Orthopedic surgeon Andrew Hecht, MD, notes that when it comes to headaches, and neck, arm, and shoulder discomfort, “using the incorrect pillow can certainly exacerbate many of the underlying problems linked to these symptoms, and it certainly can keep you from getting a good night’s rest.” Sleep expert Michael Breus, PhD, states that “pillows can not only impact the quality of our sleep, but also how healthfully we rest and recharge.” How well we “rest and recharge” during sleep makes all the difference in how we feel.

To understand the importance of sleep, picture your body as a factory where essential work is performed on the night shift: heart and blood vessels are repaired, hormones are released, the immune system is strengthened, energy is restored, brain function is increased, and dreaming, which is essential for mental health, takes place. If we don’t get enough sleep, or if our sleep cycles are interrupted multiple times a night, “either due to snoring, difficulties breathing or waking up frequently throughout the night — then we miss out on vital body processes, which can affect our health and well-being the next day and long term.”

Additionally, studies have shown a link between sleep deficiency and a number of health issues such as memory loss, irritability, depression, suicide, heart disease, high blood pressure, diabetes, stroke, and obesity.

Understanding how important good sleep is to our health, it’s worth taking a little time to figure out how to maximize our sleep time. Finding the right pillow, just like finding the right mattress, can be a simple, yet critical, factor in improving the quality of your sleep.

So, how do you find the pillow that’s perfect for you? It really comes down to understanding just a few key factors.

First, you need to know your primary sleeping position—back, side, stomach, or a mixture of all—as this will determine the ideal loft (or height) of your pillow. Second, you need to understand the degree of softness or firmness you prefer in a pillow material, as this will influence the level of support you’re looking for. Let’s take a quick look at each of these two areas.

Know Your Sleeping Position

A good mattress should support your body, keep the spine in alignment, and prevent any rolling from side to side when you’re relaxed. A good pillow should be an extension of your mattress, keeping your spine in perfect alignment.

Sleeping on a pillow that’s either too high or too low can disturb that alignment, causing pain and discomfort. Using the right pillow with the proper support can make all the difference in experiencing a deeper, more beneficial sleep.

If you’re a back sleeper:  Look for a low-profile pillow that cushions your head without tilting it forward. It should also provide the right support at the neck to keep your spine in alignment.  Some pillows offer extra lift or even a curved design in the bottom third of the pillow for better neck support.

An easy way to test whether a pillow has the right lift is to lie down on a mattress with the pillow under your head. Your head and neck should remain level with your spine and not tilt up or down—think alignment. You can also tell if a pillow is right for you by standing erect against a wall with the pillow behind your head.  If the pillow has the right lift, your head will be centered above your shoulders, not angled forward, and in alignment with your spine.

If you’re a side sleeper:  Look for a pillow with medium loft and a firmer fill.  According to chiropractor Rachael Wall, side sleepers should make sure their pillow adequately fills the space between the shoulder and neck.

  • If the pillow is too low, that will cause the neck to drop below the horizontal alignment of the spine causing “pressure in and around the neck.”
  • If the pillow is too high, the head and neck will slope upward, rising above the horizontal alignment of the spine. This can result in “a gapping and stretching on the underside of the neck” affecting the ligaments and muscles and causing pain and tension over time. Additionally, Wall says, “You get a slight compression inwards on the joints of the neck on the upper side” which can also cause pain and discomfort.

If you’re a stomach sleeper: Look for a low-profile pillow, or go without a pillow altogether.  You may also find that sleeping with a pillow under your abdomen will help alleviate lower back pain.

Choose the Right Fill

The material that your pillow is made from (whether it’s a loose “fill” material such as polyester fill or a solid material such as latex foam) is the single most important component in determining how soft or firm (supportive) your pillow is.

Finding the ideal balance between softness and firmness for support is critical for restful sleep, but that’s easier said than done. A softer a pillow might feel more comfortable, but it typically provides less support for head and neck alignment. The more firm a pillow, the more support it provides, but often with less comfort.

Today there are a wide range of fill options to choose from, each with their advantages and disadvantages. Below are a few of the most common types of pillows on the market, including a couple of styles that are gaining in popularity, and a brief overview of their pros and cons.

Polyester-fill pillows

  • Pros: Soft, relatively inexpensive, lightweight, easy to scrunch into different positions, easy to clean.
  • Cons: Filling has a tendency to bunch up and get lumpy over time, not very durable, short lifespan of about 6 to 24 months

Down-fill pillows

  • Pros: Very soft, easy to shape, breathable, lightweight, long lasting
  • Cons: Lack firm support, can be expensive, feathers sometimes poke through cover, can be problematic for people with allergies

Buckwheat-fill pillows

  • Pros: Firm and supportive, moldable and conforming, breathable, durable, natural materials, removable husks for adjustable support
  • Cons: Heavy, a bit pricey, can be noisy when changing positions

Water-based pillows 

  • Pros: Contouring, can customize height and support, pain relieving, naturally cooling
  • Cons: Heavy, somewhat expensive, questionable durability, can be noisy

Memory foam pillows

  • Pros: Firm and supportive, pressure absorbing, contouring, durable, last for years
  • Cons: Firmness uncomfortable for some, heavy, not breathable, can tend to get warm, relatively expensive, can have an initial odor, have been known to off-gas

Latex pillows 

  • Pros: 100% natural, both soft and supportive, pressure relieving, organic, hypoallergenic, breathable, moisture and heat dissipating, durable, long lasting
  • Cons: Relatively expensive, can have an initial odor

Taking time to find a pillow that’s right for you may be one of the best investments you make in your health. So when it comes time to look for that next pillow, take into consideration your preferred sleeping position and the balance of softness versus support that you need for overall comfort. Getting these two factors right can go a long way in helping you find the pillow that’s perfect for you.