Best Firm Pillows - Reviews and Buyers Guide

Updated August 1, 2019

A proper night’s sleep is almost wholly dependent upon your overall sleep comfort. This has much to do with what choices you have made in your mattress sleep surfaces, but if you still aren’t sleeping as well as you feel you should, consider what pillows you are using.

Your pillow is much more important to restful sleep than you realize, and picking the best option for your sleep preference should be considered. Below are the firm pillow reviews of our hand-picked choices, each of which we spent multiple nights within various sleep positions.

Back and Neck Alignment

Ideally, your back and neck should be in proper, supportive alignment through the night, no matter what position you sleep in. Your spine is supported through correct posture through the day, but many of us forget that as we sleep this is just as important.

Your spine encases your central nervous system which plays a vital role in your overall health, and helps keep you balanced and upright, as well as serves as the main passageway of the messages your brain sends to the rest of your body. Poor alignment doesn’t just result in back pain and achy muscles, it often results in increases in insomnia, anxiety, depression, and headaches- to name a few.

Sleep Position vs. Pillow Comfort

Many of you may already be aware that your mattress firmness is directly related to your sleep comfort, and this varies depending on if you are a back, side, or stomach sleeper. Your sleep needs are also unique to your body weight, height, and shape- but the general rule of thumb is that side sleepers usually need a more plush, softer surface in order to help cradle hips and shoulders, and allow the spine to stay straight throughout the night.

Back and stomach sleepers need more firm support to help uplift hips and shoulders to keep them from sinking and creating tension on the soft tissues of the back, and pulling the spine out of alignment.

But what you may be unaware of is that even with the correct mattress, your posture may be being affected by your pillow choices.

Side Sleep Position Needs

A side sleeper allows for a gap to occur between their shoulders and head, and this space should be properly supported in order to allow the soft tissues to relax, and let the spine fall naturally into position.

Firm pillows with wide gusset help fill this space to cradle your head, and allow your neck to rest comfortably upon the material beneath. Side sleepers also often create pressure upon your knees, and a pillow placed between your knees can help alleviate this pressure, and help keep your spine aligned.

Back Sleep Position Needs

Back sleepers benefit from a thinner, firm pillow that supports your neck. Ideally, you want a pillow that has an extra loft in the bottom third of the pillow to allow your neck to rest upon. A memory foam pillow is often a popular pick for back sleepers as it helps create a cradle for the weight of the head while correctly supporting the space between the head and shoulders.

Avoid to thick of a pillow that will lift the head too far forward when laying upon it. A pillow placed under your knees can also help align the spine and keep pressure off your lower back.

Stomach Sleep Position Needs

Sleeping on your stomach creates the most stress upon your back and usually always has some degree of alignment issue since your head will often be turned to one side or the other through the night. Therefore it’s important to control how much strain is being put on your neck as much as possible.

A thin pillow, or no pillow at all, is ideal to help keep your neck aligned with the rest of your spine. Placing a pillow under your hips may also help keep your hips from sinking and placing strain along your lower back. Stomach sleepers may also benefit from a body pillow if sleeping with a pillow of some sort is a comfort must.

Why Would You Want a Firm Pillow?

As mentioned, thicker, firmer pillows are the best choice for side sleepers to help support the neck and head. Medium-firm to extra-firm choices are the most popular for side comfort, whereas a thinner medium firm with a firm down or down alternative, or memory foam that conforms to the neck is a back sleeper preferred choice.

Pillow Loft

Pillow loft refers to how high it sits when laying flat. A pillow with a high loft with be a thicker pillow, whereas a pillow with low loft will be more on the thin side. A high lift pillow also often looks a bit more rounded out and have a gusset, or panel along the sides to make the pillow a bit more rectangular in shape.

