Posted on: July 13th, 2021

Soft pillow, thick pillow, foam pillow, feather pillow… Pillows. Who would have ever thought this would be such a big blog topic?

These days, we have so many things to choose from in every facet of life. I have to say, I miss the days when I had fewer choices to pick from (especially at the grocery store!). Too many choices make the decision that much harder and I get asked about pillows so often I figured I would help you all out.

What Pillow Do You Need?

I remember back when I was in physical therapy school, all of my classmates and I were so eager for the “right” answer. I also remember all of us being so frustrated when our professors’ answers were “it depends”. Grrr… how in the world does that help me??!

In school, we want things black and white, but in real life most of the things we encounter happen in the grey area. So, fast forward to this post, and I will have to say the same thing…it depends. You see, each one of us has a different makeup that influences much of the choices we make in life. With regard to pillows, it depends on your size, what position you prefer to sleep in, how firm or soft your bed is, and if you have allergies to certain fabrics and fillers.

Here is where to start: a pillow is meant to support your head and neck so that your muscles can rest at night while you sleep.

This means if you are a side sleeper you will likely need a thicker pillow than if you are a back sleeper. A pillow should fill the space from the mattress to your head without having to scrunch it up or have your arm under the pillow to provide the support.

Stomach sleepers ideally should not have a pillow under their head or neck while sleeping to allow the spine to remain better aligned.

Now if you are a back sleeper, but use more than one pillow because your neck is uncomfortable lying flatter, the issue is not that you can’t find a thick enough pillow. The problem is that you have poor posture likely from slouching on the couch while you watch the evening news, or because you spend most of your day slumped over a desk.

Pillows & Posture

When poor posture is an underlying issue, most people stack pillows to support themselves at night. The problem with doing this, is that you are encouraging the dysfunction and over time your body will prefer that position over one where you don’t look like a little old lady walking down the street all hunched over. There is a gradual progression that helps, along with manual therapy, to allow you to lie on your back with one, normal-sized pillow without pain.

This is also a good place to inform the wives out there (because let’s face it, they are usually the ones doing the buying) that the pillow that is right for you, is not necessarily the pillow that is right for your partner. Why?? Because most men have much broader upper bodies and shoulders than their female counterparts. So my recommendation is to buy a few pillows of different thicknesses to have you both try them out. The ones that get the boot can just go in the guest room for when the in-laws visit. Or do what I do, pass it off to the dog for her bed.

But what should it be made of you ask?!? Well, again, that depends. Feather pillows obviously are no good for people who have allergies to creatures that are covered in them. Foam-type pillows may not be good for those of us to have the dreaded night sweats or simply turn into a furnace when they sleep at night. What I do not suggest is pillows that have pre-made dents or bumps in them to “support” your head and neck. The reason…peoples’ heads are not one-size-fits-all. I know that sounds strange, but it is a very true statement and most of those types of pillows simply do not fit most people correctly.

Buying the Right Pillow

Now, when it comes to price I look for less expensive for several reasons.

First, I don’t like spending my money on trivial things like pillows. I would much rather be traveling and exploring the world.

Second, and this will shock most people, you should be replacing your pillows every 9-12 months! I’ll wait for you to gather yourself before I continue… Yes, pillows should be replaced at least once every year. This is not only because your pillow gets full of dead skin cells, dust mites, and God only knows what else, but also because the material (no matter what the advertisement says) starts breaking down then.

I get it, the pillow still looks nice and fluffy when it is lying on your bed after you make it (if you do). But, if you press your hand into the area where your head rests at night, you will most likely find that you can press to the mattress through the pillow. This doesn’t often take much pressure at all. Now imagine your head, which weighs 12-15 pounds, lying on it for 4-8 hours of sleep (I’m jealous if you get more). There should be no surprise after reading this, that a pillow that you have had since you were a little girl (seriously, a 45-year-old patient of mine told me that is how long she had been sleeping on the same pillow (YUCK) is not doing a good job of supporting the weight of your head at night so your muscles can rest.

The Great Pillow TLDR

Clear as mud?? The takeaway is this. It really comes down to preference when it comes to buying a pillow that is good for you. Can you spend $60-80 on a pillow to sleep on, sure… if you have an infinitesimal amount of money literally lying around your house and that’s your thing, go for it! I’m more around the $25 pillow (plus a discount coupon) goer. The worst part is that by the time I go to get another one to replace it, the bloody store no longer carries it so the process starts all over again!

I am not really a proponent of recommending specific products because as I stated above, each one of us is so incredibly different in our needs and preferences. However; in this case, I would like to put a plugin for a newly innovated pillow that has some versatility for those fed up with the never-ending search for the perfect pillow. Now, I do not get paid, nor do I have any affiliation with this product. But as a physical therapist, I think it has a lot of potential for solving many of these differences when buying pillows.

The makers of The Coop Pillow have found a way to modify the thickness of your pillow to meet your body size, and they have made it washable. This addresses two of the items that make pillow buying frustrating. They are a bit pricey for my britches, but I think they are fair for those who want to try and make their pillow last longer than a year. Check them out. but don’t hold me accountable if you don’t like them. This is merely a suggestion for those who are overwhelmed with their pillow buying experience.

Hope this has been helpful to some of you as you prepare your search for the perfect pillow for you. Until next week…remember…you are not “crazy”, it is not “just in your head”, and you are not “just getting old”.