While creating vision boards at the start of this year, one of my girlfriends mentioned she always makes it a goal to improve her posture. Although I’ve never included a magazine cutout of an aligned spine on my collage of aspirations, I have to admit that I, too, wish I sat up a little straighter. It’s on my mind when I attend my weekly classical Pilates classes or take my daily walks—and I occasionally regret dropping out of ballet at the ripe old age of three. My social media algorithm seems to know this, because I’m consistently getting targeted ads about posture-correctors—sports bras, ergonomic chairs, and the like. Lately, it seems the posture pillow has taken over the stature-correcting craze.
While ergonomic pillows are hardly a new invention, social media seems to be churning them back into the zeitgeist. Some are as simple as a memory foam or contoured pillow, others are quite elaborate contraptions that keep your neck and spine in a precise position. As with any health and wellness trend, it’s my journalistic prerogative (and personal interest) to ask the question: Does pillow choice actually have any bearing on well-being? And do posture or contour pillows actually work?
Vogue’s Favorite Posture Pillows
How do posture pillows work?
Simply put: A posture or contour pillow is designed to support the natural curve and alignment of the neck and head during sleep. These pillows typically elevate the neck while allowing the head to rest slightly lower, helping maintain neutral alignment. “Research on sleep ergonomics suggests that proper cervical support can reduce neck muscle strain, decrease morning stiffness, and improve perceived sleep quality,” says Lindsy Jackson, PT, DPT.
What’s more, by helping to maintain neutral cervical positioning, posture-supporting pillows may help improve sleep comfort and reduce waking symptoms such as tension headaches and daytime sleepiness, as Tara Phaff, DPT explains. “There is a consensus among researchers that promoting the natural lordotic curve of the cervical spine is essential for inducing longer periods of deep sleep,” she says. Bonus points if the pillow has cooling features, “which can help promote sleep quality by lowering body temperature, reducing sweating, and slowing heart rate.”
That said, “evidence about these pillows’ efficacy is limited and inconsistent and since we cannot control what happens in our sleep, pillow effectiveness is not going to be truly standardized,” says Jackson. “While not a cure-all, they can be effective, in conjunction with physical therapy and other treatments, for individuals with neck pain or postural strain.”
Does sleep position impact your well-being?
According to Phaff, while many factors influence sleep quality, body positioning can play a role in how much restorative sleep you get. “Research suggests that poor cervical positioning during sleep can place excess stress on the neck’s joints and soft tissues,” she continues. “When discomfort disrupts sleep, it can reduce overall sleep quality, which may, over time, impact your overall well-being.” That’s because poor sleep quality has been linked to heart disease, obesity, depression, high blood pressure, and diabetes.
Here, I’ve rounded up a few different pillows that can help support different types of sleepers, based on expert recommendations and my own experience.
Best for Back & Side Sleepers: Dumos Cervical Neck Pillow
“This is the pillow I recommend to my back and side sleepers with neck pain, it has a nice cooling feature, it’s not too thick and is slightly contoured,” says Phaff. This design essentially combines the features of a contour pillow with a more traditional pillow, and it’s ergonomically designed to support the head, neck, shoulders, and back by cradling the curve of your neck. It also provides two different height options on either side of the pillow, so you can choose whichever fits your personal preference.
Best Memory Foam: Tempur-Pedic Tempur Neck Pillow
This classic memory foam pillow also comes with a Phaff stamp of approval. It’s designed to follow the natural curve of your body, therefore supporting proper alignment and comfort. This option is ideal for side or back sleepers who want extra support, but with a less rigid structure.
Best Customizable: Coop Sleep Adjustable Pillow
I’ve personally been sleeping on this Coop Sleep pillow for over a year now, and I highly recommend it to anyone who’s looking for highly-customizable support. It’s filled with a blend of memory foam and micro fiber that maintains its shape beautifully. I’m a side sleeper, and I tend to stack two pillows under my head to get the support I need. However, with this pillow, I can increase or decrease the amount of fill, in order to create the perfect height for my neck. While I’ve loved the classic pillow shape, the brand also offers crescent (ideal for back sleepers) and cut-out (specific to side sleepers) shapes.
Best for Any Type of Sleeper: SlumberCloud Hybrid Pillow
I’m a big fan of SlumberCloud bedding, and I recently tried out their Hybrid Pillow, which is designed and developed by its sister brand Avec. Similar to the Coop Sleep pillow, it offers the option to remove any amount of its shredded foam memory core, in order to get that just-right level of support. What’s more, while it doesn’t feature the same temperature regulation technology as Slumber Cloud products, it is designed to be breathable, keeping you cool and comfortable while you sleep.
