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Do You Need a Soft or Firm Pillow? A physiotherapist weighs in – The Bedding Planet

Do You Need a Soft or Firm Pillow? A physiotherapist weighs in

This post is part of the complete guide for picking the right sleeping pillow

In a life filled with tasks that drains lots of energy from us daily, adequate rest is required. Asides from healthy eating, rest takes an utmost area of importance in everyday life.

Fans of healthy and efficient sleeping always exercise the necessary steps to make their spaces essentially comfortable. Great sleeping spaces span through getting the right bed, bed stands, bedsheets, and pillows to enjoy uninterrupted rest for an extended period.

When it comes to picking a pillow, a common question that people ask is whether they should use a soft or firm pillow.

How soft or firm your pillow should be depends mostly on your sleeping position. In general, back sleepers do best with a medium pillow, side sleepers do best with a firm pillow and stomach sleepers do best with a soft pillow.

Lots of factors influence your choice of pillows, whether firm or soft. Are you looking for a verified guide to pick your pillow? Curious about what factors you should consider before choosing firmness level? In this post I’ll provide you with verified tips to make the best choice of pillow based on your needs.

Do you need a soft or firm pillow

What Makes a Pillow So Important?

You might view pillows as just a place to rest the head on while taking your daily nap or sleep. However, they play an indispensable role in how your night turns out. You don’t want to wake up on the wrong side of the bed due to discomfort over the night! The pillow’s function is mainly to keep your head and neck at great and comfortable angles. Your shoulders aren’t left out either with a great pillow. 

Furthermore, pillows help in other areas you probably couldn’t imagine. For instance, they mitigate snoring by elevating your head above the chest. Also, by draining sinuses from the nose, you wake up with a clear nose, ready to start your day. 

From a physiotherapist’s perspective, let’s look at the in-depth functions that a pillow should perform. A pillow keeps your head in a neutral place with the neck. The three natural curves in the human body, namely the neck, lower back curves, and mid-back curves, rely on your pillow to stay well-rested. A pillow helps the head sit on the neck, and failure to achieve this neutral alignment puts pressure on the neck and shoulders. 

What is Pillow Firmness, and How is it Determined?

Firmness of the Perfect Fit Extra Firm Pillow

Addressing the subject of picking between soft and firm pillows would be incomplete without knowing how to distinguish between them. That is, what exactly makes a pillow firm or soft? After several decades, there’s no precise method to check for firmness. Most companies have a unique scale for measuring firmness. 

Firmness refers to the sinking response of a pillow when pressure is applied. The creation of standard terms helps to distinguish between the various levels. These are:


Soft pillows are often best if you sleep in a position that requires little support. They easily align with the head and neck and do not resist any pressure. They are the softest of all pillows and can be uncomfortable when used in the wrong position. 

Medium Soft

Medium Soft pillows offer better support compared to soft pillows. It keeps the neck and head aligned with the barest resistance. Nevertheless, its effects are not so efficient for sleepers with thick bodies. Such persons require more firmness to handle the pressure from their weight. 


The medium pillow is the median representative in the pillow firmness environment. It provides a great deal of flexibility to different kinds of sleepers. If you’re someone who changes positions a lot to sleep, you will enjoy the level of firmness this pillow provides you.

Medium Firm

Medium-firm pillow firmness is an almost hard one but makes room for mitigating factors. They are efficiently resistant and provide the support that the head and neck need. Moreover, they handle pressure better with extra cushioning and resistance. 


Firm pillows are the heaviest types of pillows with very peculiar use cases. They provide lots of resistance to pressure and might just be the best for large-bodied sleepers. Firm pillows offer significant support to the head, neck, and back. Often, these firm pillows have a buckwheat fill. Stay tuned to learn more about the roles fills play in the firmness of a pillow. 

Materials Used to Fill Pillows and Their Effects on Firmness Level


Just like the weight of items is determined by components that make them up, the filling material determines the firmness of a pillow. Comparing these materials helps you determine the kind of soft or firm pillow to get. 

Moreover, even though most pillow manufacturers have different firmness levels. Manufacturers use similar materials in production, and this can effectively help you make comparisons. The typical pillow fillings are:


Latex is a material gotten from the sap of a rubber tree. Latex pillows provide an evenly balanced head and neck support with less fluffing or shaking. Often, pillow companies use this material to produce both soft and firm pillows. 

Memory Foam

The memory foam retains a median position in the firmness of pillows. Manufacturers often use memory foam in medium-soft and firm pillows. The memory foam is quite resistant to pressure and effortlessly jumps back to its usual position. Manufacturers make memory foam with solid foam sections or shredded fiber foams, and it’s often referred to as Viscoelastic Polyurethane foam. 

Water Pillow

The Water Pillow provides remarkable flexibility. It allows you to decide how firm you want your pillow within the soft to medium-firm levels. It features a thin water base, and you can add water through a pouch. Manufacturers also use other materials like fiber, memory foam, and plumage. 


Buckwheat kernels are the primary production materials in the pillow-making industry. Manufacturers fill buckwheat pillows with husky shells made from buckwheat kernels. Hence, buckwheat pillows are heavy and provide exceptional neck-to-head support. This material is efficient for making firm and extra firm pillows.


This type of pillow is a widespread one and was a pioneer type in the pillow industry. Pillow companies use plumage from geese and ducks to fill this pillow. However, this does not include feathers, and at least 75% must be plumage. The soft to medium pillows fall in this category. 


