How to choose the right pillow.
In my experience as a physiotherapist, not only do I trial most pillows on the market but I also ask my clients to bring their pillows into my practice so that I can assess the condition of their pillows and whether they need to be replaced and whether they are being used correctly.
A good pillow is just as important as a good bed for getting a good night’s sleep. Even though we rarely give a lot of thought to the pillows we use, buying the right pillow and positioning it correctly could be one of the most important parts of sleeping success. It is a very comforting feeling to have just the right pillow to rest an achy, tired body on. In addition to providing comfort, the right pillows can also give the necessary support for the neck and spine, alleviating or preventing many common forms of back and neck pain.
Watch this video as I demonstrate how to test your pillow.
I have seen many back and neck problems aggravated, if not caused, by bad or worn-out pillows. If your pillow is six months old or more it could need replacing. Assuming normal use and wear and tear, a polyester pillow lasts for six months to two years, a down pillow five years and a feather pillow eight years. If, however, your pillow is clearly showing signs of wear, such as loss of shape and flatness, it is time to shop for a new pillow.
If you aren’t sure if its time to replace your pillow, test the support of down and feather pillows by laying the fluffed out pillow on a hard surface. Fold it in half or thirds and squeeze out the air. Release the pillow. If it unfolds and returns to its original position it has support; a broken pillow will stay as above. Place a weight of around 300g (10 ounces), such as a trainer, on the pillow. A pillow with support will unfold itself and throw off the shoe; a broken pillow will stay folded.
Buying a New Pillow
For a good night’s sleep the pillow that is best for you is one that you can squish and fluff to meet your contours and sleeping position. Your pillow should fit you like a glove. Your goal when buying a new pillow is to know what pillow firmness is going to allow your neck and spine to be aligned properly so there is no gap between your neck and your mattress.
The traditional pillow is the mattress top pillow, used to provide support for the head, neck and upper spine while the body is lying in bed in a resting position. When determining the number of pillows to use, bear in mind that too many tilt your head forwards and too few tilt your head backwards if you lie on your back. Similarly, if lying on your side, be sure the gap between your head and shoulders is filled by pillow. Find a position that enables you to maintain a midline position. For optimum support, it is best to select a pillow that has the following characteristics:
Designed to Keep the Spine in Natural Alignment -The human neck curves slightly forwards (to sustain the weight of the head when upright), and it's important to maintain this curve when in a lying position. If the pillow is too high when sleeping on your side or on your back, the neck is bent abnormally forwards or to the side, causing muscle strain on the back of the neck and shoulders. This type of position may also cause narrowing of the air pipe, resulting in obstructed breathing, and sometimes snoring, which can hinder sleep. Conversely, if the height of the pillow is too low, the neck muscles can also be strained.
The amount and type of support you need from your pillow (whether it be one, one and a half or two pillows) depends on your sleep position as well as your weight and the density of your mattress, but always try to consider the depth of your shoulder in comparison to the distance from your head to the bed. You need to fill that large area with a pillow, thus providing an equal surface to position your head so that it is even with your spine. In short, the pillow should maintain an approximate height of 110-15cm (4-6 inches), to properly support the head and neck.
For correct sleeping posture, only your head and neck should be placed over your pillow. Do not place your shoulders on the pillow because this will elevate your upper body much higher than your lower body. You could try rolling up a hand towel and placing it in your pillow to fill the gap between your neck and shoulder. To maintain the balance of the entire body, the sleeper can place a pillow between bent knees to achieve the midline position when lying on their side.
Comfortable -A large part of what makes a good pillow is personal preference. If the pillow feels comfortable, its likely to help you relax, get a good night’s sleep and feel well-rested in the morning. The pillow’s surface can be a source of comfort – some people prefer a pillowcase with a cool smooth feeling (such as cotton), while others prefer warmth (such as flannel). The pillow filling is also a matter of personal preference.
Adjustable - To help the pillow conform to various sleep positions, it is best if the pillow can be adjusted to fit the unique shape, curves and sleeping position of the user. A pillow should mould to one’s individual shape and alleviate any pressure points.
Pillows for Different Sleeping Positions
When shopping for a new pillow, buy at least two pillows as they can be used to support other parts of your body as well as the head and neck.
Sleeping on your back: Your spine should support the natural curvature of your spine; there should also be adequate support under your head, neck and shoulders. Placing a pillow or two beneath the knees further alleviates any back strain, and is the gentlest position for the back. This position can help you drift off to sleep but bear in mind that during the night the pillows may move as you move, and if you wake up you will need to reposition them.
Sleeping on your side: When lying on your side, the pillow should support your head and neck so that your spine maintains the midline position. Weight should be evenly distributed so as not to create unnatural bending or pressure. Some people may like to place a small pillow or rolled-up towel under their waist for additional support while lying on their side, especially if they have an hourglass figure.
