Pillow for Back Sleepers: Which Height Is Right?

Back sleepers usually need a lower pillow than side sleepers. When you lie on your back, the pillow only has to fill the gap between the back of your head and the mattress. It shouldn't push your head forward, and your neck should be supported. Exactly how high the pillow should be depends on your body measurements and your mattress.

Why do back sleepers need a lower pillow?

If you sleep on your side, the pillow has to bridge the distance between your ear and the mattress. That distance is set by your shoulder, and it is usually much greater than when you lie on your back. To find out how to choose a pillow for that position, read our guide The Right Pillow for Side Sleepers.

When you lie on your back, your whole back rests on the mattress. Your head only needs enough height to stay in line with your cervical spine. If the pillow is too high, it pushes your head forward and your chin points toward your chest. If it is too low, your head sinks back and your neck doesn't get enough support.

The goal when lying on your back: your head and cervical spine are in one line, and your neck is supported without your head being lifted.

How can I tell that my pillow doesn't suit sleeping on my back?

A pillow that doesn't fit often shows up in how you sleep. These signs can occur:

• Too high: Your chin tilts toward your chest, and your gaze points forward rather than at the ceiling. Some people therefore push their arms under the pillow at night to fold it up.
• Too low: Your head tips back and your neck hangs in mid-air. Many people then stuff a towel under the pillow as well.

These are signs, not a diagnosis. You can find more on this topic at Pillow Too High or Too Low?

What determines pillow height for back sleepers?

Three things together decide the right height: your body measurements, your sleeping position and your mattress.

That is why there is no one-size-fits-all height for back sleepers. Two people who both sleep on their back can need very different pillows.

How do I determine my pillow height as a back sleeper?

Here is how to go about it:

1. Note your sleeping position and mattress. Write down which position you sleep in most of the time. Also check whether your mattress is soft, medium or firm.
2. Take three measurements. It's best to ask someone to help you (see the table below).
3. Check the side view. Lie on your back and have someone photograph you from the side. Your head and neck should form a relaxed line, with your chin not dropping toward your chest and your head not tipping back.
4. Try it for several nights. A new pillow often feels unfamiliar at first. Wait a few nights before judging it.

The page Taking Measurements: Determining Your Pillow Size shows how to take each measurement. If you'd like a rough estimate of the height first, Calculating Pillow Height can help.

How does Pillowise work for back sleepers?

Pillowise is a made-to-measure pillow made of memory foam (viscoelastic foam). Thijs van der Hilst developed it based on his experience in practice as a physiotherapist. He couldn't recommend a suitable pillow to his patients with neck complaints, so he developed his own measuring method. The pillow was created together with United Comfort Industries, which has been making ergonomic sleep products in its own factory in the Netherlands since 1990.

Your size is based on the three measurements above. Your sleeping position (back, side, stomach) and your mattress are added to that. From these, an algorithm selects the best-fitting pillow out of six sizes. Each size has its own colour: pink, orange, green, blue, red and purple.

There are two ways to get measured:

• At a Pillowise retailer near you, using the Pillowise measuring tape. There you'll find, for example, physiotherapists, chiropractors, sleep specialists and specialty retailers.

The pillow measures 55 x 35 cm. The core is made of 100% memory foam. The cover has a moisture-regulating top layer made of Tencel and can be washed in the washing machine at 40 °C. The materials are certified to STANDARD 100 by OEKO-TEX. We give a 5-year warranty on every Pillowise pillow. You can find more about the product on the page The Pillowise Pillow. How memory foam compares with other materials is explained in the guide Memory Foam Pillows.

We don't want to guess the height, but to derive it from your own measurements.

Does the right pillow help with neck complaints?

A suitable pillow helps to position your head and cervical spine well and to give your shoulder enough room. That can improve your sleep comfort. It is not a remedy.

Neck pain has many possible causes, and a pillow alone won't resolve it. If you regularly wake up with neck pain or your complaints persist, please have them assessed by a doctor. You can find general information in the guide Pillows for Neck Tension.

So: do you need to change your pillow?

Not necessarily. If you sleep on your back, wake up without complaints in the morning and your pillow doesn't push your head forward, your pillow is probably the right one. Then you don't need to change anything.

It's a different story if you often reposition yourself at night, fold your pillow or prop it up, or have to guess again with every purchase. In that case, it's worth having your measurements taken. If you switch between your back and your side during the night, give the position you lie in most of the time. You'll find an overview of all the topics around choosing a pillow in the Guide: The Right Pillow.

Determine your size yourself or get measured. Determine your size or find a retailer near you.

Thijs van der Hilst, physiotherapist (non-practising)
Inventor of Pillowise