Pillow choice should start with sleeping position, expert says

Choosing a pillow starts with how you sleep, Chris McCarthy, an associate professor at the Manchester School of Physiotherapy, told the BBC’s Sliced Bread podcast. Shoulder width, the shape of your back and mattress firmness can all affect which pillow height feels right. [1]

Side sleepers with broader shoulders generally need a thicker pillow, McCarthy said. But a softer mattress lets the shoulder sink further in, reducing the height needed. Back sleepers with a more pronounced curve at the top of the spine may need a slightly thicker pillow than those with a flatter back. He advises against sleeping on the front because it leaves the neck turned for a long time. [1]

If your pillow feels too flat, McCarthy suggests putting a folded towel underneath it. Adjusting the folds can help you estimate a useful height before buying a replacement. [1]

He cautions that the effectiveness of pillows sold as contoured, ergonomic or orthopaedic is not fully proven. Fillings involve trade-offs too, he says: feather and down can release heat but shift shape overnight, while hollow-fibre and microfibre tend to hold their shape better but release heat less well. [1]