Side sleeping is considered the healthiest sleep position because it opens up the airways to improve circulation. This position can also benefit sleepers with certain medical conditions, such as acid reflux and sleep apnea, and it also provides more comfort for pregnant women. However, using the right pillow can be a deciding factor between comfort and discomfort for side sleepers. Certain pillow sizes and materials are conducive to side sleeping, while others can cause pain and pressure points to develop.
This guide will look at the mechanics of side sleeping, explore the different pillow types, and list the top-rated pillows for side sleepers according to the people who use them every night.
Generally speaking, there are three specific side sleeping positions (as illustrated below).
More than 40% of side sleepers utilize the fetal position, with their knees tucked in and their elbows bent. Other positions include the log, which involve straightening out the legs and arms, and the yearner, where the sleeper straightens out their legs and stretches out their arms.
Some advantages and health benefits of sleeping on your side include:
- Improved spinal alignment: Sleeping on one’s side aligns the spine with the pelvis, which can decrease pain and alleviate pressure points. However, mattress and pillow choice are crucial. Supportive mattresses and pillows can improve spinal alignment, while unsupportive choices can worsen pain and pressure symptoms.
- Reduces acid reflux: People with acid reflux experience chronic heartburn because stomach acid moves up the esophagus. Sleeping on one’s back or stomach can worsen heartburn symptoms, but sleeping on one’s left side improves circulation through the airways and helps alleviate heartburn. Sleeping on the right side, however, may exacerbate heartburn (since it puts pressure on the heart).
- Reduces snoring: People with obstructive sleep apnea often snore the most when lying on their backs. Side sleeping, on the other hand, can reduce snoring for apnea patients, as well as people who snore for other reasons (such as obesity).
- More comfortable for pregnant women: Pregnant women may experience discomfort when sleeping on their back because of the weight concentrated in their stomachs. Sleeping on one’s side transfers the weight away from the body. The side sleeping position is also safe for fetal health.
However, there are some drawbacks to sleeping on your side. These include:
- Added pressure on organs: As discussed above, sleeping on the right side can increase the discomfort of heartburn. Sleeping on the left side can also cause discomfort by putting pressure on vital organs like the liver, stomach, and lungs. Sleepers can mitigate this problem to some extent by sleeping with a pillow beneath their neck, as well as pillows under their waist and between their knees.
- Fetal position issues: Those who sleep in the fetal side position are susceptible to unique problems. These include increased symptoms of arthritis, as well as diaphragm restriction that may lead to problems with deep breathing. People with arthritis or circulatory issues may be more comfortable sleeping in the log or yearner side positions.
- Wrinkles: Unfortunately, this position forces sleepers to lie with one side of their face on the pillow. This can cause wrinkles to form over time — and those who strictly sleep on one side may notice more wrinkles on one side than the other.
For side sleepers, there are several variables to consider when choosing a new pillow and comparing different brands and models.
Size: There are six standard pillow sizes to choose from, as well as a smaller specialty size for certain pillow types.
- Small (20W” x 12L”): This size is usually found with specialty pillows, such as cervical memory foam and buckwheat models. They are elevated around the neck and dip down beneath the head in order to provide targeted support.
- Standard (20W” x 26L”): This is the most common standard pillow size, as well as the most compact. It may not be ideal for people who tend to toss and turn, but Standard-size pillows are usually the cheapest option.
- Super Standard (20W” x 28L”): This is a good alternative for people who find the Standard-size too compact, including those who toss and turn.
- Queen (20W” x 30L”): The Queen is the second most popular size after the Standard. It will accommodate most sleepers who toss and turn.
- King (20W” x 36L”): In addition to being a good option for people who toss and turn, the King-size is usually long enough to provide a comfortable backrest or headrest for reading or watching TV in bed.
- Euro (dimensions vary): Euro-size pillows are unique, in that they are always square. They come in a wide range of dimensions; common examples include 26W” x 26L” and 20W” x 20L”. Many people find they are not comfortable for sleeping, but they make good head and backrests.
- Body (48-54W” x 20L”): Body pillows are exceptionally long, making them suitable for side sleepers who prefer to snuggle with a pillow while they sleep, as well as pregnant women.
Surface shape: Generally speaking, pillows come in even or curved surfaces. Even-surface pillows are far more common. They may have full or flat shapes, depending on the material. The best-known example of a curved-surface pillow is a cervical memory foam pillow, which is elevated beneath the neck and recessed beneath the head. These pillows are popular with sleepers who experience chronic neck and shoulder pain.
