The best pillows for side and stomach sleepers

Face-down, your head is already close to the mattress. On your side, your shoulder holds it several inches above it. Sleep Foundation's testers found a pillow under 3 inches generally works best for stomach sleeping, although 3 to 5 inches can suit some people, depending on head size^[2]. Side sleepers usually need at least 4 inches^[3], and in lab measurements the gap from face to shoulder averaged about 9 cm (3.5 in)^[6].

A pillow set for your side props your face-down head up and back. A pillow set for your front lets your head drop toward the mattress when you roll over. No fixed height does both, which is the key difference from side and back sleeping, where the ranges overlap. The fix is a pillow that squashes nearly flat when you're on your front and springs back when you roll onto your side.

Harvard Health's neck advice points the same way: skip stiff or thick pillows, choose one that's soft and on the flatter side, and consider memory foam or down, which mold to your head and neck^[7]. To work out your side-sleeping height, use the loft chart in our guide to choosing a pillow.

To breathe face-down, you have to turn your head to one side and keep it there for hours. Harvard Health notes that stomach sleeping forces the head to one side and puts pressure on the neck^[7]. A Cleveland Clinic chiropractor adds that it also bends the neck backward, and that holding neck muscles stretched for that long creates soreness^[8]. A thick or firm pillow makes both worse, because it lifts your head higher while it's turned.

Your lower back

Lying face-down lets your belly and pelvis sink, which deepens the curve of your lower back. In MRI scans of 50 people with low back pain, the overall lumbar curve increased from 49.3° lying on the back to 52.1° lying face-down^[9]. That's a small change, measured on a scanner table rather than a mattress, and the lowest part of the spine didn't change significantly. Mayo Clinic still describes stomach sleeping as hard on the back^[10]. A soft or sagging mattress lets your middle sink further: in a 17-person sleep-lab study, a sagging bed hurt sleep quality for people who slept face-down or on their side^[11].

Your shoulders

Many stomach sleepers slide an arm under the pillow or sleep with their arms overhead. Cleveland Clinic's chiropractor calls the arm-under-the-pillow habit a setup for rotator cuff problems^[12]. In 20 healthy volunteers, pressure under the bony arch of the shoulder, where the rotator cuff runs, was significantly lower on the back than in side or stomach positions^[13]. If your shoulder is the main problem, see our pillows for shoulder pain.

Not for everyone. The case against it rests mostly on biomechanics, and the direct evidence is thin. In a telephone survey of 812 South Australian adults, side sleeping was linked to fewer waking neck, shoulder-blade and arm symptoms, but stomach sleeping itself wasn't significantly linked to more of them^[14]. Only 40 people in that survey were mainly stomach sleepers, so the authors urged caution. A 2019 scoping review screened 4,186 articles and found just four relevant studies, too few to settle the question, though side lying was generally protective^[15].

The most direct look comes from a small Australian study that filmed 53 adults aged 18 to 45 sleeping at home for two nights^[4]. People who woke with neck symptoms spent a median of 185 minutes a night in “provocative” postures, against 84 minutes for people without symptoms. Most of that gap came from twisted side lying, with the top thigh pulled forward of the bottom one, not from lying flat on the stomach. Prone time itself wasn't significantly different between groups. The study can't show cause: neck pain may change how people sleep, rather than the other way round.

Fewer adults than you'd think, and fewer as people age. Accelerometers worn by 664 Danish workers showed 7.3% of time in bed spent face-down, with wide variation between people^[1]. Adults aged 20 to 34 spent the most time there, at 9.5%. In the 812-person survey, about 5% said they slept mainly on their front, most of them under 40, and only 3 people aged 60 or over chose it^[14].

A sleep-lab study of five age groups, from preschoolers to adults aged 65 to 80, found prone sleeping progressively disappears with age^[5]. Researchers suggest a less flexible spine and the extra effort of breathing face-down may explain the shift^[14]. If you're drifting toward side sleeping as you get older, an adjustable pillow can follow you instead of being replaced.

Pick a pillow you can make low and soft, and test it face-down before you judge it on your side. Each of our picks gets there a different way:

• Remove fill (Coop Eden, Coop Original, Helix): start by removing about a third, then take out a handful at a time. Sleep Foundation's testers suggest the Helix ComfortAdjust needs only about 5% to 25% of its fill for stomach sleeping, and its side zippers lower the profile further^[2]. The Eden is the softer Coop; the Original suits broader shoulders that need more height on the side.
• Unzip instead of unstuffing (Helix, Nectar Tri-Comfort): zippered gussets change the profile or firmness without handling loose fill.
• Go soft and low (TEMPUR-Cloud): it isn't adjustable, but the soft foam compresses deeply under your head. It suits petite side sleepers who sometimes go face-down.
• Layer down (LUXOME LAYR): use only the soft insert for a very low profile, and add the other inserts on nights you mostly sleep on your side.
• Down and feather are naturally squishable too. See our down pillow guide.

One trick works with any shredded pillow: push most of the fill toward one end. Rest your head on the thin end when you're face-down and on the full end when you're on your side.

