How Many Pillows Should You Sleep With?

While one pillow is often enough, in some cases, it’s worth sleeping with two pillows. If you are a side sleeper, sleep with one pillow under your head and with one pillow in between your knees. If you are a back sleeper, place a pillow under your knees.

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Last Updated: Fri, April 21, 2023

Are you moving out and need new bedding? Do you wind up with neck pain despite all efforts to find the right cushion? You are not alone. Randomized studies confirm that between 15 and 20% of adults around the world experiences arm pain, back and neck ache, or stiffness on a weekly basis. For some, this is an occasional inconvenience, but others are left to deal with non-specified pain almost every day.

Even if you are merely bored with your old bed, navigating the market can be hard enough. With the current offer of endless materials, mattress configurations, even sheet prints, you may find yourself feeling overwhelmed and confused. Knowing which of these things will suit you takes some trial-and-error time until you start to feel comfortable and confident in making a decision.

In these situations, it is helpful to remind yourself how many of these items you need for optimal sleep. When it comes to pillows, the fact is that most people require only one, though it needs to be of good quality and tick a few customized boxes. However, there are scenarios in which you might need an extra pillow or two (and not for décor purposes), or even prefer to sleep without any at all. Several factors may influence this decision, and we’re just about to unpack them.

The Main Pillow

Whether or not you need more than one pillow, or whether the one you already have suits you, it all depends how you feel sleeping on it. Do you get enough rest? Do you wake up without numbness or pain? Do you feel refreshed and energized in the morning? These are some goals to strive for when it comes to your bedding. The right setting should keep your spine perfectly aligned, which means no head tilting or neck strain. To achieve this state, your pillow’s loft has to be high enough to prevent your head from sinking too deep, but low enough not to push it too far in the other direction. Typically, you will come across three categories addressing the loft: low (up to three inches high), medium (between three and five inches), and high loft (five inches and above).

The material should be not only comfortable but also hypoallergenic, in case you’re one of the people whose allergies act up around bedtime. Moreover, the density of the pillow needs to meet your needs – softer or firmer, with the surface flatter or shaped. This will determine how deep your head will sink and whether the material will conform around it for additional, corrective support. Lastly, the breathability of your pillow can mean the difference between healthy rest and disrupted, poor quality sleep, especially for those who tend to sleep hot. Excessive heat can be trapped inside the pores of high-density materials such as memory foam and cause much distress for the sleeper.

However, when your pillow doesn’t already meet all or most of the criteria just mentioned, and you wake up sweating or tired, it’s time to make a change. Figuring out exactly which features will do the trick for you starts with the way your body is positioned during the biggest portion of the night.

Sleep Positions

Which way you face during sleep classifies you as a side, stomach, or back sleeper. Each of them come with many variations that have unique benefits and downsides and therefore require different levels of support.

Side Sleeping

Side sleeping is considered the best option out of the three. The way your organs are positioned when sleeping on your side means you’ll face the smallest chances of discomfort – this state is known to prevent sleep apnea, acid reflux, and snoring. Here are the three most common ways people settle down on their side:

  1. Fetal position – legs are bent in the knees and arms are in the front or under the pillow.
  2. Log position – both arms and legs are stretched out and you look as if you were standing upright.
  3. Yearner position – legs are stretched out, but arms are reaching forwards.

An adequate amount of support means different things between the three categories, but sleeping on your side makes the least room for issues. The only thing to be concerned about here is the loft of your pillow – side sleepers require higher profile, supportive surfaces to keep their head in line with the spine. Memory foam does a great job of keeping everything in place as it usually has excellent conforming properties – unless you can’t handle the heat, that is. In essence, any cushion that is on the thicker end, and keeps your head straight will do the trick, but make sure it’s comfortable.

Back Sleeping

This position can work well in certain circumstances, but not everybody will benefit from it. Acid reflux prevention, proper spine alignment, and even weight distribution across your body are some of the upsides that come with sleeping on your back. Unfortunately, facing upwards isn’t the best idea if you have sleep apnea or tend to snore, as back sleeping is known to worsen these conditions, directly impairing the efficiency as well as the duration of your rest.