Loft: Loft, or thickness, is important for side sleepers. Generally speaking, there are three categories of pillow loft:
- Low-loft: Pillows that measure less than three inches (3″) thick.
- Medium-loft: Pillows that measure three to five inches (3″ to 5″) thick.
- High-loft: Pillows that measure more than five inches (5″) thick.
Side sleepers tend to prefer medium- or high-loft pillows. The reason is simple: sleeping on one’s side creates more space between the sleeper’s head/neck and the pillow, and thicker pillows compensate for this gap. Low-loft pillows may cause the next to bend, which can lead to pain and pressure. However, in addition to sleep position, there are several other factors that should be taken into account when choosing the right pillow loft. These include the sleeper’s weight, head size, and shoulder width, as well as the mattress firmness. The table below illustrates optimal conditions for each of the three loft categories.
|Loft Category||Thickness||Optimal Weight||Optimal Head Size||Optimal Shoulder Width||Optimal Mattress Firmness|
|Low||Less than 3″||More than 230 lbs.||Small||Narrow||Soft to Medium Soft|
|Medium||3″ to 5″||130 to 230 lbs.||Average||Average||Medium|
|High||More than 5″||Less than 130 lbs.||Large||Broad||Medium Firm to Firm|
It’s important to note that some pillows offer adjustable loft; the owner simply removes or adds more filling to decrease or increase the thickness. Adjustable-loft pillows may be most suitable for side sleepers whose thickness preferences tend to fluctuate.
Pillow Material: Pillows are made from a wide range of materials, and each one has unique pros and cons associated with them. Most side sleepers prefer pillow materials that conform to their head and neck for targeted pressure relief and improved spinal alignment. However, temperature neutrality, cost, and odor/allergy potential may also be factors. The table below breaks down each of the seven most common pillow materials.
|Pillow Material||Filling Description||Pros||Cons||Side Sleeper Rating|
|Buckwheat||Roughly five to 10 lbs. of removable buckwheat hulls (outer shells)||Adjustable loft|
Too firm for some
Buckwheat pillows are suitable for side sleepers due to their above-average support and adjustable loft
|Down||Removable duck or goose down, which are the soft inner plumage found beneath the outer feathers||Adjustable loft|
Very soft and lightweight
Poor shape retention
Allergy and odor potential
Down is soft and comfortable, but some pillows may not be supportive enough for side sleepers
|Down Alternative||Polyester puffballs that mimic the softness and weight or authentic down||Adjustable loft|
Very soft and lightweight
No allergy risk
Poor shape retention
Down alternative pillows lose their shape easily and deteriorate quickly, and most side sleepers find them unsupportive
|Feather||Outer feathers of ducks or geese (may also include some down for extra softness)||Adjustable loft|
Very soft and lightweight
Quills can poke
May sleep hot
Feather pillows may be quite soft, but adjustable loft allows side sleepers to customize the supportiveness
|Latex||Solid latex, which is a natural substance extracted from the sap of rubber trees||Close conforming|
Too dense and heavy for some
Latex pillows conform closely and alleviate some pressure, but most cannot be adjusted for loft
|Memory Foam||Shredded or solid memory foam, or viscoelastic polyfoam, which softens when warm and retains shape when cool||Adjustable loft (shredded)|
Memory foam pillows (including cervical pillows) conform closely and provide good support for most side sleepers
|Polyester||Shredded or interlocking polyester fibers; polyester is a synthetic fabric||Low cost|
Good shape retention (interlocking)
No allergy risk
No odor potential
Poor shape retention (shredded)
Interlocking polyester pillows have a fuller shape, which provides more support to side sleepers, but shredded polyester pillows flatten easily and are not recommended
Moldability: In addition to the qualities listed in the table above, moldability is a pillow characteristic that is somewhat unique to side sleepers. Some pillows retain a full shape no matter how tightly a sleeper holds them, while others are moldable, or scrunchable, meaning they can be reformed to match the sleeper’s position. Moldability comes down to personal preference. The most moldable options include shredded memory foam, feathers, down, and buckwheat, while the least moldable options are solid memory foam and latex pillows.
Cost: Lastly, let’s look at price-point — which may be the main deciding factor for many pillow shoppers. All pillow materials vary by brand and model in terms of cost, but the table below contains a general price breakdown for the seven most common pillow types.
|Material||Buckwheat||Down||Down Alt. ||Feather||Latex||Memory Foam||Polyester|
|Average Price-point||$50 to $75||$70 to $100||$20 to $30||$25 to $50||$40 to $60||$50 to $60||$10 to $15|