Are different pillows for 'side sleepers' and 'back sleepers' b.s.?

Just like theres no perfect pair of running shoes for everyone, there is no one perfect pillow. But with so many choices—each promising different solutions to ensure a restful night’s sleep—the process of picking a damn pillow from the pile at Bed Bath & Beyond can seem daunting to say the least.

There are pillows for slide sleepers, pillows for back sleepers, pillows to keep you cool, pillows that are also alarm clocks, pillows that play music, and whole-body pillows that will cradle you "from head to toe," just to name a few options.

Part of the problem with evaluating pillows that promise to be life-changing is that there is not a lot of conclusive research, says Afshin E. Razi, M.D., a clinical assistant professor in the Department of Orthopaedic Surgery at NYU Hospital for Joint Diseases and a spokesman for the American Association of Orthopaedic Surgeons.

Some small studies have suggested that pillow height could affect comfort. One study by a University in Hong Kong found that pillow height affects spine alignment, another from the University of São Paulo determined that pillow height influences the amount of neck muscle activity, and a third by a pediatric hospital in Toronto found found that a neck support pillow was beneficial to people with chronic neck pain.

“What the studies are showing is that everyone has different angles and different heights, so finding the right pillow does make a difference,” says Shalini Paruthi, M.D., a member of the American Academy of Sleep Medicine and co-director of the Sleep Medicine and Research Center at St. Luke's Hospital in St. Louis. But more research is needed, she says.

It’s also helpful to take into account medical conditions, according to Sudha Tallavajhula, M.D., an assistant professor of neurology with McGovern Medical School at UTHealth Houston and medical director of the Neurological Sleep Medicine Center at TIRR Memorial Hermann.

For example, raising the head slightly during sleep is often recommended by doctors to help reduce snoring and sleep apnea. Sleeping on the left side has been found to calm acid reflux, according to a study from Jefferson Medical College, so pillows that encourage side sleeping on the left might provide some relief. Other pillows claim to help allergies or reduce neck pain. But there are other factors that could affect these conditions, too.

“I don’t know that a pillow alone will help you sleep better,” Tallavajhula says.

In fact, there are so many variables involved in sleep, that’s it hard to recommend a particular pillow, Razi says.

“I personally have not found any good data to suggest what’s good for what,” he said. “It’s all marketing.”

In other words, you don’t necessarily need to spend a lot of money to find a pillow that works for you. And specifics, such as size, filling, and shape, are often best left to personal preference.

So what should you do the next time you’re shopping for a pillow? Ask yourself what you’re looking for in a pillow—especially if you want it to solve a specific problem, Tallavajhula says.

“If you specifically have a medical condition you think you can help by using a pillow, you probably want to speak to a physician first,” she says.

Next, know your sleep style. We want our pillows to support our head and neck, so sleep position can make a difference, Paruthi said.

“For people who are side-sleepers, they may need a pillow that’s taller to support their head and neck, whereas people who are back sleepers may need a shorter height to support that head and neck area,” she says.

So make sure to try the pillow before you buy it, Razi says. That can make buying a pillow online tricky—unless you’ve already tried the pillow and know you like it. While some stores offer lie down areas for a few minutes, Razi suggests lying there for at least 15 to 20 minutes to see which one helps you relax more. See if your local pillow store has a trial you can do before you purchase, too. It’s often best to take the pillow home and test it out before you decide for sure that it’s the one for you, he says.

But overall, don't place too much weight on your pillow when it comes to sleep. Things including your mattress, your environment, and your state of mind can also play a role in sleep. Ensuring a quiet space, a dark room, and a cool temperature can help.

And most importantly, give yourself enough time to get the good sleep you need. Adults should get at least seven hours of sleep a night, Paruthi says.

“Getting enough sleep is one of the three pillars of a healthy lifestyle,” she says. “We should make sure we’re having good diet, regular exercise, but also getting enough sleep.”

There may not be enough data to say for sure which pillow wins the day. But given that we spend about a third of our lives asleep, it’s worth taking the time to find the one that works best for each of us, Paruthi says.