Medium to high loft pillows (4-6 inches) maintain neutral spine alignment. Your head should rest level with your shoulders, not tilted up or down.

Medium-firm provides the best balance. Too soft allows your head to sink, straining your neck. Too firm pushes your head forward out of alignment.

Down and down alternative both work well. Down offers moldable support that conforms to your neck curve. Down alternative provides consistent firmness and is hypoallergenic.

Your ear should align with your shoulder when lying on your back. If your chin tilts toward your chest, the pillow is too high. If your head tilts back, it's too low.

Adjustable or medium-loft pillows can work for combination sleepers. Look for pillows that compress slightly when side sleeping but maintain support when on your back.

400-600 thread count cotton sateen provides durability and breathability. Higher thread counts feel softer but may trap heat during sleep.

Replace pillows every 18-36 months depending on quality. Down pillows last longer with proper care. If your pillow no longer springs back when folded, it's time to replace it.