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How to find the perfect pillow for back sleepers

Foam or down? Thick or thin? Your questions about pillows answered.

woman sleeps on her back Credit: Getty Images / fizkes

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While choosing the right mattress for your sleep position gets all the attention, your pillows are key to maintaining spine alignment throughout the night and making the most of your rest.

Back sleepers are power players in the sleep world, as this is often considered the best sleep position for back and neck health, somewhat preferable to side sleeping and much preferable to stomach sleeping. However, when sleeping on your back, the wrong pillow can cause your neck to overextend or your head to jut out, a recipe for stiffness and a less than ideal morning.

But there are so many pillows on the market for back sleepers, touting different features, how do you choose?

What back sleepers need to know about how they sleep

If you’re a back sleeper, congratulations. Lying on your back may be the healthiest sleep position for spinal alignment, and people who prefer back sleeping represent just eight percent of the population.

This position is desirable because your weight is evenly distributed across the large surface area of your back while your neck remains neutral, which is also why this position is good for people with back pain. Lying flat on your back also reduces the number of potential pressure points between your body and the bed, which can cause discomfort for side sleepers.

Aside from choosing a good pillow, back sleepers can make themselves even more comfortable by sticking a small, rolled towel beneath their head or neck, and a thin pillow or folded blanket under the knees to support the curvature of the lower spine.

Pillow basics for back sleepers

stack of pillows
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Different materials and fills have pros and cons that are important to consider when shopping for your next pillow.

Back sleepers who are on the market for a new pillow should look for a somewhat thin pillow, which can limit stress placed on your neck and keep the head from jutting forward all night. The trick is making sure the pillow is also sufficiently supportive, so your head won’t sink in and tilt too far back and strain your shoulders or neck in the other direction.

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Some pillows for back sleepers have a curved shape that contours to the neck and head. These are often made of memory foam, which has the added benefit of a longer lifespan than, say, a traditional down pillow, which permanently compresses over time.

Back sleepers should avoid gusseted pillows, which have a panel sewn around the edges to provide more loft, because it will push your head up too much. Look for a medium level of support, with some give but enough density to cradle the head. Pillows that provide sufficient support for back sleepers may be labeled as “medium density,” or “medium-firm.”

What pillow filling is best for back sleepers?

contoured pillow
Credit: Getty Images / ribeirorocha

Contoured pillows can be a good choice for back sleepers, because they cradle your head and support your neck.

Choosing the material that plumps out your pillows is in large part personal preference. However, there are some benefits and, likewise, downsides to common fillings that back sleepers should be aware of when shopping for their next pillow.

Memory foam

This spongy material was developed by NASA in the 1970s to help cushion airline pilots and passengers. Now, it’s everywhere in the bedding world. The material is highly absorbent but has a soft surface that allows it to mold to your head and neck. The combination of these features fuels claims that memory foam mattresses and pillows are highly supportive and comfortable. However, more research is needed to determine if these features actually improve people’s sleep. One of the downsides of foam worth considering? The material can retain body heat more than other fills.

One attribute that may make foam, or latex, an attractive option to side sleepers in particular is that the material may be formed into contoured pillows with a “B” shape. Also called cervical pillows (referring to the vertebrae in your neck), their shape supports head and spine alignment of back sleepers when the less elevated part of the pillow is under the neck. Some people love them, others not so much, so if you’re curious, you’ll need to try one to find out if it works for you. Products from companies like Casper and Nectar offer customers a guarantee of 50 to 100 nights, so they can sleep on the pillow and send it back if they don't like it. Even some retailers like Bed Bath and Beyond, have generous return policies.

If you’re eager to try a contoured pillow, check out the Therapedic Classic Contour Memory Foam Pillow, which is well reviewed by back sleepers for its height and versatility (you can orient the higher bump under your neck to provide support if you sometimes prefer a side sleeping position).

For those who don’t want to try a contoured pillow just yet, the Tuft and Needle Foam Pillow has 4.5 stars our of 3,100 reviews and a 100-night guarantee, so you can return it if you aren’t among those legions of fans.

Down feather

These pillows are filled with duck or goose feathers and can be a nice choice because they contour to your head and neck without retaining heat. However, they may be uncomfortable for some back sleepers, due to the limited neck support and lack of stability.