Back sleepers take up about 13% of the total population. They commonly spend their nights in these positions:

  1. Savasana – facing the ceiling, arms, and legs straightened out as if standing upright.
  2. Soldier – same as Savasana except with one leg bent at the knee.
  3. Starfish – legs stretched, arms above the head.

When you lay down in this manner, there are a few things to be addressed. First, your main pillow needs to have a lower medium loft and preferably some contouring properties, filling out the empty bit of space below your neck. A good option for this would be a pillow with a divot.

Stomach Sleeping

Officially the worst option out of the three, sleeping on your stomach does come with some pros – it prevents snoring and sleep apnea. Unfortunately, the list ends there, as the downsides to this way of sleeping take over. When you sleep on your stomach, your entire weight distributes around your core and presses your organs into the bed. Besides decreasing their ability to expand and impairing the way they function, this also creates a great deal of stress in your ankles and wrists as they are left to handle your body’s pull. Furthermore, stomach sleeping causes even more wrinkling and breast sag than side sleeping. The discomfort caused by this position makes stomach sleepers toss and turn noticeably more often than other types of sleepers, reducing the quality of their sleep.

Finally, this position is a bad idea if you experience back or neck pain, as your spine is likely to be curved, especially if you use a thick pillow or have a very soft bed. In fact, stomach sleepers are the only group that would benefit from sleeping without a pillow altogether. If this notion is too strange for you, using a thinner but moldable pillow would be optimal, as it would allow you to turn around as much as you need to without sacrificing your comfort.

Common Types of Pillows

By now, you’ve hopefully got a picture of what you should be looking for. To give you a bit more insight into whether a model type may suit you or not, let’s take a look at the general characteristics of the ones most commonly found on the market.

Memory foam is an overall good pick for corrective purposes. This material molds around your head and neck, filling all gaps and leaving no room for bad posture. The surface of most models is around medium firm, as it’s meant to prevent you from sinking in too deep. The flaws of memory foam stem from its high density. If you are someone who struggles with excessive heat during the night, this material would be a bad idea as it’s compact structure leaves little room for air to circulate. Additionally, if you like those pillows that feel supple and soft at first touch, the memory foam surface might feel a bit awkward and hard at first, as it takes some time before it molds around you. Overall, memory foam is a widespread favorite and recommended for people who experience neck pain or headaches.

Latex is known for its soft feel and long lifespan. Highly responsive and mold resistant, this type of cushion is also eco-friendly. According to this trial, latex is deemed most helpful for dealing with persistent headaches and arm pain upon waking. However, latex definitely doesn’t sleep the coolest of the lot and can be pricey, especially the organic models. Before you decide to give it a go, make sure you aren’t allergic.

Gel-infused pillows are made for hot sleepers. Cooling property is their main selling point, along with being hypoallergenic. Even some memory foam models are infused with gel for this reason, but that usually gives them the “average” instead of “heat-trap” status in this area.

Feather pillows have been used for quite a while. They are famous for their light weight, softness, immediate responsiveness, and admirable durability. Like all other models, though, they have their cons. For one, they aren’t very breathable, disqualifying them for hot sleepers. Further, the feathers can poke through the fabric, causing skin irritation even for people who aren’t allergic. Lastly, those whose allergies act up at nighttime, as well as those who are allergic to feathers – better look at other options.

Contour pillows curve down in the middle part (think: headrests on a massage bed, except not empty in the center) and considered suitable for side and back sleepers. They are very supportive, promote good posture, and help reduce snoring.

When One Pillow Isn’t Enough

As mentioned above, most issues with pressure points and pain can be prevented or decreased to an extent by purchasing a suitable pillow. However, there are times when an extra mile is necessary.

Every one of these positions has a pressure point or two besides the one around the neck area. Your mattress would preferably address these, but if this isn’t the case and you can’t replace it, or you simply require sturdier support, additional pillows come in handy.

Side sleepers: to decrease the stress on your hips, professionals sometimes recommend placing another, thin pillow between your knees, or getting a body pillow that can be used in a similar manner. The goal here is to keep your pelvis straight. If you experience chronic pain in the lumbar area despite doing everything right, you may also put a thin layer below the knees or ribs.

