Carrying your own pillow when traveling may seem excessive to some people, but physiotherapist Chris McCarthy says there is a good reason to be particular about where you rest your head. The wrong pillow can contribute to neck discomfort, and the best choice depends largely on how you sleep.
McCarthy, an associate professor at the University of Manchester’s School of Physiotherapy, says most people fall into three categories: side sleepers, back sleepers and stomach sleepers. He advises against sleeping on your stomach because keeping the neck turned in one direction for a long period can stretch and irritate muscles or ligaments.
For people who sleep on their backs, the main consideration is the amount of flexion in the upper spine and neck. Someone with a greater natural curve may need a thicker pillow than someone with a flatter back.
Side sleepers should consider the width of their shoulders. In general, broader shoulders require a thicker pillow, but the mattress also plays an important role. A firm mattress allows the shoulder to sink less, meaning a thicker pillow may be needed. On a softer mattress, the shoulder sinks farther, so a thinner pillow may be more appropriate.
McCarthy recommends using a folded towel underneath the pillow if it feels too flat. Adjusting the number of folds can help determine the approximate height needed when choosing a new pillow.
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Specialized pillows marketed as anatomical, ergonomic or orthopedic may help some people, but McCarthy says the evidence is not conclusive. For side sleepers, a slightly raised section supporting the neck may be beneficial. A rolled towel placed underneath the pillow can be used to test whether additional support improves comfort.
The filling also matters. Feather and down pillows can help dissipate heat, but they may change shape during the night, particularly for people who move frequently while sleeping. Fiber and microfiber fillings tend to maintain their shape better, although they may not dissipate heat as effectively.
Ultimately, McCarthy says there is no single pillow design that works perfectly for everyone. The ideal choice should be adjusted to each person’s sleeping position, body shape, mattress and comfort needs.