Closely identical to the down pillows. However, this pillow is filled mainly with duck feathers and goose feathers instead of plumage. Feather pillows fall within the category of soft to medium-firm pillows. 

Down Alternative

These are pillows filled with polyester fibers instead of plumage-like down pillows. The aim is to replicate the soft texture of the down pillow. This material is an excellent fill for mild to medium-firm pillows. 


Polyester filler for pillows is a multipurpose filling material for soft to firm pillows. Polyester fibers have impeccable resistance to pressure, and the quantity of filling determines the pillow’s firmness.

Sleeping Posture and How it Affects your Pillow’s Firmness (Soft to Firm)

After exhaustively discussing the various kinds of fillers and their influence on the firmness. Sleeping posture is the next most important thing to pursue. Making a pillow choice heavily depends on the way you sleep. Hence, there’s no universally great pillow for everyone except a group of same position sleepers.

Your sleeping posture works hand in hand with the right pillow for you to create the required alignment. Read on to learn how to choose between soft and firm pillows depending on your sleeping posture. 

Back Sleepers

As the name implies, back sleepers sleep with their backs on the mattress with their face looking upwards. Hence, it is essential for the pillow you choose to provide natural support for the forward neck curve. You must position the pillow base where the neck is slim to help maintain neutral alignment and prevent sloping forward or backward. 

Back sleepers need a medium pillow that provides both medium loft and medium firmness to achieve a neutrally aligned spine. Pillows made with materials like memory foam that are less resistant to pressure are convenient for back sleepers.

Curious how medium loft and firmness influence the comfort of back sleepers? Let’s find out in more detail:

Medium Loft

Medium loft relieves pressure between your neck and shoulders by providing a buffer between these parts of your body and your mattress. The balance of a medium loft pillow is the perfect match for a back sleeper. A very lofty pillow keeps your head faced upward and makes your neck ache. Moreover, a less-than-average loft creates no buffer and defeats the essence of a pillow. 

Medium Firmness

If the neck and shoulder agree already, how about the spine? That’s the job medium firmness performs to make you comfortable. It supports your head to keep it aligned with your spine and resists pressure enough to keep your pillow in shape. A pillow that flattens out during the night will cause a lot of pain by morning. 

Response to pressure

Materials that adjust to pressure make the head feel cradled and hold it in alignment with the neck. They also provide an extra cushion for your temples if you’re a back sleeper that loves to tilt your head to one side. 

Side Sleepers

Side sleeping takes off pressure from the discs, ligaments, and muscles. If you’re having body pains, taking a night’s rest in this position would prove very helpful to your health.

A Side sleepers pillow should be proportional to the space between your shoulder and neck. That way, it keeps your head aligned with your neck. A high loft pillow with firmer support does the job here. Here’s how:

High Loft

A pillow with a higher loft resists more pressure and keeps the alignment between the head and neck intact. It relieves stress on your shoulder and ensures it’s not bearing your whole body mass alone. Feeling your shoulders sinking into your mattress means your pillow does not have a standard high loft.

Firm Support

Having pillows that provide firm support that last all through the night is essential for side sleepers. It keeps your neck and spine aligned all through the night. A very soft pillow could lose this alignment when you sleep for a couple of hours. 


As a side sleeper, your pillow should be adjustable to suit your needs at any point in time. Pillows filled with feathers, kapok, down and down alternatives come in handy. You can easily make a butterfly shape and rest your neck in the middle to keep it balanced all through the night. 

Stomach/Front Sleepers

Stomach sleepers have the most complexities with finding the right pillow. Physiotherapists advise avoiding this position altogether. However, what happens to those who are already comfortable sleeping this way?

Experts advise getting orthopedic pillows to maintain a neutral alignment. However, if you do not want to get an orthopedic pillow, you have other alternatives. Placing a pillow below your chest puts your neck in a more neutral position. 

However, the ideal pillow for front sleepers is a low loft, soft support, and adjustable pillow. This is why:

Low Loft

A pillow loft of around two inches or shorter is perfect for a front sleeper. This type of loft keeps the natural curve of your spine intact. Also, your head stays aligned without getting craned upward.

Comfy Support

Pillows that provide comfy support ensure your head remains aligned by creating a buffer between you and your mattress. A firm pillow only displaces your neck out of alignment with your spine. 

Soft Filling Materials

An adjustable pillow with materials like memory foam, feather, and down alternatives is an excellent fit for stomach sleepers. These materials are less resistant and provide the proper support needed. 

Wrapping it up

After an exhaustive examination of picking between soft and firm pillows, it’s evident that your needs determine the choice of your pillow. Other factors that can influence your pillow choice include your shoulder size and the firmness of your mattress.

Picking The Right Pillow For Sleep: A complete guide – Parts:

1. Why do we Sleep on Pillows? Here’s what research says
2. Pillow Stuffing Types: Pros and Cons of All Common Materials
3. Do You Need a Soft or Firm Pillow? A physiotherapist weighs in
4. How High Should Your Pillow Be? Ideal height for your sleeping position
5. What is The Healthiest Pillow to Use? Based on science
6. When to Replace Your Pillow? Average lifespan of all pillow types
7. How to Recycle Your Pillow? 12 things you can do with an old pillow
8. How Much Do Pillows Cost? Average price of all pillow types
9. The 9 Best Affordable Pillows For All Sleeping Positions

Niklas Lampi

My name is Niklas and I'm the author and content operator at The Bedding Planet. I've always had a big interest in bedding and more specifically sleep. If I find something that makes me sleep better, whether that's a lifestyle change or a better bedding environment, I'm ready to share it with the world!

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