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A firm pillow can keep the head level during sleep. This in turn may help prevent sinking and potentially avert aches and pains.

The right pillow can help reduce nighttime pain, so a person can get a better night’s sleep. Pillows that do not provide appropriate support may cause headaches or shoulder pain and worsen existing pain.

In this article, we discuss the potential benefits of firm pillows, what to look for in a firm pillow, some of the top options available online, and alternatives.

There is little scientific research supporting the idea that a specific pillow firmness can improve or harm a person’s health.

However, an uncomfortable pillow can make it difficult to sleep, or contribute to morning head or back pain. This means it is important for a person to choose a pillow that feels comfortable and does not put their head in a painful position.

Some research suggests that the thickness or height of a pillow may affect pain levels. A 2015 study found that people with shoulder pain reported medium height pillows to be most comfortable and low height pillows to be least comfortable.

A pillow that is sufficiently firm to elevate the head may help with some medical conditions, including reflux and heartburn.

Some factors a person may wish to consider when choosing a firm pillow include:

  • Pillow height: Higher pillows may feel firmer and offer more support, but they may also hold the head in an uncomfortable position. By contrast, lower pillows might feel less supportive.
  • Material: The pillow material will affect how firm the pillow is. Microbeads and buckwheat tend to provide the firmest support. Memory foam, down, and down alternative pillows offer more adjustable support.
  • Warranty and customer service: More expensive pillows often come with a warranty. It is worth reading the warranty terms carefully and checking online reviews to ensure the company honor their warranties.
  • Price: People who are uncertain what level of support they need may want to consider testing out lower price pillows first.
  • Adjustability: Some pillows offer adjustable support, such as the ability to remove pillow inserts. This makes it easier to select the right height and firmness.
  • Additives and allergens: People with allergies or who have concerns about toxic chemicals may wish to check the pillow components and look for certifications, such as CertiPUR-US.

The best firm pillow offers significant support without placing unnecessary strain on the upper back or neck.

Below, we present a selection of some of the top firm pillows available on the market.

Please note that the writer of this article has not tried these products. All information presented is purely research-based.

Helix Adjustable Pillow

Helix Adjustable Pillow features a removable insert. This allows sleepers to adjust both the firmness and height of the pillow to suit their needs and preferences.

The gel microfiber core has cooling benefits, which may help prevent overheating and night sweats.

Helix offer a 1-year warranty and a 100-night in-home sleep trial.

Helix Adjustable Pillow is available for purchase online.

Brookstone Layer Adjust Pillow

This medium-firm pillow uses a combination of memory foam and down alternative filling. It is a good option for people who want support but who still want some cushioning.

The pillow features three layers of material, and sleepers can remove layers or even fold them to get their ideal sleep surface.

The company do not offer refunds.

Brookstone Layer Adjust Pillow is available for purchase online.

SpineAlign Pillow

This pillow features a notch for the neck so that the shoulders and neck can remain at different heights while still getting comfortable support.

Users can adjust the level of support by removing or fluffing the internal foam. The foam is CertiPUR-US certified as free from common harmful chemicals.

The company claim this pillow promotes spinal alignment and may relieve aches and pains.

SpineAlign Pillow is available for purchase online.

Hullo Buckwheat Pillow

This pillow uses buckwheat filling for firm but adjustable support. Users can adapt the support level and height by removing some of the buckwheat hulls.

The organic cover is hypoallergenic, making it suitable for people who have allergies. There are no foams or bird feathers used, which reduces the risk of exposure to harmful chemicals or allergens.

Buckwheat is a sustainable and vegan-friendly material. The pillow is breathable and will not overheat.

Hullo Buckwheat Pillow is available for purchase online.

Utopia Bedding Gusseted Pillow

This medium-firm pillow provides support that reviewers say still offers some give.

The poly fiber filling is unlikely to irritate allergies. Additionally, thanks to the breathable material, the pillows do not retain heat or cause the user to overheat while sleeping.

The affordable price point is ideal for users who are uncertain about which pillow might work best.

Utopia Bedding Gusseted Pillow is available for purchase online.

Some alternatives to a firm pillow include:

  • Sleep wedge: A sleep wedge can elevate the head at night, offering firm support.
  • Adjustable bed: An adjustable bed allows a person to move their head and neck into the most comfortable position.
  • Memory foam pillow: A memory foam pillow offers support that conforms to a person’s body, potentially providing high support without creating pressure points.

A firm pillow will not treat any serious medical conditions, but it may help a person who wants significant support for their head and neck while they sleep.

Choosing the right pillow is highly personal, and a person’s sleeping needs can change over time. Therefore, it is advisable to experiment with different options and be prepared to replace a pillow when it starts to lose firmness, which is often after about a year.