How to choose the best pillow for you: an essential guide.

Sleeping well starts with your neck, with the right pillows for each sleeping position. The right pillow, especially if it's ergonomic, supports your head, keeps your spine aligned, and relieves pressure points, which can reduce neck pain, prevent tingling in your shoulders, and even improve breathing. Small differences in height, material, and shape make all the difference. And the choice is simpler when you know what to look for.

How the body aligns during sleep

The spine prefers a neutral position. This means the neck shouldn't fall backward or be pushed forward. Proper support, such as a good orthopedic pillow with adequate firmness and comfort, fills the space between the head and the mattress without creating awkward angles.

• When viewed from the side, the cushion needs to compensate for the width of the shoulder.
• When lying on your back, the pillow maintains the natural curve of the neck without raising it excessively.
• When lying on your stomach, the goal is to minimize neck rotation, which is difficult and sometimes requires creative solutions.

A good reference point: when lying down, your nose and sternum should be aligned vertically, and the line of your ears should be parallel to the mattress.

Sleeping position and correct height

Pillow height, also called loft, is the first parameter to be considered in sleep ergonomics. It varies with position, mattress, and body.

How to easily calculate the pillow height for side sleepers: Sit with your back against a wall, shoulders touching it, then lie on your side close to the wall in a natural posture. Measure the distance between the wall and the center of your neck. This is the target height for the pillow when compressed.

Your body matters too.

Shoulder width, weight, and mattress type all change the equation.

• People with broad shoulders need higher pillows when sleeping on their side.
• Soft mattresses cause the shoulders to sink in, which reduces the necessary height.
• Lighter people compress the pillow less, so they may need slightly lower heights for the same support.
• If you have a longer neck or a pronounced curve, a contoured neck support helps maintain the natural curve.

A rule of thumb: test the pillow with your mattress, not on a store counter. The combination of both sets determines the alignment.

Materials and what changes in the feeling

Not all pillows behave the same way throughout the night. Temperature, ability to recover their shape, resistance to allergens, and maintenance depend on the material.

Some versions contain gel, graphite, or copper. These additives can help with heat dissipation or surface hygiene, but the foam design and cover ventilation have a greater impact on actual comfort.

Formats that can solve specific pain points

• Contoured cervical brace: two heights with a central curve to support the cervical lordosis. Useful for neck pain or post-injury, provided the height is correct.
• Adjustable filling: microfiber, chopped viscoelastic material, or shells. Allows you to remove or add material until you find the right fit. Ideal for those who change positions or share a pillow.
• Body pillow: an elongated shape that hugs from the knee to the chest. It helps side sleepers stabilize their pelvis and shoulder.
• Wedge pillow: useful for gastroesophageal reflux, it raises the torso without bending the neck. The regular pillow goes on top.
• Butterfly or side cutouts: designed for those who use CPAP or to relieve shoulder pressure.

Small changes in shape make a huge difference in snoring, reflux, shoulder pain, and provide better rest.

Temperature and perceived temperature

Sleeping with a warm neck is an invitation to micro-awakenings. For those who get warm easily:

• Choose ventilated latex, shell filling, or hollow fiber microfiber.
• Covers made of percale cotton, linen or Tencel offer a cool and breathable feel.
• Perforated viscoelastic foams with air channels perform better than glued-on gel layers.

Those who feel cold easily may prefer denser knits, down, or compact foams. The important thing is to match the cover with the filling: a good cover can transform the feeling of temperature.

Allergies, certifications and hygiene

Dust mites love moisture and dead skin. A simple routine reduces exposure:

• Use a breathable, dust mite-proof pillow protector, and opt for a comfortable orthopedic pillow.
• Wash your pillowcase every 1 to 2 weeks.
• Air the cushion in the sun from time to time, whenever the cushion material allows.

Regarding certifications:

• OEKO-TEX Standard 100 indicates fabrics tested for unwanted substances.
• CertiPUR-EU applies to polyurethane foams with specific chemical restrictions.
• GOLS and GOTS refer to latex and organic textiles.

Those with rhinitis may prefer microfiber, latex, or buckwheat shell pillows. Modern treated feathers can work, but require thorough washing and drying.

Sizes that make sense in the bedroom.

In Portugal, the most common sizes are 50 x 70 cm and 60 x 60 cm. There are narrower ergonomic formats, for example 40 x 60 cm, which fit into specific pillowcases, providing ideal ergonomic support for the neck and head, thus promoting correct ergonomics during sleep.

• Double bed: two 50 x 70 pillows fit comfortably in the width.
• Single bed: 50 x 70 or 60 x 60, depending on aesthetic preference and mattress height.
• Body pillow: check the length, ideally above 120 cm to support the knee and torso.

Check for compatibility with the pillow and bedding you already own to avoid loose pillowcases.

Budget, value and durability

It's not always necessary to spend a lot. What pays off in the long run is the stability of the support and the ease of maintenance.

Average lifespan with daily use:

• Viscoelastic: 2 to 3 years, may lose resilience with heat and humidity.
• Natural latex: 3 to 5 years, often longer, maintains height consistently.
• Feathers/down: 3 to 5 years, requires fluffing and thorough drying after washing.
• Microfiber: 2 to 3 years, tends to flatten over time.
• Buckwheat husks: 3 to 5 years, you can replace the husks and renew the life of the pillow.

