How to Find the Best Pillow for Side Sleepers

Key Takeaways

Side sleepers need a thicker, medium-firm to firm pillow (typically around 5 inches thick) to bridge the gap between ear and mattress, keeping the neck and spine in neutral alignment.

Placing a pillow between your knees prevents hip twisting, while positioning firm pillows in front of or behind your body prevents rolling and relieves spinal pressure.

No single pillow fits everyone; each sleeper needs a setup tailored to their specific body dimensions, posture, and mattress firmness (especially couples sharing a bed).

Side sleepers usually need a higher-loft, supportive pillow that fills the space between the head and shoulder. The goal is to keep the head, neck, and spine in a neutral line rather than tilting the head up or down. Pillow height should also account for shoulder width, mattress firmness, and how deeply the body sinks into the mattress.

Side sleeping is incredibly popular—and for good reason. Side sleeping can redistribute stress from other parts of the body, including the hips, shoulders, and even the neck, says Thomas Tozer, chiropractor with Imperium Chiropractic in Wisconsin.

That said, side sleeping can make it difficult to keep your head and neck in a neutral position, which can lead to pain. That means finding a pillow that offers the right blend of comfort and support is key.

How to find the best pillow for side sleepers

Pillow Position / Purpose	Firmness / Loft	Pressure-Relief Need	Support Need	Materials to Consider
Head & Neck Pillow	Medium-Firm to Firm / Medium-High Loft (~5 inches, based on shoulder dip)	High (cushions head, shoulders, and neck sensitive points)	High (fills the gap between ear and shoulder to keep spine straight)	Memory foam, polyfill (orthopedic style), contoured/gusseted pillows
Between-the-Knees Pillow	Medium-Firm to Firm	Moderate (prevents pressure where knees touch)	High (prevents top leg from pulling hip out of alignment)	Contoured memory foam, dense polyfill
Back / Front Body Support	Very Firm / High Loft	Low to Moderate	Very High (prevents rolling or flattening under body weight)	Dense memory foam, solid latex, firm polyfill (King-sized or body pillows)

Alignment and body weight

Choose a thicker, firmer pillow

To determine whether a pillow is right for you as a side sleeper, Tozer recommends first evaluating how far you “dip” into the mattress while lying on your side. “If the shoulder is dipping into the mattress two inches, for example,” he says, “the [pillow’s] appropriate thickness might be about five inches to support your head to stay in line with your spine.”

Whatever the distance, it must be filled to keep your head straight. Without a pillow’s support, your head will drop toward the mattress, bend your neck, and cause stress on muscles, nerves, and tendons—a recipe for waking up with back pain, tingling arms or legs, or even developing sciatica.

As a side sleeper, you need a slightly thicker, firmer pillow for optimal alignment. An extra-wide gusset—the band of fabric joining the top and bottom panels together—can be helpful by adding to the pillow’s overall thickness. Tozer recommends “entry-level” polyfill orthopedic pillows to his patients. He also says memory foam pillows are a good option.

Opt for memory foam filling

Memory foam softens when it comes to your body and conforms to your unique shape. Due to its ability to mold to your curves, it offers excellent pain and pressure relief for your head, neck, and shoulders. It’s a great option for a variety of sleep styles, including side sleeping.

Place a pillow between your knees

For additional support, placing a pillow between your knees will keep your hips in proper alignment. As with a strained neck from inadequate support, improperly aligned hips also force the spine out of alignment and can cause nerve and muscle pain. Like the pillow you choose to place under your head, a knee pillow should be plenty comfortable yet also strong enough so you don’t crush it while sleeping.

Put a pillow behind your back or in front of your stomach

A supportive pillow behind your back or in front of your stomach (or both) will provide complete support by keeping your body in position. Back or stomach support pillows should be very firm so they don’t flatten from your body pressure. King-sized pillows make the best body pillows.

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How to Tell If Your Setup Is Wrong

If your pillow setup isn’t properly aligned to your body, your neck and spine will pay the price. Here are the key warning signs that your current arrangement needs an adjustment:

Waking up with a stiff neck or morning headaches: Your head pillow is likely too flat (causing your neck to bend downward toward the mattress) or too thick (forcing your head upward out of neutral alignment).
Tingling, numbness, or “pins and needles” in your arms or legs: Poor neck alignment compresses nerve pathways, while lack of proper hip support can exert pressure on the sciatic nerve.
Lower back or hip soreness: Sleeping without a pillow between your knees causes your top leg to slide forward, twisting your pelvis and straining your spine.
Waking up on your stomach or back: If your setup lacks firm support behind your back or in front of your chest, you’ll naturally roll out of position overnight.
Constantly fluffing or folding your pillow: If your pillow flattens out during the night, it lacks the firmness or density needed to maintain proper alignment.

FAQs

Does body weight change the recommendation?

Yes. Body weight affects how deeply you sink into a mattress or pillow, so the same firmness or loft can feel different from person to person. Use general sleep-position guidance as a starting point, then adjust for body type and comfort.

How can I tell if my sleep setup is supportive enough?

Your head, neck, and spine should feel comfortably aligned without excessive pressure or deep sinkage. Persistent pain, numbness, or tingling should be evaluated by a healthcare professional rather than addressed only by changing bedding.

The bottom line on pillows for side sleepers

Just remember: Tozer says it’s important to buy pillows suited to your individual needs. This is particularly important for couples who share a bed because too often they’ll buy two pillows, “yet the two who will be using those will be different,” says Tozer, adding that the goal is “buying a pillow that is individually fit to their sleep position and posture.”

Need more advice on finding a pillow? Here’s how to choose the right pillow for your sleep position.

John-Manuel Andriote

John-Manuel Andriote began writing about health and medicine while working on a master’s degree in journalism at Northwestern University in the mid-1980s. He is the author of six books, including an award-winning history of the HIV-AIDS pandemic, a book focused on building resilience, and a “fable for kids ages 5 to 105” based on the true story of a runaway cow in Andriote’s home state of Connecticut. He has contributed articles to newspapers and magazines ranging from The Atlantic to The Washington Post. He writes the “Stonewall Strong” blog focused on resilience for Psychology Today. Andriote since August 2021 has been the senior writer for Winship Cancer Institute of Emory University, in Atlanta, Georgia.

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