By Angela Haupt in The Washington Post, May 20, 2022.
Washington Post Stock Photo
If you used to love your pillow but now find yourself trying to pound it into a comfortable shape, that’s not surprising. “Some people get used to the same sort of pillow over time, but the reality is that as we grow, we change,” said Shelby Harris, a board-certified behavioral sleep medicine specialist in White Plains, N.Y. “As we get older, our backs start to change, our neck positioning starts to change, we might snore more, and pregnancy happens.”
Finding a new pillow that suits you may take some time; the market is crowded. In addition to your run-of-the-mill cotton or polyester pillow filled with feathers or (adjustable) foam, there are specialty options you might not be aware of. The water pillow — which advocates claim improves sleep quality and reduces neck pain — has taken TikTok by storm. Other people swear by buckwheat, cervical or wedge pillows.
There’s little scientific evidence suggesting that any of these specialty pillows are a worthwhile investment, said Raj Dasgupta, an assistant professor of clinical medicine at the Keck School of Medicine at the University of Southern California who specializes in pulmonology and sleep medicine. “And why would there be?” he said. “Pillows, like people, are very individualized, and picking the right pillow is very subjective.”
Here, experts weigh in on the pros and cons of four popular specialty pillows.
Water pillows
Todd Sinett has been sleeping with a water pillow for years — which means he’s ahead of the curve, because they’re now in vogue. (The #waterpillow hashtag has collected millions of views on TikTok.) These pillows, which are marketed as a way to relieve neck pain, are dynamic; in other words, they conform to the shape of your head, said Sinett, a New York City-based chiropractor. “You want a pillow that’s dynamic, that can move around with you, because no one sleeps in one particular pattern,” he said.
Dasgupta notes that when his patients ask him about pillows, this is often the type they’re curious about. “Lots of people swear by them,” he said. He likes that water pillows are adjustable: You can customize the water level, which determines the firmness.
Still, he points out a few downsides: It requires some effort to fill up a water pillow, and the directions aren’t always easy to follow. You also have to change the water every six to 12 months. Water pillows — which range from about $60 to more than $100 — are often heavy and, like water beds, can spring leaks. There’s also little research on them. Still, Harris said, “if you have the money and want to try it out, I have no problem with it.”
Cervical pillows
Cervical pillows are — no surprise — designed to support the cervical spine, also known as your neck. There are numerous versions, including some that have a D-shaped indentation in the middle for your head, and others that are horseshoe-shaped.
“What they’re trying to do is accentuate the natural curvature of your neck,” said George Cyril, assistant attending physiatrist at the Hospital for Special Surgery in New York City. “A lot of times when folks have back or neck pain, they’ve kind of lost that natural curvature, and that’s put a lot of strain on their neck.” Nestling your head into a cervical pillow, the thinking goes, takes pressure off the neck, alleviating pain, he said. These pillows are best for people who sleep on their backs, said Cyril, and side sleepers should avoid them. “They’re usually not high enough to support your neck if you're a side sleeper,” which could lead to more pain, he said.
One research review — in which the authors analyzed the results of five studies — concluded that cervical pillows did not reduce chronic neck pain. However, an older, small study that asked participants to test six neck pillows for three weeks found that products with a good shape that provided firm support could be recommended as part of a neck-pain treatment regimen. “If you're someone who wakes up with headaches a lot, and if you have a lot of neck tension and neck pain, you might find that a cervical pillow really does benefit you,” Harris said. She recommends trying several varieties to figure out which works for you.
Anti-snoring pillows
Snorers breathe through their mouth instead of their nose, and when lying flat, their tongue can cover their airway, causing vibrations as they breathe. An anti-snoring pillow is a wedge designed to elevate the head. “You’re opening the airway up slightly — and even that can have a really dramatic effect on snoring,” Dasgupta said. How effective anti-snoring pillows are depends on “the severity of the snoring,” Harris said. If you’re just a low-key snorer, who breaks into the sporadic rumble, you might find one useful. But anyone who snores consistently should talk to their doctor about obstructive sleep apnea, which occurs when your throat muscles relax and block your airway, and requires medical treatment.
Some research suggests anti-snoring pillows can be helpful for those with mild sleep apnea, though it’s still important to have a diagnosis. A study published in Sleep Medicine, for example, found that snoring intensity reduced by 51 percent with an anti-snoring pillow. Another study, published in a Brazilian journal, noted that elevating the head led to a “significant increase in the caliber of the upper airways” in obstructive sleep apnea patients.
Buckwheat pillows
Buckwheat pillows — which are stuffed with the hard outer casings, or hulls, of buckwheat seeds — have long been popular in Asia, and are now becoming more common in the U.S. They tend to be solid enough to keep your head level throughout the night, so it doesn’t sink into a cloud of softness. Many are adjustable, and you can add or remove hulls to achieve your ideal level of support. According to a small Korean study published in 2019, using a buckwheat pillow helped decrease neck and shoulder pain among elderly people. Cyril noted that buckwheat pillows are a nice alternative to water pillows for side sleepers who crave a pillow that will remain consistent throughout the night but don’t want to deal with water. Plus, buckwheat has a cooling effect, which can be a good option for those who run warm. The pillows aren’t suitable for those with a buckwheat allergy, however, and can become flat and need to be replaced faster than other specialty pillows.
You’ll also need to prepare for an adjustment: “It’s an acquired feel, to say the least,” Harris said — like sleeping on a pile of beanbags. “Not everyone likes the firmness of it.” Some people also report that the shells are noisy, which could bother light sleepers, and the pillows can be quite heavy.