Pillows often play a bigger role in sleep comfort than mattresses. People can sleep peacefully on pillows of varying thicknesses and materials. Be skeptical about claims regarding “contour pillows,” “memory foam,” layers of water or gel, and herbal fillers. The evidence is limited, at best. As with mattresses, your comfort is what counts.
Still, if you have neck pain, your pillow may be part of the problem. Your pillow should help keep your neck aligned with the rest of your spine. Don’t sleep on too fat a pillow or too many pillows, or without a pillow, since that can cause your neck to flex or extend.
If you sleep on your back or side, as generally recommended, a pillow should just fill the contour of your neck. A softer pillow is usually better for sleeping on your back or stomach, a firmer one if you sleep on your side. Pulling the edge of the pillow down between your chin and shoulder will help support your neck when sleeping on your side. If your mattress is soft, choose a fatter pillow; if your mattress is firm, a thinner one. Pillows wear out faster than you think: If yours feels thin, lumpy, or lifeless, replace it.