Investing in a pillowcase and protector extends its lifespan. A pillow that keeps the neck aligned saves on physiotherapy sessions and less productive days.

How to choose the best pillow for you

Whether in the store or at home during a trial period, look for clear signs to ensure a good night's rest.

• Lie down in your usual position for 5 to 10 minutes.
• Check the ear-to-shoulder line; it should be parallel to the mattress when lying on your side.
• Do not feel any localized pressure in the ear or jaw area.
• When the cushion is turned, it follows suit without losing support.

At home, give your body a few days. Muscles and ligaments accustomed to a different posture need time to relax. If morning stiffness worsens after a week, adjust the height or consider a different material that offers more support.

Common mistakes worth avoiding

• Choosing based solely on touch is not enough. The neck feels differently than the palm of the hand, so it's also important to check the firmness of the pillow.
• Excessive height for those who sleep on their back. Increases snoring and neck tension.
• Go to the opposite extreme when there is pain. If you have acute inflammation, a medium and stable height is preferable to one that is too firm or too soft.
• Using two thin, mismatched cushions creates hinges and pressure points.

Small, well-made decisions beat improvised solutions.

Simple adjustments that work.

• Is your pillow a little too low for you? Use a thicker cover or a flannel pillowcase in winter to gain 0.5 to 1 cm.
• Is your pillow slightly high? Remove the filling if it's adjustable, or opt for a tighter-fitting percale pillowcase that compresses it a bit.
• Shoulder pain when sleeping on your side? Hug a second thin pillow so your top arm doesn't fall forward.

Accessories help refine the experience without having to switch products right now.

Special cases

• Sleep apnea and CPAP: opt for moderate heights; designs with side cutouts prevent the mask from shifting.
• Pregnancy: Body pillow stabilizes pelvis and knees, reducing lower back tension.
• Cervical hernia: cervical models with two heights, choosing the edge that keeps the head neutral.
• Sleeping on your stomach out of habit: use a nearly flat pillow and place a small one under your hips to relieve lower back pain.

Whenever you experience persistent pain or frequent tingling, it's worth talking to a physiotherapist or sleep medicine doctor. The right pillow, with the necessary firmness, helps, but it doesn't replace a diagnosis.

Maintenance that prolongs comfort.

Monthly routine:

• Fluff the pillow to redistribute the filling.
• Air it out outdoors on a dry day.
• Vacuum the cushion cover using the upholstery nozzle.

Washing:

• Covers: Wash at 40 to 60 degrees, depending on the fabric.
• Microfiber and feathers: Machine wash on delicate cycle, dry completely with dryer balls to maintain volume.
• Viscose and latex: Do not wet the inner part. Clean only in specific areas and always use a removable cover.

If a bad odor appears, sprinkle baking soda on the surface for 1 hour and then vacuum to help neutralize it.

When to replace

• He wakes up with stiffness that disappears throughout the day, and the pillow is visibly flattened.
• When folded, the pillow does not regain its shape, especially if the filling is designed to recover its shape.
• Persistent stains and odors even after cleaning.

Changing postures at the right time prevents the body from adapting to a harmful posture.

Quick guide by profiles

• Side shape, wide shoulders, firm mattress: medium to high latex, 11 to 13 cm thick, traditional or contoured shape.
• Narrow sides and shoulders, soft mattress: adjustable dense microfiber, 9 to 11 cm, remove the filling until aligned.
• Back, sensitive neck: contoured cervical area in perforated viscoelastic material, 8 to 9 cm at the highest point.
• Mixed, warm: ventilated latex, 9 to 10 cm, percale cotton cover.
• Belly, cannot be changed: flat pillow 5 to 6 cm thick in soft microfiber, thin pillowcase.

If you fall between two sizes, an adjustable model saves you trouble.

Quick questions

Which ergonomic pillow is best for neck pain in the morning?

• Something with consistent support and the right height for your position. Contoured latex or viscoelastic foam works well when the height is just right.

What if I snore more with a high pillow?

• Reduce the height by 1 to 2 cm and keep your head aligned. Sleeping on your side helps reduce airway collapse.

Does downy fur cause allergies?

• The allergy is often to dust mites, not feathers. Quality models, well washed and dried, with anti-mite protection, work for many sensitive people.

Is it worth paying for gel?

• It can help with the initial feeling of coolness. The core ventilation and breathable cover contribute more to the temperature throughout the night.

Can I use the same pillow with any mattress?

• The mattress alters the actual height required. If you've changed your mattress, reassess your pillow.

Shopping checklist

• Main sleeping position defined.
• Approximate height measurement required, taking the mattress into account.
• Material preference aligned with thermal sensitivity and allergies.
• Breathable cover and anti-mite protector included.
• If possible, a model with a trial period and a clear return policy.
• Relevant certifications for the type of material chosen.
• Maintenance plan: washing, aeration, replacement of filling in the case of adjustable items.

Help your body rest. A comfortable and well-chosen pillow acts as a bridge between your mattress and your anatomy, providing support where needed, yielding where necessary, and allowing sleep to do its work. The right pillows make all the difference.