How to pick a pillow for optimum rest

Big, small, medium. Soft, hard, in between. Nonallergenic, contoured, full-body. Sometimes it seems there are as many kinds of pillows as there are people who sleep on them.

The simple solution: Just find a pillow that feels right.

"A pillow can make a good sleeping situation better, but I don't think that, in and of itself, that it's the primary cause of neck problems," said Dr. Jared Brandoff, attending spine surgeon at the North Shore-Long Island Jewish Health System. "If you're not waking up in pain, you did a good job."

Still, with all the available options, a wise shopper might want to keep some things in mind:

1. Be cautious of ultrasoft pillows. You want to make sure that the pillow supports your head and neck without allowing them to fall out of their natural alignment.

"Finding the right thickness and firmness is important," Brandoff says. "Firmer is probably better than too soft, and it shouldn't be so high that your neck is abnormally bent."

2. Consider a full-body pillow if you have pain during or after sleep. "It not only maintains your neck in proper alignment but also your upper and mid spine," Brandoff said. "For many people who have upper- and lower-back problems, it's one-stop shopping for your entire spinal column."

3. Be careful if you have special health needs. A British study published in the journal Allergy in 2005 found that tested pillows were crawling with fungi that can harm those with allergies, asthma or weakened immune systems. Plastic pillow covers may provide protection from fungi and germs inside pillows.

4. Consider the material. There's been little research into how pillows of different materials affect sleep, but Australian researchers have found evidence that pillows filled with latex or rubber may do the best job of preventing pain and improving sleep. They don't recommend feather pillows. People with allergies to substances such as latex need to pay close attention to the pillow's insides. Brandoff suggests using pillows made of natural instead of synthetic materials if you have allergies. People allergic to feathers, though, might need to go the synthetic route.

5. For airplane napping, try a neck pillow. "Neck pillows on airplanes are a great idea because they help maintain normal cervical alignment and posture and decrease muscle fatigue," Brandoff said. The small oblong pillows with a half-moon-shaped cutout to fit around the neck are also sometimes suggested for bed use, especially for those who sleep on their backs.