Pillow Talk

Pillow menus are a thing. Really. Many high-end hotels now offer guests an array of different pillows to choose from that all promise a good night’s sleep. A few of the more common options might include:

  • Aromatic pillows that are infused with herbs and essential oils (typical ingredients include chamomile and lavender) that promote deep relaxation.
  • Down/Feather pillows are a worldwide favorite because they are warm, soft, plush and scrunchable (is that a word?)
  • Buckwheat pillows, which are filled with buckwheat hulls that conform to the size and shape of your head and neck.
  • Contoured pillows: These pillows are built with two prominent contours on the long sides with a flat section through the middle. Back sleepers and people with neck pain sometimes like these pillows.
  • Memory foam pillows: This polyurethane type cushion was developed to help NASA astronauts get a good night sleep. The material is said to quickly mold its shape to fit your head and bodily contours.
  • Body pillows are full-length pillows that can be used as a bolster to provide extra support for side sleepers, to position between the knees, or just to cuddle around. (I admit it…I have used a body pillow for my entire adult life)
  • Maternity pillows: As the name implies, these are pillows that help support the belly and back (while keeping the hips aligned), which helps reduce the stress associated with pregnancy-related weight gain.
  • Microbead pillows: These are filled with tiny little synthetic beads that ergonomically adjust to your features.

I’m not sure that I can help you choose which pillow you should pick the nest time you’re at a nice hotel… but “pillow talk” is actually a rather common conversation I have with patients in my office. Many of them have problems like pain, fatigue, and other symptoms, which are related to poor sleep. And sometimes a new or different pillow can make a huge difference in their lives.

Picking the Right Pillow (a Checklist of Things to Look For)

When it comes to pillows, it is difficult to offer specific advice. Every patient is unique (in terms of their physical shape, psychological preferences, sleep position, and allergic sensitivities), which means that one-size fits all solutions are not possible. But I can offer a few general guidelines. Here is a checklist of things you should consider about the pillows you choose or use:

  • Size, shape, and material: You’ll want a pillow that feels comfortable night after night. The thickness, size, and give-and-take of the filler can all have a big impact on the support and stability they give your neck and spine. Finding the right pillow size/thickness/softness can be a matter of trial and error, but you’ll want to find one that keeps your spine in a neutral position. That means that your neck is not flexed, extended, rotated, or side bent in your preferred sleep position.  It can help to have another person look at you (and even take a photo) while you’re laying down on the pillow to assess the position of your neck and head. Keep trying. If you are still waking up with neck and back pain, then you may want to look into another shape, size, or material.
  • Non-Toxic: People spend typically spend a third of their nestled into their pillows. But many pillow fillers and covers are treated with toxic chemicals and flame retardants that you do not want to be breathing all night. Some of these chemicals are suspected of causing immune problems, disrupting hormonal balance, and contributing to cancer risk.  If you are concerned about exposure you should insist on pillows that are certified to be free of harmful materials.
  • Allergy Free: Pillows are a breeding ground for dust mites, mold, and fungi. To mitigate these potential allergens you should wash your pillowcases at least once a week and consider using mite-proof pillow protectors.

Hot Tip:  I have often found that simply rolling up a bath towel so that it’s about as big around as your arm and then putting in your pillowcase along the long side of the pillow can really help people who tend to wake up with neck pain.


Hay fever, eczema, chronic nasal congestion, and neck and back pain can all be caused or exacerbated by pillow problems. One recent patient of mine told me that she cured her husbands morning sniffles by changing his pillows and washing their covers more often.

Sleep should be a time when your body repairs itself and detoxifies. You should feel rejuvenated when you wake up. If you find yourself suffering from postural problems, allergies, insomnia, or daily fatigue, then you may want to try something new off of the pillow menu.  

Take good care,

Dr. Josh