Sleeping on your stomach: When sleeping or resting on your stomach, your pillow should be relatively flat or removed. This will help keep your spine in line and enable you to sleep better. In this position, it is often best to place another relatively flat pillow under your stomach. They will help minimise the amount of strain on your lower back as well as the amount of twisting for your neck.
Press Play to watch Sammy Margo, Sleep Expert, talk about choosing the perfect pillow filling.
Filling The fill of the pillow you choose is important. Different fills provide different advantages and degrees of firmness, and they can range in price from tens to hundreds of pounds. Again, the right pillow for you depends on your budget and your individual needs.
Naturally filled pillows, such as down or feather pillows, give you comfort and adjustability. They can support your head, eliminate pressure points and increase facial circulation to decrease face squashing.
Down pillows are the ultimate in comfort and luxury. However, if your pillow has any chance of becoming damp – such as in an extremely humid area or in a camper van or boat – it may not be the best option as it can develop an odour. Down is also not an option if you suffer from asthma or have allergies.
Cotton-filled pillows are available in a range of thicknesses and comfort levels. If you can pinpoint the proper combination you require, a cotton-filled pillow is an ideal choice. They also have the benefit of working well for people with allergies.
Foam-filled pillows are inexpensive. They are often of lower quality than your average pillow with a less comforting, luxurious feel. They come in a range of fills from solid to shredded and pellets.
Orthopaedic pillows exist in several different shapes and materials. Some promise to keep their shape or mould and conform to your head and shoulders, always keeping spine alignment as the number one focus. Bear in mind, though, that just because a pillow is orthopaedic, doesn’t mean it will be good or right for you.
If you are thinking about buying an orthopaedic pillow, consider the different materials they are made from, and pull them out of their boxes and inspect them before you buy. Read the labels to understand what you are purchasing and what the promises are. It’s also a good idea to consult a physiotherapist about the best position to use them in as I’ve seen a number of my clients aggravate neck or shoulder pain after sleeping with an orthopaedic pillow in the wrong position.
Pillows with sponge-type foam that recoils often fall under the same category as orthopaedic pillows. Known for how well they retain their shape, they are often unconventionally shaped.
Husk and seed pillows will also mould to the contours of your head and shoulders and keep the shape until you move. They do have a small disadvantage that no other pillow has, and that is their noise factor. Some people claim that they make a small rustling noise that can be unsettling. The noise is slight, and for many the comfort they offer far outweighs any small sounds that the pillows may emit when in use.
Pillow Shapes and Sizes
Contour pillow: A pillow with a curved design that adapts to head, neck and shoulder contour for back sleepers and side sleepers, and can help relieve neck pain and stiffness, frozen shoulder and headaches. Try to buy one that has a flat bit at the back so it doesn’t force your neck too far forwards.
Neck pillow or travel pillow: These pillows are horseshoe shaped, designed for the neck contour. They are called travel pillows since they are mostly used by travellers to keep their neck straight while they take a comfortable nap on board or train or plane.
Wedge pillow: A triangle-shaped pillow that provides a slope for placing the body in a diagonal position. This is a multi-purpose pillow, but is mainly used to relieve the symptoms of acid reflux during sleep.
Lumbar pillow: A half-moon-shaped pillow used at the lower back to comfort and relieve lumbar pain and maintain a correct sitting position. Likewise, they are used underneath knees for leg elevation and as neck support for relaxation and massage.
Knee pillow: An hourglass-shaped pillow that can be placed between your legs to elevate your lower body and keep a straight side-sleeping position.
Body pillow: A long, curved pillow for total body support that cradles head, neck, shoulders, back, lower back, legs and knees. It replaces other pillows and gives full comfort to the side sleeper.
Gadget pillows: These pillows contain a number of gadgets such as MP3 players to lull you to sleep with calming music; fragrance pillows to calm you with soothing smells; chill pillows to help cool you down and so on. If you want to buy these pillows don’t let the promise of a gadget compromise on the comfort.
Gill, 45, had been experiencing chronic neck pain following a road traffic accident three years previously in which she sustained a whiplash injury. She was unable to get off to sleep at night without the use of painkillers. Gill likes to sleep on her right side and is a petite lady with a narrow frame. The gap between her shoulder and neck was small, but all the pillows she had been buying were designed for ‘Mrs Average’. I showed her how to ‘butterfly’ the pillow so that it fitted her neck and allowed her neck to be in the midline position to reduce pain.
How to make a butterfly pillow:
Tie a soft scarf, hair band, string, elastic or bandage around the middle of the pillow to make it form a butterfly shape. Put your head on the narrowed part of the pillow and tuck the edges around you. Many patients find a butterfly pillow reduces pain.
By providing yourself with comfortable pillows on a regular basis, that goal of a full night of restful sleep will not be just a dream. I also suggest that once you find that pillow of your dreams you try and see if there are any smaller versions of it available so that you can take it with you when you are sleeping away from home.