Beautyrest Gusset

Sealy High Loft

Just because a high loft pillow looks thicker and more solid, this doesn’t mean it doesn’t cradle your head and neck in all the right places. The same goes for a thinner pillow. A low loft doesn’t mean a flat, lifeless pillow with no support. The best way to determine what loft is right for you is to take into account your sleeping position. High loft pillows are popular with side sleepers and for use as a body pillow, whereas lower lofts provide better comfort for many back and stomach sleepers.

Higher quality materials also maintain their loft for much longer. Down feather pillow, and buckwheat husk, are some of the higher-end fillings used that maintain loft for longer periods of time.

Pillow Size

Pillows are not a one size fits all, and knowing the differences, and your needs, can help you determine the best comfort for you. The standard, most common pillow size is 20×26 inches, but a super standard, queen, and king size are 20×28, 30, and 36 inches respectively. Standard sizes are the best for sleeping in any position, with the larger sizes occasionally being more popular with side sleepers to help fill in the spaces between your head and shoulder and provide more support.

Be sure to purchase pillowcases that fit your pillows, especially if they are larger and have a high loft in order to keep from compressing the materials.

What to Consider When Choosing a Firm Pillow

What is your sleep position?

Knowing your sleep position is the first step in choosing the correct pillow. It doesn’t matter if you think you like a fluffy, large pillow if it doesn’t suit your sleep style it isn’t going to provide the correct comfort.

Do you know the difference between a high and low loft?

If you have never paid attention to pillow loft before now, and are unsure of the differences between the two, you may want to visit a sleep store that will allow you to check it out. High loft pillows are incredibly comforting for certain positions and use, but may not work well for an entire night’s sleep. Pay attention to your neck support and how straight your neck is in relation to your spine when resting in your normal sleep posture.

Test your pillow age every 18 months to 2 years

Even when purchasing a new pillow you should test out your pillow life by folding it in half to check its spring back. Pillows that have materials that compress and have been stored too long that way may not provide the support you need. And with use pillows can also collect allergies and oils from your skin. A pillow protector is always a good idea.

Our Top 5 Firm Pillow Picks

We have slept with, cuddled with, napped upon, bunched up, and lounged around with these following firm picks to give you our best rundown of each product to suggest to you.

1. Perfect Fit Extra Firm Density Standard Size


  • Filling: Polyester fiberfill
  • Loft: medium thin
  • Density: Extra Firm

The Perfect Fit extra firm pillow has a 2 inch gusset to provide a medium loft, polyester fiber fill, in an overall thinner pillow design created for back and side sleepers. The thinner design allows for back sleepers to align their head and spine to their back, whereas side sleepers have enough loft support for a neck cradling affect.

The 233 thread count cotton cover allows for maximum airflow to keep you sleeping cool, and allow body moisture to dissipate to keep your pillow fresh. Plus the gusset is quilted to help provide shaping, and keep the pillow from breaking down overtime. The polyfill is also hypoallergenic to help deter a buildup of allergens.

This is a good pillow choice for back sleepers and lighter side sleepers. The loft conforms to your head and supports your neck well, but maybe a bit too thin for heavy side sleepers who may need a bit more material to fill the space between their head and shoulders. It is also a good choice for placing under stomach sleepers hips to help take pressure off the lower back.


  • Flatter design for wider variety of sleep styles
  • Poly fill doesn’t bunch
  • Breathe well


  • May be too thin for heavy sleepers
  • Loft may break down quickly

Read our full review.

2. Bedsure Memory Foam Contour Firm Pillow


  • Filling: Memory Foam
  • Loft: Thin
  • Density: Medium Firm

This non-traditional, memory foam pillow provides shaping and contouring for back and side sleepers who need the proper neck support for true muscle relaxation. The memory foam shaping allows for the pillow to be used two different ways to work as an uplifting neck rest with space to cradle your head in alignment with the rest of your spine.

The density of the foam does take a bit of time to truly conform and soften under your body heat, but holds its shape well once you have found a comfortable position. This therapeutic design is made specifically to allow for maximum neck relaxation, as many muscle and soft tissue tension is caused by improper neck support through the night.

