Best Pillow for Side and Back Sleepers: One Pillow, Two Heights

Why does switching between side and back make pillow shopping harder?

Because each position leaves a different-sized gap between your head and the mattress, and a pillow has to fill that gap without tipping your neck up or down.

On your side, your shoulder lifts your head away from the bed. Sleep Foundation's medically reviewed side-sleeping page puts it simply: since the shoulders raise the head further from the bed, side sleepers usually do best with a thicker pillow (Sleep Foundation). Its side-sleeper pillow guide says that usually means at least 4 inches, and over 6 inches for broad shoulders (Sleep Foundation).

On your back, your head rests much closer to the mattress. A 2016 biomechanics study of people lying on their backs found that as pillow height went up, the head and neck were raised and extended (Ren et al., PeerJ 2016). Harvard Health adds that a pillow that is too high or stiff keeps the neck flexed overnight and can leave you stiff in the morning (Harvard Health).

So the height that keeps a side sleeper's neck level can be too tall once that same person rolls onto their back. Cleveland Clinic's rule of thumb is the target in both positions: the pillow should keep your neck parallel to the mattress, not bent down or up (Cleveland Clinic).

The sources don't fully agree on the numbers, and that's worth knowing before you buy. Sleep Foundation's neck-pain guide suggests 3 to 5 inches for side and back sleepers alike (Sleep Foundation), while its side-sleeper guide sets 4 inches as the usual floor for side sleeping. Read together, they point to the same practical answer: a combination sleeper needs either a pillow that can be two heights, or one that lands in the narrow overlap and accepts a small compromise.

3 ways to get two heights from one pillow

Every pillow sold for combination sleepers uses one of three tricks. The table above lays them out side by side; here is what each looks like in practice.

1. Loose fill that you set, then let squash

Adjustable pillows are bags of shredded memory foam, usually mixed with fiber. You unzip the cover, remove fill until the side position feels level, and zip it back up. Because the fill is loose, you can also push some of it toward the ends of the case to lower the middle before you settle on your back. Sleep Foundation suggests adjustable pillows when you're unsure what loft you need (Sleep Foundation), and that is exactly the situation of someone who sleeps two ways. The full fill-removal process has its own page: how to set up an adjustable pillow for side sleeping.

2. A contour with a tall edge and a low edge

Cervical contour pillows are shaped foam with a raised roll along each long edge. On the UTTU the two rolls are different heights, listed at 5.2 and 4.5 inches, so you turn the pillow around depending on how you plan to start the night. The Royal Therapy (5 inches for its Queen) works differently: you change its height by removing a middle layer. The catch is that you have to remember to rotate it, and you may not do that half asleep at 3 a.m.

3. A medium height that splits the difference

A mid-loft pillow sits in the overlap between the two positions. It is the simplest choice and the least precise. It tends to suit people whose night leans heavily toward their back, with only a little side sleeping.

How to dial in a pillow you'll use in both positions

The order matters. Set the pillow for your side first, because that is the position with the bigger gap and the one most combination sleepers spend longer in. Then check whether it is tolerable on your back.

• Lie on your side in your usual spot and have someone look at your neck, or use a phone camera on a timer. You're looking for a neck that runs parallel to the mattress and, in Mayo Clinic's words, stays in alignment with your chest and back.
• Give each setting time. In a lab study of side lying, 70.8% of participants had stabilised within 15 minutes on a pillow (Hodkinson et al., Ergonomics 2013), so judge a setting after a quarter of an hour, not after the first ten seconds.
• Roll onto your back. If your chin tips toward your chest, the pillow is too tall for that position. With loose fill, push some of it toward the ends of the case before you settle on your back. With a two-edge contour, turn to the lower edge.
• Keep the setting for a few nights before changing it again, and note how your neck feels on waking.

Your mattress changes the answer too. Cleveland Clinic notes that a firmer mattress needs a thicker pillow because your shoulder won't sink in much, while a topper or pillow-top lets the shoulder sink and calls for a thinner one (Cleveland Clinic). If you add or remove a topper, revisit your pillow height.

Two-edge contour vs mid-loft: which compromise is easier to live with?

If you reliably fall asleep in one position, the contour is the better compromise. You set the edge for your starting position, and the shaped foam keeps that height through the night. Harvard Health's advice for side sleepers is a pillow that is higher under the neck than under the head (Harvard Health), and a contour's raised roll is built to do just that.

The mid-loft pillow suits people who move constantly and won't rotate anything. It asks nothing of you, but it may feel low on your side if you have broad shoulders, since Sleep Foundation says broad shoulders may need a pillow over 6 inches and a mid-loft pillow aims for the middle.

There's a third option worth naming: an adjustable pillow sits between the two. It has no fixed edges, so you can't rotate it to a lower setting, but you can reshape its loose fill by hand. For most people who switch positions every night, that ability to re-tune the height is why I'd still call shredded fill the best pillow for side and back sleepers as a starting point. Readers whose main issue is neck pain should also see our guide to pillows for side sleepers with neck pain, and solid-foam fans can compare more contour shapes on the cervical pillow page.

Match the pick to your shoulders, mattress and habits

There's no single best pillow for side and back sleepers for every body, so use the list at the top as a starting point, then narrow it down with three questions.

How wide are your shoulders? A 2025 study of side sleepers found that shoulder width, combined with pillow height, predicted the shape of the neck curve, although comfort ratings didn't track it (Tian et al., 2025). In plain terms, what feels comfy isn't always what lines you up. Broad-shouldered readers should lean toward the Coop Original or the 6.5-inch Royal Therapy Extra and see our picks for broad shoulders. Narrow frames suit the UTTU.

How soft is your mattress? If you sink in deeply, Sleep Foundation notes that even a 4-inch loft can be too high. Start lower and add fill.

Which way do you lean? Mostly side with some back: shredded fill set for the side. Mostly back with some side: the Coop Eden with fill removed, or the Casper. Side and stomach instead of back: that's a lower-height problem, covered on our side and stomach sleeper page.

Two small extras help both positions. Mayo Clinic suggests a pillow between your legs when you're on your side and one under your knees when you're on your back (Mayo Clinic). A knee pillow made for side sleepers covers the first. For the wider picture of every pillow type, go back to our main guide to the best pillow for side sleepers or browse the full side sleeper pillow shop.