The Importance of Choosing the Right Pillow, According to a Physiotherapist

Dr. Chris McCarthy, a physiotherapist and associate professor at the Manchester School of Physiotherapy, emphasizes the critical role a pillow plays in maintaining spinal health. He notes that he personally brings his own pillow when traveling, a practice he finds essential for ensuring proper support.

Understanding Your Sleep Position

McCarthy categorizes sleepers into three main types: side, back, and front. He strongly advises against stomach sleeping, as it forces the neck into an extended, unnatural position for prolonged periods, potentially leading to muscle and ligament irritation. "If there's one thing there's a really good consensus on... in the physiotherapy world about treating spinal pain, it's don't sleep on your front," he stated.

For back sleepers, McCarthy points out that the natural flexion in the upper spine, which can increase with age, dictates pillow choice. Individuals with a more pronounced curve may require a thicker pillow compared to those with a flatter back.

The Impact of Mattress Firmness

When it comes to side sleepers, shoulder width is a key factor in determining pillow thickness. However, McCarthy highlights that the firmness of the mattress significantly influences this. "Broad shoulders need a thick pillow [if] you're on a very firm mattress," he explained. Conversely, on a softer mattress where the shoulder sinks in more, a thinner pillow is needed to maintain proper alignment.

To adjust pillow height, McCarthy suggests using a folded towel as a temporary measure. This allows individuals to experiment with different thicknesses to find what works best before purchasing a new pillow. He also notes that this method can help in measuring the ideal pillow height for future purchases.

Pillow Shape and Material

Specialized pillow shapes, such as contoured or ergonomic designs, have not been definitively proven to be superior, according to McCarthy. He notes that some evidence suggests a slightly higher front edge for pillows can benefit side sleepers by supporting the neck.

Regarding materials, feather and down pillows offer breathability, which can be advantageous on warmer nights. However, they tend to lose their shape throughout the night, especially for active sleepers, potentially leading to neck strain. Hollow fibre and microfibre fillings generally retain their shape better, though they may not offer the same cooling properties. Some pillows incorporate firmer materials in the lower half to help maintain structural integrity.

McCarthy, who uses a foam pillow, advises that the ideal pillow is a personal choice and often requires experimentation. He recommends utilizing trial periods offered by some manufacturers. "There just isn't a one-off design that is perfect for everybody or every position, I'm afraid," he concluded. "You really have to personalise it."