How to choose a pillow if you change positions during sleep?

September 23, 2025 •

3 min read

Did you know that up to 30% of adults consider themselves combination sleepers, regularly changing positions throughout the night? This makes finding adequate neck and spine support a major challenge. Here's how to choose a pillow if you change positions during sleep to ensure optimal comfort and alignment.

Quick Summary

For individuals who frequently shift sleeping postures, selecting an adjustable pillow or a specifically designed multi-position pillow is the best approach. These options allow for customization of loft, firmness, and support to accommodate the varying needs of side, back, and stomach sleeping throughout the night.

Key Points

Adjustable Fill is Key: For combination sleepers, pillows with removable shredded memory foam, microfibers, or buckwheat hulls offer the best customizability for varying sleep positions.
Material Matters: Look for responsive materials like shredded memory foam or natural latex, which adapt to changes in your position better than traditional materials.
Match Pillow and Mattress: The perfect pillow works in tandem with your mattress. A firmer mattress may need a softer pillow, while a plush mattress might require more support.
Consider Contoured Options: Some multi-position pillows feature ergonomic shapes designed to support both side and back sleeping, although they offer less customization.
Prioritize Spinal Alignment: The primary goal is to maintain a neutral spine. The right pillow should bridge the gap between your head and the mattress, regardless of your orientation.
Don't Forget Cooling: If you toss and turn due to heat, seek out pillows with cooling technologies like gel-infused foam or breathable covers to help regulate temperature.

Why Combination Sleepers Need a Special Pillow

If you find yourself starting the night on your side and ending up on your back or stomach, you're a combination sleeper. This habit presents a unique challenge for your pillow. A pillow with a high loft (height) might be perfect for supporting a side-sleeping posture, keeping your head in alignment with your spine. However, that same pillow would likely be too high for back or stomach sleeping, causing your neck to crane upward and creating strain. Conversely, a soft, thin pillow is ideal for stomach sleepers but offers little to no support for side sleeping. The key is to find a pillow that can adapt to your movements and provide consistent, healthy spinal alignment, regardless of your position.

The Adjustable Pillow: The Ultimate Solution

For combination sleepers, adjustable pillows are often the most effective solution. These pillows come with a removable fill, such as shredded memory foam, microfibers, or buckwheat hulls, allowing you to customize the loft and firmness to your exact preferences. The flexibility means you can remove or add filling as needed to find the perfect level of support. A firmer, higher setting can be used for side sleeping, while a softer, flatter setup can be configured for back sleeping. Over time, you'll find the ideal balance that works for your unique sleep patterns.

Material Matters for Versatility

While adjustability is key, the material of the pillow's fill also plays a significant role in providing comfort and support for all positions.

Shredded Memory Foam: This material is highly adaptable and responsive. It can be easily molded to fit the contours of your head and neck, providing excellent pressure relief. The shredded nature allows for better airflow than a solid block of memory foam, addressing potential heat build-up.
Natural Latex: Latex pillows are naturally responsive and springy, offering a buoyant feel that pushes back against your weight. This makes them ideal for side-to-back transitions. They are also naturally breathable and hypoallergenic, though often less customizable in terms of loft unless shredded.
Down Alternative: For those who prefer a softer, fluffier feel, down alternative offers a good balance. These pillows can be fluffed and shaped to provide temporary support, though they may not hold their shape as well throughout the night as foam or latex.

Comparing Pillow Types for Combination Sleepers

Choosing the right pillow can be overwhelming. This table breaks down the main options to help you decide.


Feature	Adjustable Shredded Memory Foam	Natural Latex	Contoured/Multi-Position	Down Alternative
Support	High, customizable	High, responsive	High, targeted	Medium, soft
Adjustability	Excellent	Limited (unless shredded)	Fixed	Moderate (fluffable)
Feel	Contour-conforming	Buoyant, springy	Specific, ergonomic	Plush, fluffy
Best For	Maximum personalization	Active, hot sleepers	Those with consistent patterns	Soft, plush feel
Price	Mid-to-High	Mid-to-High	Mid-range	Low-to-Mid

Fine-Tuning Your Sleep Setup

Choosing the right pillow is only one part of the equation for a good night's sleep. Your mattress and overall sleep hygiene also play crucial roles. Ensure your mattress provides adequate support and is not causing pressure points. Additionally, consider how a new pillow interacts with your mattress firmness. A softer mattress might require a firmer pillow, and vice-versa. Proper body alignment is the goal, and your pillow is the crucial tool for maintaining your neck and head's position. For further information on the importance of proper spinal alignment, read expert advice on the Sleep Foundation website.

A Better Night's Rest Awaits

With the right pillow, combination sleepers can stop compromising on comfort and finally achieve consistent, healthy sleep. The key is finding a solution that caters to the dynamic nature of your sleep, whether through adjustable fill, responsive materials, or a specialized shape. Paying attention to these details can dramatically improve your rest and overall health. Don't settle for a one-size-fits-all approach; a customizable solution is within reach.

Frequently Asked Questions

A combination sleeper is someone who sleeps in multiple positions throughout the night, often starting on their side, shifting to their back, and occasionally ending up on their stomach. This constant movement requires a versatile pillow that can support different postures.

Yes, especially an adjustable pillow. By allowing you to add or remove fill, a single pillow can be customized to provide the ideal loft and firmness required for side, back, and even stomach sleeping. It's the most versatile option for those who change positions frequently.

Yes, shredded memory foam pillows are an excellent choice. Unlike solid memory foam blocks, the shredded fill can be molded and adjusted, offering superior contouring and pressure relief that adapts as you move. Look for options with removable fill for customization.

There's no single ideal firmness, which is why adjustable pillows are so beneficial. A combination sleeper's pillow should be medium-firm by default but should have the ability to become firmer for side sleeping (by adding more fill) or softer for back/stomach sleeping (by removing fill).

Signs that your pillow is not right include waking up with neck pain, stiffness, or headaches. If you constantly fluff, fold, or adjust your pillow during the night, it's a clear sign that it isn't providing consistent support and it's time for an upgrade.

Using multiple pillows is not ideal for combination sleepers. While it may seem like a good idea, stacked pillows can shift and lose their position as you move, potentially causing further neck strain and disrupting your sleep. A single, versatile pillow is a more reliable solution.

An adjustable pillow with a shredded fill, such as memory foam or latex, is typically the best option. It allows you to create a higher loft for side sleeping and then redistribute the fill to a lower profile for back sleeping, ensuring proper spinal alignment for both positions.