Proper Pillow Height Determines Your Best Pillow

What "correct" pillow height means

A pillow has one structural job: keep your head in line with your spine. Lie on your side in front of a mirror, or have someone photograph you from behind. Your nose should point straight ahead, and the line from the back of your head down through your neck to your upper back should be roughly straight. If your head tips toward the ceiling, the pillow is too tall. If it sags toward the mattress, it is too short or too soft.

Height by sleep position

• Side sleepers need the most loft, because the gap between the head and the mattress is about as wide as the shoulder. Broad-shouldered sleepers often need 5 to 6 inches of supported height; narrow-shouldered sleepers closer to 4.
• Back sleepers need a moderate amount — usually 3 to 5 inches — enough to fill the hollow under the neck without pushing the chin toward the chest.
• Stomach sleepers need very little, 2 to 3 inches at most, and often do better with a thin, compressible pillow.
• Combination sleepers are the argument for adjustable shredded fill: you can remove or add filling until one pillow works in two positions.

Loft is not the same as thickness on the shelf

The number printed on the packaging is the pillow's height uncompressed. What matters is the height once your head is on it. A 6-inch down pillow may compress to 3 inches; a 5-inch latex or solid-foam pillow may still be close to 5. That is why two pillows with identical listed loft can feel completely different, and why firmness and loft have to be judged together.

Your mattress changes the answer

A soft mattress lets your shoulder sink in, which shrinks the gap your pillow needs to fill — so a softer bed usually calls for a slightly lower pillow. A firm mattress keeps the shoulder up and increases the gap, calling for more loft. If you change mattresses and your neck suddenly complains, your pillow is often the actual culprit.

Signs your height is wrong

• Morning stiffness or an ache at the base of the skull that eases through the day.
• Waking up having pushed the pillow away, doubled it over, or tucked an arm underneath your head — all attempts to correct loft in your sleep.
• Jaw tension or a sore throat, which can follow a chin-to-chest angle held for hours.

Replacing versus adjusting

Before buying anything, try adjusting what you own: remove fill, fold a thin pillow, or add a folded towel under the case to raise it. If your pillow has gone lumpy, no longer springs back when folded, or has developed a permanent dip, adjustment will not save it. Persistent neck pain, numbness or pain that wakes you is worth raising with a clinician rather than solving with bedding.