The lumbar region is the back sleepers’ main pressure point. You can elevate most of the discomfort by putting a thin pillow under your knees, prompting your back to sink more deeply into the surface of your bed and filling the awkward gap between.

For stomach sleepers, a thin cushion placed under your hips may be of additional help in reducing the pressure in your muscles and joints caused by sinking too deep into the mattress.

Pregnant sleepers often need plenty of support, too. As the stomach grows, new pains and uncomfortable stretches create much distress to the expecting mother. For this reason, doctors frequently advise using a body pillow to hug around, which will ensure the stomach is adequately supported. Fixing up extra pillows behind the back, between or under the knees is also not rare. Just try not to pile up a bunch of thin pillows on top of one another, and instead opt for one pillow per area. You may think there is no difference, as the height is the same, but that may do more harm than good. By picking one over many, you decrease the possibility of one cushion sliding out or falling off the bed.

Body Pillows

This oversized cushion, although used mainly by pregnant people, may benefit pretty much everyone who is looking for a whole-body support system in the bed. There are two common types of body pillows: the U-shaped, meant for side and back sleepers alike, and the I-shaped one indicated only for side sleepers. Not convinced? Here are some features that prove body pillows are worth a shot:

  1. Relief from pain in critical points – if you put one leg over, hip stress is taken care of. Hug it with your arm and ensure the shoulders and elbows are relaxed, too.
  2. Decreased tossing and turning. The U-shaped ones, in particular, are designed to lock you in place comfortably, helping you fall and stay asleep.
  3. Decreased snoring. By preventing you from turning over to your back during sleep, this cushion will stop you from snoring as well.
  4. Relief from neck or back pain. Having something to lean over ensures your muscles won’t need to be tense to keep you in place, minimizing chances of numbness or pain the next morning.
  5. Stress relief. A body pillow is essentially a grown-up version of a teddy bear. Not only will holding onto it make you feel more safe and secure, but your brain will associate the two and start releasing oxytocin, a hormone that reduces stress.

Knee Pillows

Although we have mentioned the possibility of placing a thin layer between or under your knees, there are specialty items made precisely for this purpose. Most knee pillows are hourglass-shaped, which promises they won’t slip away during your sleep. They are meant to relieve any aches and discomfort that you may feel while sleeping on your sides, such as tension in your calves or hips. They also suit people who want to prevent the contact between their legs – a reasonable request, especially during summer or for those with skin issues.

Although placing it between their knees may not be beneficial or even practical for them, back sleepers who struggle with slow circulation can put a wedge-shaped knee pillow under their legs instead and promote healthier blood flow. Pregnant women could use the support when back or pelvis issues arise, but also as a measure to prevent such difficulties in the first place.

Lastly, people with chronic pain, injured individuals, and those with restless leg syndrome (RLS) may find comfort in using a knee pillow. As RLS causes tension and pain in one’s legs, and can make them shake for hours during sleep, some knee pillows are specially designed with straps that can be tied around the legs and decrease excessive movements. Besides aiding the person with RLS, this is also helpful if they sleep with a partner, as a precaution against being kicked during sleep.

Wedge Pillows

These cushions come with a tapered incline, intended to slightly lift up your head, legs, torso, or any other area you may need them for. They are usually on the firm end, meant to use alongside your regular pillow and not instead of it. A wedge pillow can be handy for plenty of scenarios: as back support while watching TV or resting on your sofa, as an elevated headrest to prevent acid reflux, a platform for your legs to promote blood circulation, etc.

A wedge pillow can come as a single piece or have multiple parts. Highly customizable and sturdy, these products can vary in almost every aspect and suit a broad audience of customers. Here are some reasons you may want to consider buying one for yourself:

  1. Conforms closely to your body
  2. Convenient and comfortable
  3. Prevents varicose veins
  4. Decreases snoring
  5. Promotes better blood and air flow
  6. Helps with acid reflux


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Laura Garcia is a freelance writer based in Chicago. She holds degrees in writing from Drake University. When she’s not busy writing, Laura likes to spend as much as time as possible with her husband James and three-year-old son Elijah.

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