To choose the best down pillows for back sleeping, look for something that is medium firm, which will compress somewhat but not leave your neck unsupported, like the well-reviewed Brooklinen Down Pillow—back sleepers will want to opt for the “mid-plush” option, which touts the “perfect balance of softness and support” for that sleep position.

Back sleepers who use down pillows should plan to replace them every year or so, as that’s typically how long the loft lasts before it really falls flat. Sinking into the feathers at night feels good when your head first hits the hay (or fluff), but sleeping on a collapsed pillow all night may leave you less than happy in the next day.

Down alternative

These pillows are stuffed with a synthetic material that replicates the loft and feel of goose and duck down. The material is considered hypoallergenic and therefore a good choice for allergy sufferers, as long as it’s kept clean of dust mites. Pillows with down-alternative fill also tend to be cheaper than those with natural feathers. However, synthetic-fill pillows tend to have a shorter lifespan than true down pillows, because the fill is less durable.

For back sleepers, this synthetic fill carries the same potential too-soft issues of feathers, as well as the long-term compression concerns. If you decide to go the down-alternative route, the Brooklinen Down Alternative Pillow is beloved by reviewers, some of whom say it’s like “sleeping on a cloud.” The “mid-plush” option is suitable for back sleepers.

Bamboo

This type of pillow is newer to the market. The name might make you think that the fill is made from bamboo, but it more often refers to fibers used in the pillowcase. Many of these pillows contain regular memory foam fill, but the bamboo fibers on the outside are purportedly sweat-wicking and help keep you cool at night.

Back sleepers who sleep hot, but prefer the support of foam, may like a bamboo-encased pillow, like the Xtreme Comforts Shredded Memory Foam Pillow, which is also our favorite overall bed pillow from our testing. It’s generously filled with shredded memory foam, but offers the option to remove fill to find your ideal thickness and density.

How to wash your pillow

Washing bedding
Credit: Getty Images / Olga Nikiforova

You should probably be washing your pillow more often.

Most down-alternative and many down-filled pillows are machine-washable, so you can put them through your washer and dryer at home. Just check the label before you buy, because dry-clean-only pillows could prove to be a hassle. Lab tests found that sample swabs from unwashed pillowcases, that had been used for just one week, had 17,000 times more colonies of bacteria than a toilet seat.

Foam pillows are more complicated to clean because many can’t be thrown straight into the washing machine. Check the tag to be sure, but if your pillow can’t go into the washing machine, you can treat them more like mattresses, says Jon Chan, lab manager at Reviewed. Sprinkle baking soda over the pillow surface, let it rest for an hour, then vacuum it up, he suggests.

For back sleepers who are also allergy sufferers

allergy sleepers
Credit: Getty Images / PeopleImages

For people with allergies, there are additional considerations to account for when buying a new pillow.

We spend a lot of time with our pillows. Back sleeper’s faces may have less contact with the pillow’s surface, but allergies could still be triggered by your bedding. Pillows pick up dust and, of course, dust mites. For the 20 million Americans with dust mite allergies, spending a night up close and personal with these organisms can have unpleasant side effects.

People with allergies and other sensitivities, like eczema and contact dermatitis, can experience symptoms due to their bedding, at night and even during the day, says Melanie Carver, Vice President of Community Health at the Asthma and Allergy Foundation of America (AAFA).

Fortunately, there are hypoallergenic pillows, as well as encasements that can make any pillow hypoallergenic. Look for pillows and covers that are certified asthma and allergy friendly by the Asthma and Allergy Foundation of America. Pillows with this certification “have an effective fabric barrier that prevents dust mites and other dust mite allergens from passing through and making contact with skin,” according to the AAFA. This certification also guarantees that the pillow can be washed regularly, to remove allergens "without losing [its] shape and appearance.” Regular washing is essential for easing allergy symptoms.

The bottom line on pillows for back sleepers

Back sleepers want to look for a pillow that can keep their spine aligned while they catch some zzz's. As such, their pillows need to offer a balance of supportive density while being fairly thin. Hitting the right balance prevents back sleepers’ necks from craning up or back throughout the night. Foam pillows designed for back sleepers are often a good choice, because they cradle the head and support the neck, though some back sleepers may find happiness in medium-firm down or down-alternative options. Ultimately, pillow selection boils down to all-night comfort, which is very personal, and has to be determined by each individual sleeper.

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Prices were accurate at the time this article was published but may change over time.

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