Healthy, Restful Pillows...


Dr. Jodi Perrin | Brannick Clinic of Natural MedicineWhen was the last time you had to think about buying a bed pillow? Do you know how to pick a pillow offering the best sleep quality? A lot of people don’t put much thought into the pillows they purchase. Selecting a good pillow is just as important as selecting a good mattress. Picking a pillow can be challenging for many people. Even I struggle despite knowing what to look for in a proper supportive pillow. I have purchased and returned at least 5 pillows this past year. I will not claim to be an expert in picking a pillow. There are just too many variables to consider for me to say, “this is the perfect pillow.” When looking for the best pillow, a person needs to consider the types of pillows, sleep position, individual preferences and any underlying medical issues. To help you navigate through the pillow world, I can offer tips and guidelines to help you pick the best one.

Why does your bed pillow matter?

Good quality sleep is multi-factorial and good sleep posture is one of those factors. Your pillow (and your mattress) is what supports a good sleep posture, so you do not wake up with pain or stiffness. Good sleep posture means your body is in alignment with your knees, hips, spine, chest, shoulders, head and neck. When the sleep posture does not support proper alignment, you get twisting, bunching or craning that can cause muscle strain, pain and sleeplessness.

Comfort is important as well when selecting a pillow. A company may boast its pillow promotes the best alignment while sleeping, but if it is not comfortable it could still result in sleeplessness.

Before we get into how to pick a pillow, we need to first consider if it is time to replace yours. Here are a few questions to consider when you are looking at your old pillow: What does your pillow look like? How old is your pillow? Is it covered with sweat and drool stains and have a weird lumpy shape? How does it smell? Does it hold its shape when you drape it over your arm or just sag? If you fold it in half, does it bounce back or stay folded? Are you waking up with neck or upper back pain? If it fails these tests, it’s time for a new pillow.

The life expectancy of a pillow can vary depending on the quality and materials it is made from. Memory foam pillows may last up to 3 years. Feather pillows will generally last longer than synthetic ones. A higher quality pillow will last longer than an inexpensive one. On average, most pillows need to be replaced about every 18 months. I know you may love that feather pillow you have had for 20 years, but I can guarantee it has no support left in it. Besides the loss of support and structural integrity, it also collects dead skin cells, dust mites, mildew, mold and fungus. This can cause breathing problems and have the potential to trigger allergies.

Tips for picking a pillow

Picking the “right” pillow depends on the individual. There is no perfect pillow that is going to work for everyone. The best way to pick a pillow is to determine what you want from one and then experiment with those fulfilling your criteria. The following is a list of things to consider.

1. The Fill

There are many choices when it comes to pillow fill options. No one is better than another. What you pick will depend on your criteria and comfort.

Down: Down pillows are generally lightweight softer pillows. The filling can be a mix of goose or duck down and feathers. Some down pillows even have a core of other material wrapped in the down and feathers to add some neck support for people that want it.

If you are considering a down pillow, quality matters. An inexpensive down pillow may potentially cause allergic reactions in individuals who are susceptible due to being insufficiently cleaned. Microscopic dirt can remain in the down, which can cause allergy symptoms. You will want to look for a pillow labeled as hypo-allergenic down, if you tend to react to down pillows.

Down alternative and polyester: Synthetic down alternative and polyester are generally less expensive and have to be replaced more frequently than a down pillow. They range from soft to firm, though the soft is not nearly as soft as a down pillow. Over time, they have a tendency to flatten and lose their shape.

Wool: This fill is not as readily available in stores. Wool is generally a firm pillow and can be from sheep or alpacas. Alpaca wool will be a bit softer than sheep wool. Wool is naturally hypo-allergenic and resistant to dust mites and mold. These pillows are also great at helping to regulate body temperature. They will keep you warm in the winter and cool in the summer.

Cotton: Cotton fill pillows are easy to find and like wool in that they are naturally hypo-allergenic and resistant to dust mites and mold. Cotton pillows tend to be a bit of a firmer pillow.

Latex: This is another pillow type not readily available in stores, but there are options online. Latex pillows have more of a medium firmness and hold their shape well. Latex is great for allergy sufferers as it is resistant to dust mites and mold. These pillows can be found with a contoured design that adds extra support to the head and neck.

Memory foam: Memory pillows are the current trend. It softens and contours to your head, neck, and shoulders. The material distributes weight evenly across its surface in order to reduce pressure points. These pillows are also usually found with a contoured design to support the head and neck. Memory foam tends to retain heat and may lead to sweating and discomfort. Recent trends have led to memory foam pillows with added ventilation to help reduce the heat retention but overall, the material still retains heat. Being a synthetic material, these pillows can give off a chemical smell until they are well aired out. If you prefer a softer, cuddly pillow, this is not the choice for you. Companies are making variations of memory foam pillows with a softer down alternative or cotton outer shell to allow for that soft pillow feel with the support of memory foam. Another recent trend to soften memory foam is shredded memory foam pillows. These pillows are usually a combination of synthetics and memory foam that look like torn up pieces of a memory foam pillow.

2. Fill weight

The weight of your pillow is a personal preference. Down and synthetic or polyester pillows tend to be light. Memory foam is heavier and wool, cotton and latex fall somewhere in the middle.

3. Quality

Quality of a pillow can impact comfort, support and longevity. Think of how many hours you will spend with your pillow. Try to select the highest quality pillow your budget will allow.

4. Size

This is another personal preference. For the most part, people only need a standard size/queen pillow. If you need a larger pillow, make sure it supports proper sleep posture.

5. Synthetics and chemical processing

Synthetic materials such as memory foam and polyester are made with chemical processes. Quite a few natural materials have undergone antimicrobial treatments. When selecting a pillow, consider your own allergies and chemical sensitivities.

Can sleep posture impact your pillow choice?

Absolutely! Many individuals have a dominant sleep position, though nearly everyone switches sleeping position at some point throughout the night. Are you a side sleeper that sometimes ends up on your back? Or that semi-side/stomach sleeper that ends up on your stomach? You need to find a pillow that will support you in all your sleep positions.

Here are a few things to consider:

Back sleepers will need a flatter pillow or one that is contoured to promote the natural curves of the head and neck. Generally, back sleepers would do well with a soft pillow.

Stomach sleepers may be better off with a soft thin pillow or no pillow at all. (Chiropractic side note: This position is not good for the neck or the low back.) Stomach sleepers may want to consider a pillow under their stomach or pelvis to reduce strain on the low back.

Side sleepers may need a firmer thicker pillow to support their head and neck to maintain proper alignment. They may even want to consider a pillow between their knees to reduce pressure on the knees and hips. A side sleeper should look for a pillow that is as wide as the distance between your ear and outer edge of your shoulder. Some specialty side sleeping pillow will have a little shoulder contour. A pillow with a 1 – 2” gusset (thicker flat edge of a pillow that provides greater height to a pillow’s thickness.) can help reduce neck and upper back pain in a side sleeper.

Your pillow is an important investment in your health. Many people don’t realize the impact a pillow can have on their sleep quality and ultimately, their quality of life. If you’re having sleep issues or suffering from neck and back pain, take some time to look at your old pillow and use these tips to help you pick one that offers you the most comfortable and restful sleep.

Dr. Jodi Perrin, ND, DC