called a ‘chiro-pil-o’, you can see them here) and have sold for years, is height adjustable so it can be good for all sleeping positions. There are other height adjustable pillows available. Another pillow that I have sold is a water pillow, called the chiro-flow pillow (you can see it here). It is a little more expensive but comes with a water reservoir in the back that you fill up, the more water you add, the higher the pillow.
2. Decide on what material you like.  I personally like memory foam, but there is heaps of other options.  Again it is a personal preference.  Remember that some cheaper foams and feather pillows do compact over time so may need to be replaced sooner.  What material you like is often linked with the next decision.
3. Decide how firm you like your pillows.  Good quality foam is often firmer than other materials like feathers.  I have personally found that firmer pillows give me better support, but it may be different for you. Just remember that your comfort level is important, but the pillow also needs to be able to give the proper support.
4. Decide on your level of investment. The price of pillows varies from a few dollars to several hundred.  As with most things, you get what you pay for.  In my mind sleep is one of the most important things we do so having a good pillow is essential and worth the investment.  There are not many things you can buy these days for around $80-$150 that you use for 7-8 hours a day and last years.  However, just because a pillow is expensive doesn’t mean it the best one for you.  You still need to look at the above 3 points first.
5. Try the pillows out in the store. Try the pillow for a few minutes and see how they feel.  A 5 minute trial is definitely not like a full 8 hour night, but you can get the idea of what it may be like.  If you can’t lie down you can lean against a wall in your favored sleep position and see if your neck is in alignment with the rest of your spine.

Bear in mind it can take a good few days to get used to a new pillow so persevere with it.  Once you are used to it, it will hopefully give you the best chance of getting a good restful night’s sleep. If you are having a few issues with neck pain or back pain that is limiting your sleep it would be worthwhile to get it assessed, your body will thank you for it.