Pile 'Em High or Keep It Low: How Many Pillows Should You Sleep With?

A man sitting cross-legged on a bed with a pillow resting on his knees, thinking about how many pillows you should sleep with.

Written by: Gabrielle Talan

Gabrielle, a former insomniac turned sleep writer, brings over a decade of content expertise to her work. For the past 3 years, she's focused exclusively on sleep topics – a happy choice that helps give her the deep and restful sleep she craves.

So, how many pillows should you sleep with? When it comes to quality sleep and comfort, the number of pillows matters. Are you one of those who stack multiple pillows for a comfy nest? Or do you prefer a more minimalist approach with one or two pillows?


Read this to know how many pillows you should ideally sleep with and why it matters. Keep in mind that it depends on your sleep position and what will benefit your health and well-being most.

Key Takeaways

  • Most sleep experts recommend sleeping with one pillow under your head. However, your pillow needs to suit your sleeping position and other factors.

  • The correct amount of pillow ensures proper spinal alignment and relieves pressure points. Using an incorrect number of pillows can cause joint or muscle discomfort.

  • Side sleepers can benefit from two pillows: one to support the head and another between the knees.

  • Back sleepers can consider using two pillows: one beneath the head and another under the knees.

  • Stomach sleepers should sleep with a thin, single pillow under the head. A slim pillow beneath the pelvis helps with proper spine alignment.

  • Some health conditions benefit from using multiple pillows, including COPD, chronic allergies and sleep apnea.

Table of Contents

How Many Pillows to Place Under Your Head

A man sleeping supine on an orthopedic pillow underneath his head.

In general, placing just one pillow of the correct height under your head is ideal for a good night's sleep. This varies from person to person.


Some people prefer to sleep with multiple pillows in certain medical situations, such as:


  • Using two pillows elevates the head, preventing stomach acid from traveling back to the esophagus if you suffer from GERD or acid reflux.

  • If you're a snorer or have mild sleep apnea, elevating your head helps keep your airways open and prevents the tongue from collapsing toward the back of the throat, reducing the likelihood of breathing pauses.

  • If you're congested from sinusitis or have chronic allergies, elevating your head helps with mucus drainage.

  • Multiple pillows under the head can prevent fluid buildup and help the lungs expand if you have COPD or congestive heart failure. Science confirms that sleeping with your head elevated helps your lungs work better. A 2022 study published in Trends in Anaesthesia and Critical Care showed that elevating the head allows for deeper breaths and better oxygen flow throughout the night, easing respiratory stress.(1)


The number of pillows also varies by sleep position and body type. Also, using more than one pillow for other body parts may provide additional support.

How to Find the Right Number of Pillow(s) for Your Sleeping Position

Three people sleeping on the side, back and stomach positions with pillows under their head, knees and pelvis, indicating how many pillows you should sleep with according to sleep posture.

To prevent pain, proper spinal alignment while sleeping is essential. There's an ideal pillow for every sleeping position. The specific number and placement of your pillows are also instrumental in eliminating morning aches and improving overall sleep quality.


  • Side Sleepers: Most people sleep on their side, a position best supported by two pillows. One pillow under their head and the other between their knees for extra support.

  • Back Sleepers: Back sleepers tend to benefit from using two pillows: one underneath the head and one under the knees.

  • Stomach Sleepers: People who sleep in this position have it tough because they're extra prone to neck and back pain. For this position, one low-loft pillow with a medium-soft firmness works well.

How to Choose the Right Pillow(s)

The secret to waking up without neck pain starts with a pillow that's tailored to your unique sleep style. Choosing the perfect pillow depends on several factors, including loft, firmness, shape and material. Here's a breakdown of your options:

Pillow Height (Loft)

  • Low: Pillows with a low loft typically have a thickness of three inches or less.

  • Medium: Pillows with a medium loft are usually three to five inches thick.

  • High: A high-loft pillow has a thickness of five inches or more.

Pillow Firmness

  • Soft: Pillows like these usually run thin. They allow your head to sink yet offer sufficient cushioning for proper spinal and neck alignment.

