By Stacey Colino
For The Washington Post
Most people realize that mattress quality can affect how well they sleep. Pillow quality doesn’t always get the same consideration, but it should. Research has found that the right pillow can determine whether you have a good night of slumber or one spent in discomfort.
This isn’t surprising, says sleep specialist Michael Breus, founder of SleepDoctor.com and author of the book “Sleep Drink Breathe: Simple Daily Habits for Profound Long-Term Health.”
“The pillow is like a bed for your head,” he says. But “people don’t think about the equipment as much as they do the process,” he adds. “Sleep is a performative activity, and equipment matters for performance. Pillows are an important purchase.”
Pillows aren’t a one-size-fits-all item, though, making it tricky to find the sweet spot for your comfort. Experts say it’s critical to choose one that keeps your head, neck and spine in a healthy alignment. Beyond that, it’s a matter of personal preference, which can depend on many factors, including your sleep position and a pillow’s loft (or thickness) and firmness.
As far as comfort goes, pillow technology has evolved considerably in recent years. Gone are the days when the choice of filling was limited to down, cotton or feathers. You can buy pillows filled with a down alternative (such as polyester or plant-based fibers), memory foam, latex or buckwheat hulls. “You may need to try several options before you find the perfect fit,” says Sean Wilging, a physical therapist with Ohio State University’s Wexner Medical Center in Columbus.
In addition to the traditional pillow sizes (standard, queen, king or square-shaped Euro style), there are specialty pillows – such as neck (or cervical) pillows, body pillows, wedge pillows, knee pillows and pregnancy pillows — available to address specific health issues.
Here’s a step-by-step guide to help you find your optimal pillow — and how to care for it once you find it.
Identify your preference for plushness
In other words, determine whether you gravitate toward squishy or firm pillows, Breus says. Having this info can help you start to narrow down what type of fill to look for. Down, feather and cotton pillows tend to be on the soft side, while memory-foam and latex pillows are firmer. Buckwheat pillows typically have a grainy texture.
Consider your initial sleep position
“It doesn’t matter if you switch positions during the night,” Breus says – your starting sleep position should guide your pillow choice. If you start out sleeping on your side, you’ll want a thicker, firmer, high-loft pillow that keeps your nose in line with your sternum (or breastbone), Breus says.
If you usually sleep on your back, a thinner, low-to-medium loft pillow can help your spine stay in a healthy position. And if you sleep on your stomach — which isn’t recommended because this position can strain your spine and neck — choose a pillow with a short height to avoid having your neck extended while it’s rotated, Wilging says.
Factor health considerations into your choice
Some pillows are designed to address specific health needs. If you have chronic neck pain, for example, choose a neck or cervical pillow that has a divot in the middle to support and elevate the neck while cradling the head, Breus says. “You cannot get into deep sleep when your neck is in pain,” he adds.
Compact pillows designed to be placed between the knees can reduce pressure on the hips and legs while you’re sleeping. These can also be helpful for people “with low back pain who may benefit from a pillow placed between the knees to minimize lower back curvature,” says Sudha Tallavajhula, a sleep medicine physician at UTHealth Houston.
Wedge pillows placed under the head may help with snoring and congestion. People with allergies or asthma might want to try hypoallergenic pillows, says Tallavajhula, which resist the growth of bacteria, mold and other allergy triggers.
Pregnant people may benefit from using a pregnancy pillow, which typically has an elongated C- or U-shape that contours to the entire body, Breus says. “Placing the lower section of the pillow between the legs can help reduce pressure on the knees and spine.”
And pregnant or not, if you tend to get hot while you’re sleeping, “you may find that [pillows with] feather or synthetic filling have a cooler feeling, while foam materials tend to be warmer,” Wilging says.
Practice good pillow care
Proper care can maximize the lifespan of your pillow. “Be sure to change out or wash pillows every so often,” Wilging says, “because pillows can trap dust and other allergens that may affect your nasal passages while you’re sleeping.”
If you don’t use dust-mite-proof covers, the American Cleaning Institute recommends washing pillows at least four times per year. Consult the manufacturer’s care instructions on how to clean your pillow. Recommendations vary depending on the pillow’s materials and construction.
Know when to replace your pillow
“It’s time to replace your pillow when it no longer supports your head and neck in an aligned position,” Wilging says. “If you find your head and neck tilting forward, backward or to the side in a major way, it’s time to buy a new pillow.” The same is true if the pillow develops irregular clumping, deep impressions or unpleasant odors — or if you’ve changed your sleep position.
Replacement time may come sooner than you expect. “Pillows should be replaced a lot more often than they are -— between 18 and 24 months for down or natural fill,” says Breus. “The structural integrity degrades quickly.” By contrast, memory foam pillows can last for up to three years.
Think of it this way: “You sleep every single night for hours and hours. The pillow is an important purchase,” Breus says. “It’s a small thing that can make a big difference,” he adds — both in the quality of your shut-eye and how you feel the next day.
