The right pillow—contour or otherwise—is really unique to each individual. “Factors such as sleeping position, shoulder width, history of neck pain, and personal comfort all matter,” says Jackson. “Contour pillows can be helpful for certain sleepers, particularly those with chronic neck discomfort, but they are not necessary for everyone. I do recommend that clients trial any pillow changes for at least a week or two to allow for an adjustment period, before determining whether or not the pillow is appropriate for them.” And, for anyone who really wants an individualized pillow, there are always custom options available (similar to a custom insole).
As for what to look for when choosing the ideal pillow, here are a few factors to consider to help support better rest.
Sleep Position
First and foremost, it’s important to identify what type of “sleeper” you are: side, back, or stomach. “Matching pillow height and firmness to sleep position improves alignment and comfort,” says Jackson.
For instance, side sleepers generally need a thicker, firmer pillow to keep the neck aligned with the spine, says Jackson. Whereas back sleepers often benefit from a medium level of support that maintains the natural cervical curve without pushing the head forward. And, lastly, stomach sleepers typically require a very low pillow, or none at all, to prevent excessive neck extension and rotation.
Height
Height (also referred to as “loft”) should maintain neutral alignment based on the person’s preferred sleep position. “The ideal pillow is one that supports neutral alignment, matches the sleeper’s body type and position, and maintains its structure over time,” says Jackson.
Side sleepers generally need a higher loft, to account for the placement of the shoulder, says Sherry McAllister, DC, chiropractor and author of Adjusted Reality. How do you know if you’re getting enough support as a side sleeper? “Number one, you’re going to feel your shoulder, and may even feel shoulder discomfort. You may also feel your ear pushing into the pillow because there’s not enough support,” she says, adding that you should take note if you feel pain in the curve of your neck (if that’s the case, this pillow isn’t right for you).
For back sleepers, a medium loft of around four to five inches is generally best, says McAllister. You also want to make sure that you’re comfortable and the pillow isn’t pushing your head forward, “because that means you’re going to be stretching all of those ligaments at the back of your neck all night long, and you’re probably going to end up with a mild tension headache or a full-blown headache.”
Material/Firmness
Another consideration is the material of your pillow. “Firmness should be supportive enough to prevent sinking, but not so firm that it creates pressure points,” says Jackson. “Memory foam and latex provide structured support; adjustable-fill options allow customization.”
In fact, one study suggests that pillow material significantly affected neck fatigue and sleep comfort. “Neck fatigue was less common in people using latex or memory foam material compared to feather and cotton filled,” says Phaff. “Materials that maintain shape and provide firmer, more consistent neck support may reduce sleep neck and shoulder discomfort.“ Durability and breathability also matter: in other words, look for materials that retain shape and promote airflow, to improve long-term comfort.
Shape
“Studies have found that pillow shape was the biggest factor influencing sleep-related symptoms, including head fatigue, neck fatigue, neck pain, and shoulder pain,” says Jackson. “With flat pillows reporting the most sleep related symptoms, and peanut shaped and contour pillows (pillows that provide support and have a curve with higher sides and height of 7-11cm in the center, rather than flat) and a cooling surface were reported to be more comfortable and provide symptom relief.” In the same study, back sleepers reported fewer waking symptoms with contour pillows compared to side sleepers.
Side sleepers were more sensitive to pillow height (rather than curve of the pillow), reporting more waking symptoms if the pillow was too high or too flat, preferring the head and neck to be aligned parallel to the surface of the bed. So, while contour pillows may be a better choice for back sleepers, a pillow with adjustable height may be a better option for side sleepers. For back sleepers, “having a little extra support kind of at the base of your neck can help keep you in a nice position,” says McAllister.
Overall, “I advise choosing pillows that meet evidence-based criteria: appropriate thickness for sleep position, moderate firmness for support, and materials that retain shape over time,” says Jackson. “Brands that offer ergonomic or adjustable options can be especially helpful because they allow for customization.”