  • Medium: These pillows usually have a firmness level ranging from medium to medium-soft. They're thick enough to provide good support for the neck and shoulders. They also don't flatten quickly.

  • Firm: These are thicker with higher loft than other pillows.

Pillow Shape

  • Standard: This pillow features a classic rectangular design. It's available in various sizes, heights, filling materials, and firmness. It supports all sleeping positions.

  • Wedge: This pillow has a unique triangular shape. It's designed to support and elevate the upper or lower body.

  • Contour: Its contoured design supports the head and neck of side or back sleepers. Some are also placed between the knees.

  • Orthopedic Pillow: It is designed to offer ergonomic support to the neck. It includes an elevated section to align with the neck's natural curve and a recessed area for the head.

  • Roll: This pillow is shaped like a cylinder. It can be used as a body pillow or positioned under the knees when lying on your back.

  • Body Pillow: This is favored by side sleepers and pregnant women. It's unusually long, allowing sleepers to encircle their arms and legs around it. It's also used for support while sitting up.

Pillow Material

  • Memory Foam Pillows: These deliver exceptional support and alleviate pressure as they conform to your head and neck shape.

  • Down Pillows: These moldable pillows are known for their soft and luxurious feel. They can be fluffed up or compressed according to your preference.

  • Latex Pillows: These are long-lasting and responsive. They're also breathable, which makes them an excellent choice for hot sleepers.

  • Buckwheat Pillows: These are packed with buckwheat hulls. They're customizable and promote correct spinal alignment.

How to Sleep With Multiple Pillows

Finding the best number of pillows for your sleep position sometimes takes using more than one to strike a good balance of comfort and alignment. Here's a breakdown of how to arrange your pillows to protect your spine and support your joints.

As a Side Sleeper

A pillow under the head with a loft of four to six inches and a medium-to-heavy firmness is ideal. It'll help keep the nose aligned with the breastbone and fill up the space between the ear and shoulder.


Meanwhile, a pillow between your legs helps maintain spinal alignment, improve sleep posture and ease back pain.


Sleeping during pregnancy is the time you can actually enjoy multiple pillows. Note that the ideal sleeping position while pregnant is on the left side.

As a Stomach Sleeper

Put a low-loft, thin pillow under your head to help keep your neck and spine aligned and reduce neck rotation. While it doesn't work for everyone, sleeping without a pillow under your head is worth a shot.


If you must use multiple pillows, keep in mind that it's an exercise in strategic alignment rather than adding height. Place a flat and firm pillow under your pelvis. This stops your lower back from over-arching.

As a Back Sleeper

Place an orthopedic pillow under your head to support the neck's natural curvature. A rectangular pillow with a low-to-medium loft works, too. If you need extra elevation, use two pillows, but make sure that the bottom pillow's placement starts at your shoulder blades. Then, top it off with the second pillow.


A contoured or knee pillow placed under the knees will reinforce natural spinal alignment. Keep your knees slightly bent as you put the pillow under them. It'll help reduce pressure on your joints and lower back.

Why Is Choosing the Right Number of Pillows Important?

So, how many pillows should you sleep on, and why does it matter? The ideal number keeps your spine aligned and eases pressure points so you wake up pain-free. Utilizing too many or too few pillows can adversely affect your health.

Too Many Pillows on the Bed

Stacking too many pillows under your head will prop it up unnaturally, resulting in neck strain. Using too many pillows also throws your spinal alignment off, leading to a stiff neck and back pain. If your spine isn't aligned, the pain it causes can interrupt your sleep, affecting your sleep quality.


An excess of pillows can cause poor sleep posture. According to a study published in PLoS One, people who wake up with a painful neck usually spend most of the night in awkward positions that trigger that pain.(2)


Using pillows to support other parts of your body isn't just about random placement. They must be of a particular loft and firmness and placed in specific body parts, according to sleep position or health needs.

Too Few Pillows on the Bed

Pillows exist primarily to give your neck and head adequate support as you sleep. That said, let's look at the case of sleeping with no pillow.


In general, sleeping without a pillow underneath your head isn't recommended. Some stomach sleepers, however, find it more comfortable. On the other hand, side and back sleepers who go pillowless wake up with a stiff neck or a sore back. That pain can radiate upward, potentially causing tension headaches.


