How to Choose the Perfect Pillow

Dr Sophie Bostock on ITVs This Morning sharing 'How to Pick the Perfect Pillow'

Buying a new pillow will not solve every sleep problem, but the wrong pillow can contribute to poor sleep, neck pain, shoulder tension, headaches, stiffness, or overheating.

We spend around a third of our lives in bed, so the position of your head and neck during sleep matters more than many people realise. A pillow that is too high, too flat, too firm, or too soft can place strain on the muscles and joints of the neck for hours at a time.

Your ideal pillow will depend on a number of factors:

1. Your sleeping position

2. Your preferred pillow material

3. Any sleep or health issues affecting your comfort

1. How to Match Your Pillow to Your Sleeping Position?

Your sleeping position is one of the biggest factors in choosing the right pillow. Different positions place different demands on the neck and spine, so the ideal pillow height and firmness can vary considerably.

On average we change position 10-20 times through the night, but we often have a preferred sleeping position.

Side Sleepers

Side sleepers usually need a higher, firmer pillow to properly fill the gap between the neck and shoulder.

The goal is to keep the head aligned with the spine rather than tilting down towards the mattress. If the pillow is too flat, the neck may bend awkwardly sideways overnight, which can contribute to neck stiffness or shoulder discomfort in the morning (Yamada et al. 2023).

If you constantly fold your pillow, bunch it up, or stack multiple pillows together, this is often a sign that your current pillow does not have enough loft or support. People with broader shoulders typically need a deeper pillow as well. For a quick test... stand against a wall. Does the pillow roughly fill the space between your ear and shoulder? 

A pillow between the knees can also help to keep the hips aligned and support the lower back.

Memory foam and latex pillows are often popular choices for side sleepers because they maintain their shape better through the night.

Back Sleepers

Back sleepers generally do best with a medium-height, medium-firm pillow.

The pillow should support the natural curve of the neck without pushing the head too far forwards. A pillow that is too high can force the chin towards the chest, potentially increasing neck strain and even narrowing the airway during sleep, whereas a pillow too flat may reduce neck support.

A pillow under the knees can also reduce pressure on the lower back and help the spine stay aligned.

Many back sleepers prefer memory foam, microfibre, or softer latex pillows that provide support while still allowing gentle cushioning around the head and neck.

Front Sleepers

Front sleeping is usually the most demanding position for the neck because the head remains rotated to one side for long periods.

Front sleepers therefore tend to need a much flatter, softer pillow, or in some cases, no pillow under the head at all. Thick pillows can place the neck into a more extended and twisted position overnight, which may worsen neck pain or headaches.

Some front sleepers find that placing a pillow under the hips or pelvis helps reduce strain on the lower back.

How does pillow choice change depending on my mattress?

Your mattress also affects the pillow height you need.

A softer mattress allows the shoulders and body to sink deeper into the bed, meaning you will usually need a lower pillow to maintain good alignment. Firmer mattresses keep the body more elevated, which often works better with a slightly higher pillow.

This is why a pillow that feels perfect in one bed may not feel right in another.

2. How to Choose the Best Pillow Material?

Pillow material affects far more than comfort alone. Different materials influence support, temperature regulation, durability, breathability, and how well a pillow maintains its shape over time.

Hollow Fibre or Polyester Pillows

Hollow fibre pillows are affordable, lightweight, washable, and widely available, making them one of the most common pillow types in the UK.

They are often softer and easier to compress, which some people enjoy, but they can flatten relatively quickly and may lose support faster than other materials. Polyester pillows can also trap more heat overnight, making them less ideal for hot sleepers.

Feather and Down Pillows

Feather and down pillows are known for their soft, luxurious feel and are often favoured by front sleepers because they compress easily.

Down pillows tend to be breathable and mouldable, but they may not provide enough support for some side sleepers. Feather-based pillows can also lose shape over time and sometimes require regular fluffing.

People with allergies may prefer to avoid natural feather fillings unless the pillow is specifically treated to reduce allergens.

Down Alternative or Microfibre Pillows

Down alternative pillows aim to recreate the soft feel of down while remaining hypoallergenic and easier to wash.

They are often a practical middle-ground option for back sleepers who want softness without the higher cost or allergy concerns associated with natural down.

Quality varies considerably between products, however, and cheaper options may flatten quickly.

Memory Foam Pillows

Memory foam pillows contour closely to the shape of the head and neck, helping distribute pressure more evenly and maintain spinal alignment.

While memory foam is often marketed as the “best” pillow material for neck pain, current research does not show clear superiority over every other pillow type. Support, shape, and correct height may matter more than material alone.

These pillows are often especially popular with side sleepers and people looking for more structured support. However, some memory foam pillows can retain heat, although newer cooling foams and gel-infused designs aim to improve temperature regulation.

Latex Pillows

Latex pillows provide a supportive but slightly more responsive feel than memory foam.

They tend to spring back into shape quickly, maintain their structure well over time, and are often naturally breathable. Many people find latex pillows cooler than traditional memory foam.

A systematic review found latex or rubber pillows may help reduce waking neck pain and improve pillow satisfaction in people with chronic neck pain (Chun-Yiu et al. 2021).

Because latex is generally more durable, these pillows can last longer than many synthetic alternatives, although they are often more expensive initially.

