Buying a new pillow? Here's what most people get wrong, according to pillow and sleep experts

When was the last time you purchased a new pillow? I don’t know about you, but I’m guilty of holding on to pillows for years — easily five or more (I may or may not still have one from grad school … and I’m in my mid-30s now). Turns out I’m not alone. When I asked my Yahoo colleagues, Home Editor Elizabeth Berry and Senior Home Editor Jessica Dodell-Feder, who led our testing of more than 50 pillows, about the mistakes people make when buying and replacing pillows, they both pointed to the same thing: not replacing them soon enough.

“I hold on to pillows way too long — and so does my mom and her mom, although that’s irrelevant, but I am just saying … could be genetic,” Berry admits. Dodell-Feder agreed: “I think we’re all guilty of this — it feels wasteful to get rid of them after a few years.”

But holding on to a pillow for too long may contribute to poor spinal alignment and allergen buildup, including dust mites.

When it comes to actually buying a new pillow, how do you avoid common pitfalls? To find out, I talked to Berry and Dodell-Feder, plus two sleep medicine doctors and a physical therapist, to get to the bottom of what most people get wrong when buying new pillows — and what to do instead. Here’s what experts say to keep in mind as you start researching the best pillows for your bed.

🚩 Mistake No. 1: Ignoring your sleep position

✅ What to do instead: Figure out your dominant sleep position (or accept you’re a combination sleeper) — and use that information to help narrow down your options.

According to physical therapist Jennifer Lesko, the No. 1 mistake is failing to take your sleep position into account. Whether you sleep mostly on your back, stomach or side, she says the goal is a pillow that supports the natural curvature of your spine and neck. “This allows adequate spacing between facet joints in your cervical spine and neck, so your nerves are not compressed and your neck musculature is not being overly stretched or shortened when you sleep,” she explains. Over time, poor alignment can lead to neck or spine pain — or even degenerative conditions, she says.

The tricky part, as both Berry and Lesko point out, is that not everyone stays in one position all night. That’s why Lesko says she rarely recommends pillows that are permanently shaped, including memory foam.

Instead, she usually points people toward down or down-alternative pillows: “You are able to form it to support neck alignment regardless of sleep position and accommodate broader shoulders on your side or possibly a forward head on your back.” For the same reason, she notes that adjustable-fill pillows can also help, since you can reshape them as needed to keep your head aligned with your spine.

🚩 Mistake No. 2: Not factoring in your body size or mattress firmness

✅ What to do instead: Use the nose-to-chest-center test at home (or in-store) rather than assuming a certain loft or firmness is universally “correct.”

While sleep position influences ideal firmness and loft, your body size matters too — especially if you’re a side sleeper. “Larger-shouldered side sleepers typically have a greater distance between their head and shoulder and therefore will likely require additional pillow height to fill this gap,” says Dr. Hanul Bhandari, a double board-certified neurologist and sleep medicine specialist.

In contrast, he adds that smaller-framed individuals tend to have a shorter distance between their head and shoulders and may not need the extra loft. Lesko agrees, noting she often sees clients choosing pillows that are too big or too high for their frame.

How soft or firm your mattress is can also affect whether you need a taller or shorter pillow. “With an extremely soft mattress, it is common for your shoulder and torso to ‘sink’ into the mattress, thereby requiring a slightly shorter pillow. Conversely, when using a very hard mattress, there is much less ‘sinking,’ and consequently, a thicker pillow may be required by many side sleepers,” says Bhandari.

So how can you tell if the pillow height is right for you? Bhandari recommends a quick nose-to-chest alignment test:

Lie on your mattress in your usual sleeping position and relax.
Nose points in the same direction as the center of your chest = correct loft.
Nose tilts down toward the mattress = loft is too low.
Nose tilts up toward the ceiling = loft is too high.

🚩 Mistake No. 3: Assuming price equals quality

✅ What to do instead: Look for adjustability and fit over price tag or flashy marketing.