Shredded foam, kapok and down move out of the way. Solid memory foam and latex blocks don't. Sleep Foundation suggests a soft to medium-firm pillow for stomach sleepers, as long as it keeps the head at a comfortable angle^[2]. That rules out most pillows designed only for side sleepers.

• Shredded memory foam: squashes under your face, shifts as you turn and lets you set the amount. The best all-round fill for this combination.
• Down and feather: the most compressible, so they flatten easily for stomach sleeping. On your side they need a high fill weight to hold up.
• Solid memory foam: compresses slowly and only partly. It works only if the block is already low and soft.
• Latex, contour and gusseted high-loft pillows: built to resist exactly the compression you need face-down. In pooled trials, latex pillows reduced neck pain slightly more than other types^[17], so latex still makes sense if you rarely go face-down.

For more on foam types, see our memory foam guide.

Many side-and-stomach sleepers end up in between: on one side, rolled forward, top knee hitched up. It gives you the pressure on your front that you like, with less neck twist than lying flat. But it can twist your lower spine instead, unless you support the top leg.

In the home-video study above, this posture was what set the neck-symptom group apart: a median of 153 minutes a night in side lying with the top thigh pulled forward, against 75 minutes for people without symptoms^[4]. The researchers reclassified three people's posture as supportive because a pillow or duvet held up their top thigh, so it no longer pulled the spine into rotation.

1. Hug a long body pillow and rest your top knee and thigh on it, roughly level with your hip.
2. Set your head pillow a little lower than for full side sleeping. Soft shredded fill lets your face sink in as you roll forward.
3. Rest your top arm on the body pillow rather than under your head pillow.

If a knee pillow is enough on its own, see our knee pillow guide.

Use a very thin pillow or none under your head, and a thin one under your hips. Sleep Foundation suggests placing the hip pillow from the lower abdomen to mid-thigh, so your middle doesn't sink into the mattress^[18]. Mayo Clinic gives the same hip advice, and says to use a head pillow only if it doesn't strain your back^[10].

• Head: under 3 inches and soft^[2]. On an adjustable pillow, this is the low setting, or the thin end of pushed-over fill.
• Hips: a flat pillow or folded towel under your lower belly and pelvis. Start thin, since the goal is to stop the sag, not to arch you the other way.
• Arms: not tucked under the pillow or stretched overhead, which keeps tension on the shoulder joint^[8].
• Mattress: Sleep Foundation suggests medium to firm for stomach sleepers, with lighter people at the softer end^[18]. If you have chronic low back pain, a 313-person trial found medium-firm beat firm for pain in bed^[19]. See the mattress step in our pillow guide.

Change how you fall asleep first, and expect it to take weeks of practice. Cleveland Clinic's chiropractor says you can train your body to stay on your side or back, but that it takes practice^[8]. We found no study that times how long the switch takes.

1. Start on your side, hugging a body pillow. It recreates the pressure-on-the-front feeling stomach sleepers like and blocks you from rolling face-down.
2. Build bumpers. Firm pillows, a rolled blanket or a long body pillow on either side make it harder to roll onto your stomach^[18]. A pillow behind your back helps for the first few weeks.
3. Set your head pillow for side sleeping. A pillow left at stomach height lets your head drop when you're on your side, which makes the new position uncomfortable. If you still roll over often, settle on a middle setting.
4. Don't worry when you wake on your front. Adults change position about 1.6 times an hour^[1]. You control how you start the night, not every turn after it.
5. Judge by how you wake up, after a few weeks. Not by where you wake up.

The evidence that switching helps is encouraging but weak. In a pilot study of 20 physically active women averaging 62 years old, the 10 who got four weeks of sleep-position advice reported significantly less back pain afterward^[20]. A later review recalculated the difference between the advised and unadvised groups and found it too uncertain to call^[15]. An older report, described by the survey authors above, found that 74% of 23 stomach sleepers with spinal symptoms reported satisfactory improvement after changing position^[14].

• Skin: pressing your face into a pillow compresses and drags the skin, causing what one review calls sleep wrinkles, which differ from expression lines^[21]. In 542 French women aged 44 to 70, 11% had visible sleep lines^[22]. Side sleeping presses one cheek too.
• Jaw: in a study of 200 people, jaw joint disorders were more common in habitual stomach sleepers than in controls, and most common (44%) in those who also had a deviated nasal septum^[23]. It's one cross-sectional study, so treat it as a hint. If your jaw clicks or aches in the morning, mention your sleep position to your dentist.
• Snoring and sleep apnea: here stomach sleeping has an upside. In 27 people with sleep apnea, one night on a mattress and pillow built for face-down sleeping cut the median number of breathing interruptions from 23 to 7 an hour^[24]. Side sleeping gives a similar benefit^[18]. Don't self-treat apnea; see our CPAP pillow guide and talk to your sleep doctor.
• Pregnancy: Sleep Foundation advises pregnant people to avoid stomach sleeping^[18]. Side sleeping with a body pillow is the usual alternative.
• Babies: everything on this page is for adults. Babies should be put to sleep on their backs until age 1, with no pillows in the sleep area^[25].