Best for Spine Alignment: Therapeutica Cervical Orthopedic Foam Pillow
If you’re looking for a full-blown posture pillow, then try this option from Therapeutica, which comes recommended by some of the chiropractors I consulted. In fact, it was designed by a chiropractor to promote spine alignment and reduce neck discomfort while sleeping. It’s made using a durable molded foam that maintains its shape over time, making it ideal for side and back sleepers.
How do you choose the best pillow?
The right pillow—contour or otherwise—is really unique to each individual. “Factors such as sleeping position, shoulder width, history of neck pain, and personal comfort all matter,” says Jackson. “Contour pillows can be helpful for certain sleepers, particularly those with chronic neck discomfort, but they are not necessary for everyone. I do recommend that clients trial any pillow changes for at least a week or two to allow for an adjustment period, before determining whether or not the pillow is appropriate for them.” And, for anyone who really wants an individualized pillow, there are always custom options available (similar to a custom insole).
As for what to look for when choosing the ideal pillow, here are a few factors to consider to help support better rest.
First and foremost, it’s important to identify what type of “sleeper” you are: side, back, or stomach. “Matching pillow height and firmness to sleep position improves alignment and comfort,” says Jackson.
For instance, side sleepers generally need a thicker, firmer pillow to keep the neck aligned with the spine, says Jackson. Whereas back sleepers often benefit from a medium level of support that maintains the natural cervical curve without pushing the head forward. And, lastly, stomach sleepers typically require a very low pillow, or none at all, to prevent excessive neck extension and rotation.
Height (also referred to as “loft”) should maintain neutral alignment based on the person’s preferred sleep position. “The ideal pillow is one that supports neutral alignment, matches the sleeper’s body type and position, and maintains its structure over time,” says Jackson.
Side sleepers generally need a higher loft, to account for the placement of the shoulder, says Sherry McAllister, DC, chiropractor and author of Adjusted Reality. How do you know if you’re getting enough support as a side sleeper? “Number one, you’re going to feel your shoulder, and may even feel shoulder discomfort. You may also feel your ear pushing into the pillow because there’s not enough support,” she says, adding that you should take note if you feel pain in the curve of your neck (if that’s the case, this pillow isn’t right for you).
For back sleepers, a medium loft of around four to five inches is generally best, says McAllister. You also want to make sure that you’re comfortable and the pillow isn’t pushing your head forward, “because that means you’re going to be stretching all of those ligaments at the back of your neck all night long, and you’re probably going to end up with a mild tension headache or a full-blown headache.”
Another consideration is the material of your pillow. “Firmness should be supportive enough to prevent sinking, but not so firm that it creates pressure points,” says Jackson. “Memory foam and latex provide structured support; adjustable-fill options allow customization.”
In fact, one study suggests that pillow material significantly affected neck fatigue and sleep comfort. “Neck fatigue was less common in people using latex or memory foam material compared to feather and cotton filled,” says Phaff. “Materials that maintain shape and provide firmer, more consistent neck support may reduce sleep neck and shoulder discomfort.“ Durability and breathability also matter: In other words, look for materials that retain shape and promote airflow, to improve long-term comfort.
“Studies have found that pillow shape was the biggest factor influencing sleep-related symptoms, including head fatigue, neck fatigue, neck pain, and shoulder pain,” says Jackson. “With flat pillows reporting the most sleep related symptoms, and peanut shaped and contour pillows (pillows that provide support and have a curve with higher sides and height of 7-11 cm in the center, rather than flat) and a cooling surface were reported to be more comfortable and provide symptom relief.” In the same study, back sleepers reported fewer waking symptoms with contour pillows compared to side sleepers.
Side sleepers were more sensitive to pillow height (rather than curve of the pillow), reporting more waking symptoms if the pillow was too high or too flat, preferring the head and neck to be aligned parallel to the surface of the bed. So, while contour pillows may be a better choice for back sleepers, a pillow with adjustable height may be a better option for side sleepers. For back sleepers, “having a little extra support kind of at the base of your neck can help keep you in a nice position,” says McAllister.
Overall, “I advise choosing pillows that meet evidence-based criteria: appropriate thickness for sleep position, moderate firmness for support, and materials that retain shape over time,” says Jackson. “Brands that offer ergonomic or adjustable options can be especially helpful because they allow for customization.”
Meet the Experts
- Lindsy Jackson, PT, DPT is a doctor of physical therapy specializing in chronic pain.
- Sherry McAllister, DC is a chiropractor and author of Adjusted Reality.
- Tara Phaff, DPT is a doctor of physical therapy and holistic nutritionist.