Lesko says you don’t have to splurge to get a good-quality pillow, echoing her earlier point that the most important factor is choosing a pillow that’s right for your body size and sleeping position. That said, she admits that a good down or down-alternative pillow isn’t always the cheapest option.

Still, in Yahoo’s testing of more than 50 pillows, several of our top-scoring picks came in under $100.

🚩 Mistake No. 4: Buying a pillow you can’t return or “trial”

✅ What to do instead: Prioritize brands offering returns or trial periods, especially for memory foam pillows, instead of locking into a purchase after one night.

“Similar to mattresses, there’s no one perfect pillow. What works for someone might not work for you,” says Dodell-Feder. That’s why she recommends trying out a pillow for several nights before deciding whether it’s actually a good fit. “For example, I am a side sleeper, so in theory, I should be using a firmer pillow, but I vastly prefer the softness of down,” she adds.

She’s especially cautious about making snap judgments with memory foam. “Because it takes time to conform to your body, you should sleep on the pillow for a few nights before making a final decision. That’s why it’s essential you buy pillows from a place that allows sleep trials or lets you return a pillow even if it’s out of the package,” she says.

Before you buy, check the retailer’s return policy so you’re not stuck with a pillow that causes more aches than restful sleep. And if a brand advertises a trial period, make sure it applies wherever you’re buying — some are only available when you purchase directly from the brand. Just keep in mind, per Dodell-Feder, that generous trial periods tend to be more common with pricier brands than budget-friendly ones.

🚩 Mistake No. 5: Assuming “cooling” pillows stay cool no matter what

✅ What to do instead: If cooling is the goal, make sure your pillowcase isn’t getting in the way

Cooling pillows vary in how they actually help keep you from waking up sweaty. The problem is that, depending on how they keep you cool, your pillowcase may be undoing your pillow’s effectiveness.

“When it comes to cooling pillows, don’t forget that your pillowcase can affect its coolness,” says Dodell-Feder. “Many cooling pillows feature a cover made from a cool-to-the-touch fabric like lyocell or viscose. But if you put that pillow in a pillowcase, you’re going to lose most, if not all, of that chilly feeling.”

One solution is to skip the pillowcase altogether — though that may not be practical if you’re worried about spills or stains. If you’d rather not worry about that, you can still go the cooling route: opt for a pillowcase that’s thin, highly breathable and moisture-wicking. Viscose, lyocell and silk pillowcases are all good options, and some pillowcases use specially engineered fabrics to help with heat dissipation.

🚩 Mistake No. 6: Waiting too long to replace your pillows

✅ What to do instead: Replace your pillows about every two years, and treat new pain or a flattened pillow as a signal to replace it sooner.

How often you should replace your pillow depends on a variety of factors, like materials and frequency of use, but Dr. Brandon Peters-Mathews, a board-certified neurologist and sleep medicine specialist at CommonSpirit Health, says two years is a good rule of thumb. That said, the National Sleep Foundation recommends replacing them every year or two.

Beyond a pillow simply losing its shape, Peters-Mathews says headaches, worsening allergies and neck or shoulder pain can be less obvious signs that it’s time for a new one.

Lesko also points out that it’s not always the pillow that’s changed — sometimes it’s your posture. “Pillows may have to change depending on how your posture changes over time,” she says. “The pillow you slept on in your 20s may not serve you in your 60s.”

For that reason, Lesko recommends working with a physical therapist if you start waking up with new or worsening neck and shoulder pain, to figure out whether you simply need a new pillow or if counter exercises and ergonomic changes at work are needed too.

Meet our experts

Jennifer Lesko, PT, DPT, director of physical therapy at Therapeutic Associates West Seattle Physical Therapy
Hanul Bhandari, MD, double board-certified neurologist and sleep medicine specialist, medical contributor at Alpas Wellness NOVA

Our health content is for informational purposes only and is not intended as professional medical advice. Consult a medical professional on questions about your health.