Push your pillow down so its bottom edge sits against the tops of your shoulders, with no gap underneath your neck. Your ears should line up over your shoulders, and your nose should point straight at the ceiling or straight ahead. Most neck pain comes from the pillow sitting too high up the bed, under the head only, leaving the neck unsupported.

Watch how most people go to bed. They drop the pillow near the headboard, lie down, and land with their head on it and their neck hanging in mid-air behind it.

That gap is where the trouble starts. Your head weighs around five kilos. If the pillow only holds the back of your skull and nothing supports the curve beneath it, your neck muscles spend the whole night holding that weight instead of resting.

The fix costs nothing. Slide the pillow down the bed until its lower edge is touching the tops of your shoulders. Now the pillow is supporting the neck and the head together, which is what proper pillow position for sleeping actually means.

Where the Pillow Should Sit, Position by Position

Side Sleeping: The bottom edge of the pillow should tuck right into the space where your neck meets your shoulder, with your shoulder resting on the mattress rather than on the pillow. Your head should sit level, not tipping down toward the mattress or riding up toward the ceiling. Add a second pillow between your knees to stop your top hip from rolling forward, because when your hips twist, your spine follows and your neck ends up compensating.

Back Sleeping: The thickest part of the pillow goes under your neck, with the flatter part under your head. If you are using a standard rectangular pillow, this often means positioning it slightly lower than feels natural at first. Your chin should stay level, roughly parallel to the ceiling. If your chin is tucked toward your chest, the pillow is too high or too far up.

Stomach Sleeping: Use the thinnest pillow you own, or skip it entirely and place a flat pillow under your hips instead. Your neck is already rotated in this position, and adding height increases the strain. If you cannot sleep any other way, a very low pillow under one side of your chest can reduce how far your neck has to turn.

A Simple Test to Check Your Alignment

Lie down as you normally would, then get someone to look at you from the side and take a photo on their phone.

Look for one straight line running from the base of your skull through your neck and down your upper spine. From the front, your nose should sit in line with the centre of your chest.

If your head tips toward the mattress, you need more height. If it tips upward, you need less. If the line is straight but you still feel a gap under your neck, the pillow is positioned too far up the bed rather than being the wrong size.

Fixing the Gap Under Your Neck

This is the most common complaint we hear, and there are three ways to solve it.

The first is repositioning. Move the pillow down so it meets your shoulders. This alone fixes it for most people.

The second is adding a neck roll. A neck roll pillow placed in the hollow beneath your neck fills the space a flat pillow leaves empty. It works particularly well for back sleepers who like a low pillow but still need cervical support.

The third is changing the pillow itself. If your current one has flattened out, no amount of repositioning will help, because there is nothing left to support you. A pillow with micro ball fibre filling holds its shape under pressure rather than collapsing, which is why the medicated pillow keeps its height through the night.

Supporting Positions Beyond the Pillow Under Your Head

Neck alignment does not begin at your neck. It starts at your hips.

Side sleepers should place a pillow between the knees. Without it, the top leg drops forward, rotating the pelvis, twisting the spine and forcing the neck to correct for the whole chain.

Back sleepers benefit from a pillow or roll under the knees. This flattens the lower back against the mattress and takes pressure off the lumbar spine, which lets the upper body settle without tension.

Both adjustments reduce how much work your neck has to do, even though neither one touches it directly.

How to Position Your Pillow While Sitting

The same principle applies at a desk or in a car. A rolled pillow placed at the lower back keeps your spine upright, which stops your head from drifting forward.

The forward-head posture that builds up through a long working day carries into your sleep, and it is a large part of why office workers wake up with stiff necks. Supporting your lower back during the day makes your night-time position easier to hold.

The Short Version

Slide the pillow down until it meets your shoulders. Keep your ears over your shoulders and your nose centred. Add support between your knees if you sleep on your side, or under your knees if you sleep on your back. Then make sure the pillow you are using still has enough structure left to hold all of that in place.

FAQS

Should the pillow go under my shoulders? 

No. Your shoulders belong on the mattress. The pillow’s lower edge should touch the top of your shoulders, not sit beneath them, or your whole upper body gets lifted out of line.

Is it bad to sleep with two pillows stacked?

Yes, in most cases. Stacked pillows create an uneven, unstable surface that pushes your head forward. If you need the extra height, buy one pillow with the correct loft instead.

Can I put my arm under the pillow? 

It is a sign the pillow is too low. Tucking your arm under compresses the nerves in your shoulder and often leads to numbness. Raise the pillow height instead.

How long does it take to adjust to a new position?

Usually three to seven nights. Your body has learned the old position, so a corrected one can feel odd at first. Give it a week before deciding it does not suit you.