Best Pillows for Back Sleepers Buyer’s Guide

Fewer than 10% of adults primarily sleep on their back. This position (unlike side sleeping) aligns the spine and neck and is associated with less neck and shoulder pain than stomach sleeping. However, people tend to snore more when sleeping on their back and this can lead to sleep disruption for the sleeper and their partner.

What You Need to Know About Back Sleeping

The three general positions associated with back sleeping are illustrated below. They differ in terms of arm and leg extension. In the Soldier position, the arms are fully extended while one or both knees are bent slightly. In the Starfish position, both arms are bent at the elbows with the hands resting at the head level. And in the Savasana position, both arms and both legs are fully extended.

Advantages of Sleeping on Your Back

Considered the healthiest sleep position by many medical experts, sleeping on your back is associated with a number of health benefits. Here are some of the most compelling advantages of sleeping on your back:

  • Optimal spinal alignment: Back sleeping provides more spinal alignment than other positions. However, sleeping without a pillow is considered the best position for alignment — and most people find this uncomfortable. A thicker, firmer pillow that cradles the head and neck without letting it tilt too far back is the best option for most back sleepers.
  • No extra pillows needed: People who sleep on their sides or stomachs often utilize secondary pillows between or beneath their legs for extra support. Most back sleepers do not need to use secondary pillows (but many do anyway).
  • Fewer wrinkles: Side and stomach sleepers often sleep with one side of their face on the pillow, which can cause early wrinkles to form. Because their faces don’t touch the pillow, back sleepers do not need to worry about this issue.
  • Can minimize acid reflux symptoms: Acid reflux is a medical condition characterized by stomach acid rising into the esophagus. Heartburn is the most common symptom of acid reflux. Sleeping on one’s back can alleviate heartburn and other symptoms of acid reflux as long as the pillow is supportive and elevated — otherwise, back sleeping may exacerbate these symptoms.

Disadvantages of Back Sleeping

For all its advantages, there are a number of disadvantages associated with sleeping on your back. Here are the major ones to keep in mind:

  • Higher snoring potential: Sleeping on one’s back causes breathing muscles in the airway to relax, which can lead to heavy snoring. People with obstructive sleep apnea, or OSA, are especially susceptible to snoring when lying on their back. For this reason, doctors recommend side sleeping for people with sleep apnea, as well as people who snore heavily for other reasons.
  • Greater risk of neck pain: Back sleepers can reduce aches and pains by using a supportive pillow and keeping their bodies aligned throughout the night. However, sleeping with one’s neck bent to one side can disrupt alignment and cause pain and pressure points to develop, even if the pillow is sufficiently supportive.
  • May cause issues for pregnant women: Pregnant women who sleep on their backs are at risk for compressed veins. These include the inferior vena cava, which runs beneath the uterus; a compressed inferior vena cava can cause blood pressure levels to plummet. Most physicians urge pregnant women to sleep on their sides; this position is generally more comfortable, particularly during the latter stages of their pregnancy, and minimizes the risk of vein compression.

Choosing the Right Pillow for Back Sleepers

While there are hundreds of quality pillows on today’s market, the best pillow for you may depend on your BMI and your preferred sleeping position. For help choosing the right pillow for your unique needs as a back sleeper, review the tips below.

Size

Pillows come in six standard sizes, as well as a smaller specialty size that is normally reserved for certain types of pillows.

  • Small (20W” x 12L”): This specialty size is normally associated with cervical memory foam pillows, as well as pillows made from materials like buckwheat (see below).
  • Standard (20W” x 26L”): Standard is the most common pillow size, as well as the most compact and — usually — the lowest priced. This size is not ideal for people who toss and turn, as their heads can easily slip off one of the sides.
  • Super Standard (20W” x 28L”): The Super Standard is two inches longer than a Standard, making it a possible alternative for people who toss and turn and find the smaller size to be too short.
  • Queen (20W” x 30L”): A Queen-size pillow will accommodate most sleepers who toss and turn since it is four inches longer than a Standard.
  • King (20W” x 36L”): The King is ideal for people who prefer longer pillows, and this size also provides a comfortable backrest or headrest for people who read or watch television in bed.
  • Euro (dimensions vary): Unlike the other standard pillow sizes, Euro-size pillows are square-shaped. They come in many different dimensions; the most popular dimensions include 26W” x 26L” and 20W” x 20L”. Most people in the U.S. do not sleep with Euro pillows as their primary head and neck support, but they are popular choices for backrests and headrests.
  • Body (dimensions vary): Body pillows are a good choice for sleepers who like to snuggle with a pillow. These pillows generally range from between 48 and 54 inches in length based on the shape of the pillow. You can find body pillows in a variety of shapes, including C-, U-, and J-shapes.

Shape

Pillows may have even or contoured surfaces. Even-surface pillows are the more common option; they have full or flat shapes, depending on the material, but no contours. Curved-surface pillows include cervical memory foam pillows, which are elevated below the neck and recessed below the head. Curved-surface pillows are suitable for all sleepers, especially those with neck and/or shoulder pain.

Loft

Most back sleepers prefer medium- or high-loft pillows because they elevate the neck and head. This can help the sleeper maintain spinal alignment, and it also cuts down on snoring for some. Low-loft pillows may cause the head to drop back, which can cause more snoring and may also lead to pain and pressure points.