Wool Pillows

Wool pillows are naturally breathable and temperature regulating, making them a good option for hot sleepers or people experiencing night sweats.

Wool can help wick moisture away from the body and maintain a more stable sleeping temperature throughout the night. These pillows are also often chosen by people looking for more natural bedding materials.

3. Why you should Consider Sleep Issues and Health Conditions

Your pillow choice may also depend on specific sleep symptoms, medical conditions, or comfort issues.

Neck or Shoulder Pain

Supportive memory foam or orthopaedic pillows may help maintain better neck alignment overnight, particularly if you regularly wake with stiffness or discomfort.

However, comfort still matters, a pillow that feels overly rigid may disturb sleep even if it provides good support.

Sleep Apnoea or Snoring

Poor neck positioning can sometimes narrow the airway during sleep.

While a pillow will not treat sleep apnoea itself, maintaining more neutral neck alignment may help some people reduce snoring or improve comfort overnight.

Reflux

People with acid reflux may benefit from a wedge pillow or elevated sleeping position, which can help reduce symptoms by using gravity to limit stomach acid moving upwards overnight.

Menopause or Overheating

For hot sleepers or people experiencing night sweats, breathable pillow materials can make a noticeable difference.

Wool, cotton, bamboo, latex, and some cooling gel-infused foams are often marketed as better options for temperature regulation.

Allergies

If you suffer from allergies or asthma, hypoallergenic pillow materials may help reduce irritation.

Regular washing is also important, as pillows can accumulate dust mites, sweat, skin cells, and allergens over time.

How many pillows should you sleep with?

Most experts recommend finding a single pillow that suits you. 

A single well-fitted pillow should be all you need to support the spine, whereas too many pillows can tilt your head too far forward, leading to discomfort. Natural movement during the night can also cause pillow towers to tumble, causing discomfort. 

How Often Should You Replace Your Pillow?

One of the most common sleep questions is: when should you replace your pillow?

Most pillows should be replaced every 1–2 years, although this varies depending on the material and quality.

The average UK pillow is around 3.6 years old, despite many pillows needing replacement much sooner.

Signs your pillow may need replacing include:

• Lumps or uneven filling

• Flattening that does not recover after fluffing

• Neck pain or stiffness on waking

• Yellowing or staining

• Increased allergy symptoms

• Folding in half and staying folded

  
  

Memory foam and latex pillows often last longer than polyester or feather pillows, but no pillow lasts forever.

How Often Should You Wash Your Pillows?

Another commonly searched question is: how often should you wash your pillows?

Most pillows should ideally be washed every 3–6 months, although always check the manufacturer’s care instructions first.

Using a pillow protector can help reduce sweat, oils, and allergens building up inside the pillow and may extend its lifespan.

Regular washing may also help reduce dust mites and improve allergy symptoms for some people.

What Does Research Say About the “Perfect” Pillow?

Research into pillow choice is still surprisingly limited, and there is no strong evidence that one pillow type is universally “best”.

One study, published in Rehabilitacion, suggested that latex or supportive foam pillows may reduce neck pain and morning discomfort in certain groups of people with chronic neck symptoms, although no single pillow material was clearly superior overall (Ghosh et al. 2025).

A 2021 meta-analysis found that rubber and spring pillows were associated with reduced neck pain and waking discomfort. The review also suggested that pillow height and shape may be more important for spinal alignment than the material itself.

A recent study, published in The Open Public Health Journal, comparing memory foam and wool pillows, also found that different pillow shapes suited different sleeping positions, with pillow shape appearing to influence both comfort and neck muscle activity during sleep.

In general, findings are mixed, especially when it comes to overall sleep quality.

One reason for this is that pillow comfort is highly individual. Body shape, shoulder width, mattress firmness, sleeping position, temperature preferences, and personal comfort all play a role.

In reality, the “best pillow” is usually the one that keeps your neck comfortably supported while allowing you to sleep comfortably through the night.

Are you Still Attached to Your Old Pillow?

A lot of people keep the same pillow for years longer than they probably should. Pillows are surprisingly personal, once you find one you like, it can be hard to replace it, even when it’s flattened, unsupportive, or long past its best. So can it be revived...

How to fluff your pillow?

https://www.youtube.com/watch?v=SkbbVSXapsg

You can extend your pillows lifespan if you fluff it frequently enough. While it’s not a perfect fix, it could give your pillow the boost it needs!

The Bottom Line

There is no single “best” pillow for everyone.

The right pillow depends on your sleeping position, mattress, body shape, temperature preferences, and personal comfort.

If in doubt, choose a pillow with a trial period and try it out for 7+ nights. Memory foam will take a few nights to adjust to your body shape, and some pillows have adjustable filling so that you can make them the right height for your body.

If you regularly wake feeling stiff, sore, overheated, or unrested, your pillow may be contributing more than you realise and replacing it could make a meaningful difference to your sleep quality.

I recently appeared on ITVs This Morning to discuss how to pick the perfect pillow, and we made sure to test out a range...

Products

1) Levitex Sleep Posture Pillow, £80

2) Levitex Slice Topper, £29 

4) Simba Hybrid Pillow, £109

5) Slumberdown Wool Pillow, £19

6) Silentnight Anti-Snore Pillow, £24.99 

8) Panda Hybrid Bamboo Pillow, £90

7) Putnams Wedge Pillow, £86 

Watch here to find out more specifically about these pillows!