A good pillow choice for side and back sleepers, this is a great pillow alternative for anyone looking for more neck cradling support. It is truly a very firm, low loft material and does take a little time for true contouring. The pillow is also smaller, and is designed for sleepers who move very little through the night, or not at all.


  • Memory foam molds to head and neck
  • Contouring design for spinal support
  • Protective cover


  • Very Firm
  • Takes time to soften and conform
  • Small size

Read our full review.

3. Sealy Firm Density Down Alternative Pillow


  • Filling: Alternative poly down
  • Loft: High
  • Density: Firm

This high loft, firm density pillow provides an overfilled look and boasts 2 inch high gussets to accommodate the firm down alternative poly fill. Although at first glance this choice looks very plush, the materials conform extremely well to support and cradle the weight of your head while distributing materials to allow your neck to rest comfortably.

The 300 thread count cotton cover provides great airflow to keep moisture from building up and the thick gusset is double stitched to keep from pulling as fill redistributes under applied weight. Although the down alternative has less of a down feel, and more of a plush cotton feel, it does distribute nicely like down does and plumps back up after use.

Created for side and back sleepers, this pillow is a great choice for side sleepers of all shape and size, but may be to firm and thick for most back sleepers. Although it is very supportive, especially within a reclined position upon your back, it is a very high loft when laid flat.


  • High loft provides contouring
  • Very Breathable
  • Supports neck well


  • Plush firm, not hard firm feel
  • Not a true alternative down feather feel

Read our full review.

4. Beautyrest Extra Firm Pillow

Another high loft, almost overstuffed pillow choice, the Beautyrest extra firm pillow provides plush softness with contouring head and neck support. The 2 inch high gussets are reinforced to provide proper shaping as the fill distributes with weight addition, and helps hold your head in softness while providing restful neck support.

Created for side and back sleepers, these pillows are covered with a 400 thread count pima cotton and provide decent breathability. Although lower thread counts have better airflow, no complaints surround sleeping hot or retaining moisture. The poly fill also plumps up well after each use.

Perfect for side sleepers, this pillow does provide soft comfort without sacrificing firmness or support, and is a favorite for sleepers in need of good neck support. Back sleepers may find them too firm and too high a loft for proper head contouring, which lifts the neck out of alignment can causes stress along the soft tissues of the upper back and shoulders.


  • High, contouring loft
  • Firm support
  • Excellent neck support


  • May be too ‘springy’
  • May be too firm for back sleepers

Read our full review.

5. BAMBOO Firm Shredded Memory Foam Pillow


  • Filling: Shredded memory foam
  • Loft: Medium
  • Density: Firm

Shredded memory foam provides foam contouring while allowing for a more adjustable feel to the pillow loftness. A zippered cover allows for the removal and addition of shredded memory foam to adjust the overall loft and firmness to meet the needs of all sleep positions.

Natural bamboo fibers are breathable and vent air well for a comfortable and cool sleep surface, plus the design allows for it to be removed and washed. Bamboo is also naturally dust mite resistant, making it a good solution for those sensitive to allergens.

The Bamboo pillow is a good choice for any type of sleeper if they are willing to work with the adjustments that may be needed for personal comfort. The firmness is ideal for back and side sleepers, but stomach sleepers who require a pillow may find this an ideal choice with the removal of some of the loft for a thinner pillow choice.


  • Adjustable to different sleep positions
  • Created for cervical support
  • Removable fill for comfort


  • Foam may settle and require redistribution
  • May be too firm

Read our full review.


As far as firm pillow choices go, these are our favorites currently offered on the market to provide both comfort and versatility where needed. Firm pillows are typically created to meet the needs of side and back sleepers, with higher loft options created specifically for the unique neck support side sleepers need to keep their spine in alignment.

Of the choices we’ve offered, our top pick is the Beautyrest Extra Firm Pillow which offers a plush, extremely high loft choice that contours comfortably to your head while holding it in support through the night. More importantly is how the fill distributes to comfortably support your neck to allow a true rest which moves with you through the night.