Not enough pillows can also cause pain and poor sleep quality, depending on body size. Larger people with broader shoulders may need an extra pillow to close the gap between their head and the mattress.


Speaking of mattresses, the size of your bed influences how many pillows to use, especially when you share a bed. (You wouldn't want to wake up to discover your carefully arranged pillows strewn on the floor.)


A twin or single bed can fit a single standard pillow. Full or double beds fit two standard-sized pillows. Queen-size beds fit two Queen pillows (or two standards) side-by-side, though many people use accent pillows as extras. King-size beds can accommodate up to two King pillows placed side-by-side.

Conclusion

Determining how many pillows you should sleep on depends on your needs and, of course, what's comfortable. Choosing involves experimentation. Keep in mind that the goal is proper spinal alignment.


Ultimately, that number should be influenced mainly by what benefits your overall health and well-being. We hope this article helps you decide.

Frequently Asked Questions About the Best Number of Pillows to Sleep With

How Many Pillows Should I Sleep With for Neck Pain?

For neck pain, the consensus is to use only one pillow under your head, carefully selected for your sleep position. Side sleepers need enough loft to fill the shoulder gap, back sleepers require a thinner pillow to maintain the neck’s natural curve, and stomach sleepers should use a very thin pillow or none at all.


Stacking multiple pillows usually forces the chin toward the chest and strains the muscles at the base of your skull. Your head usually needs just one, but a second pillow placed strategically elsewhere can help with neck pain.

How Many Pillows Should I Sleep With When Pregnant?

The standard recommendation is to use three to four pillows or one body pillow when pregnant.


Place a slightly elevated pillow under your head if you’re dealing with heartburn, one under your belly to ease the downward pull on your back, and another between your knees and ankles to maintain hip and pelvis alignment. Tuck a fourth pillow behind your back to prevent you from rolling onto your spine, which can compress the inferior vena cava (the body's biggest vein) and restrict blood flow.


Consider, too, a C- or U-shaped body pillow to support your head, baby bump and legs while keeping you comfortably on your side.

Should I Use More Than Two Pillows?

It depends. Using more than two pillows is beneficial when they are strategically placed in other parts of the body to maintain a neutral spine. For side and back sleepers, a second pillow between or under the knees relieves pressure on the hips and lumbar region. Pregnant women might need three or four to support the bump and elevate the limbs.


Putting multiple pillows under your head isn't recommended, as they can push the chin toward the chest and strain the cervical spine. It can also lead to tension headaches, neck stiffness, and restricted airways. Unless you have a health condition, such as acid reflux, congestion or sleep apnea that requires elevating your head, it's best to stick to a single head pillow.

Is It Better to Sleep Without a Pillow?

It depends on your sleep position. If you're a stomach sleeper, ditching the pillow often allows the head to rest flat, improving spinal health by minimizing the unnatural neck twist and lower back arching.


Side and back sleepers generally don't benefit from going pillowless because of inadequate neck support. Their heads droop toward the bed, while back sleepers might overextend their neck ligaments. It might also lead to increased snoring due to poor head elevation.

Are Three Pillows Too Many?

It depends on where you place them. If you stack all three pillows right under your head, the extreme height could force your neck into an unnatural bend, straining the cervical spine and potentially obstructing your airway.


However, distributing three pillows across your body: one under the head, another between the knees, and a third one to support the arms or back. Done right, using three pillows can maintain spinal alignment and reduce joint pressure.

Sources:  

(1) “Effect of head-end of bed elevation on respiratory mechanics in mechanically ventilated patients with moderate-to-severe COVID-19 ARDS – A cohort study.” Trends in Anaesthesia and Critical Care, pmc.ncbi.nlm.nih.gov/articles/PMC8913433/. Accessed 14 May 2026.

(2) “Examining relationships between sleep posture, waking spinal symptoms and quality of sleep: A cross sectional study.” PLoS One, pmc.ncbi.nlm.nih.gov/articles/PMC8631621/. Accessed 14 May 2026.


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