Guide to Combination Sleeping and the Best Pillows for This Position

Combination sleeping is exactly what it sounds like – a combination of all sleeping positions – side, back, and stomach.

According to a study on human sleep positions and nocturnal movements, people in the combo sleeping position sleep 54.1% of the time on their side, 37.5% on their back, and 7.3% on their stomach.

Fascinating, isn’t it?

Who Is a Combination Sleeper?

Combination sleepers are people who aren’t committed to a single sleeping position. Whether intentionally or unintentionally, they run the gamut of all sleeping positions throughout their slumber. 

According to their alternating convenience and sense of comfort, they may sleep on their side, back, or stomach.

What Are Their Sleeping Preferences?

The natural instinct of most combo sleepers is to…

  • Toss and turn as it deems them fit.
  • Use as well as avoid pillows throughout their slumber.
  • Place their pillow between the shoulders and head when sleeping on their side.
  • Hug their pillows at times.
  • Place the pillow in the curve of their neck and shoulders when sleeping on their back.
  • Seek lumbar and knee support on and off.
  • Require cushioning underneath their faces when sleeping on their stomach.
  • Seek pillows of varying firmness and loft as per convenience.

How Do You Identify Them?

Observe them when they wake up from sleep. If their hair is messed up on all sides of their heads, they could be a combination sleeper.

Messy bed linen could also be a sign of combination sleeping, which involves constant tossing and turning. Drool is another indicator. If there’s drool everywhere – on the pillow and even on the mattress – that might be a combination sleeper dribbling.

Yet another hint is the use of different pillows. Only a person who cannot decide on a fixed sleeping side tends to use multiple pillows of varied shapes and sizes.

What Are the Advantages of Combination Sleeping?

Relief From Chronic Pain

Combination sleeping is a protective mechanism to combat pain in the back and neck that develops as a result of prolonged pressure from long-held sleeping positions.

It also positively impacts pain associated with the musculoskeletal system, including bones, cartilage, tendons, ligaments, and connective tissues.

Reduced Risk of Numbness in the Shoulders and Arms

A combination sleeper will tuck one or both arms under the pillow, sleep on one arm, rest one or both arms lengthwise on either side, or place them over the head and even on the stomach or chest.

Because the arms and shoulders have no fixed position, blood flow to them is almost always adequate. The likelihood of nerve compression is also low.

As a result, numbness in the shoulders and arms is extremely unlikely.

Improved Gut Health

As previously stated, a combination sleeper spends the majority of his sleep time on his side. It is an established fact that this position improves gut health.

Gravity pushes most waste through the ascending colon, then into the transverse colon, and finally into the descending colon when a side sleeper’s body is rested on the left side.

As a result, the digestive system can function normally and gastrointestinal issues such as constipation, heartburn, acid reflux, and bloating are avoided.

See: Best pillows for acid reflux

Prevention of Snoring

People in the combination sleeping position are likely to breathe better and snore less (not lesser than a side sleeper, of course) because they are always changing positions.

Even if the airways get compressed in the back sleeping position, the body will eventually rest on one of the sides or stomach. Less snoring means lower chances of sleep disorders, sleep apnea, hypertension, diabetes, stroke, heart attack, and issues with cognitive behavior.

Improved Spine Health

Although combination sleepers spend a long time in the side sleeping position, they also spend substantial time in the back sleeping position, which mimics the neutral posture of the body.

This ensures that the natural curvature and alignment of the spine are maintained at least in parts during their slumber. As a result, the spine remains in good shape and health.

Prevention of Tension Headaches

Tension in the cervical spine during sleep frequently causes migraine-like headaches with throbbing pain on one side of the head and face, pain in the eyes, blurry vision, stiff neck, and sensitivity to light and sound.

Such problems occur when the body is only supported on one side or on the stomach. Tension headaches are extremely unlikely in a combination sleeper because they are constantly changing positions and sleeping on their back a lot.

What Are the Disadvantages of Combination Sleeping?

Combination sleeping comes with numerous disadvantages, which include the development of the following conditions

Acne and Wrinkles

Sleeping on your side or stomach in the combination sleeping position ensures that your face comes into direct contact with the pillowcase, which may contain allergens, dirt, and germs. This could result in localized acne breakouts on the face.

Furthermore, pressing a portion of or the entire face against the pillow causes friction between the fabric and the facial skin. As a result, whatever skincare products you apply before sleeping are already being wiped on the pillowcase, causing early wrinkling.

Also read: Best Pillowcases for Acne Recommended by Skin Experts

Breast Sagging

Side sleeping is a major cause of breast sagging due to the breast ligament being constantly pulled. Because combination sleepers mostly sleep on their sides, they are likely to experience this issue (but not as much as pure side sleepers).

Pillow Ear

Pillow ear is a medical condition in which the outer part of the ear swells, throbs, and hurts as a result of prolonged contact with a pillow. This condition is common in combination sleepers as they sleep on their side or stomach a lot.

Which Pillows Are Ideal for Combination Sleepers?

For a combination sleeper, a one-size-fits-all pillow doesn’t exist. Using a single regular pillow that serves all purposes isn’t recommended because it will eventually be too high for sleeping on the stomach and too low for sleeping on the side.

For optimal spinal alignment and relief from body pain, a combination sleeper needs to consider the following aspects when looking for a pillow:


Most regular pillows are meant for back sleepers, which is why a combination sleeper must use more than one specialty pillow. Your best bets are as follows:

  • Body pillows
  • Knee pillows
  • Pelvic pillows
  • Wedge pillows
  • Cervical pillows
  • Lumbar pillows
  • Pillows with an ear hole

When you’re sleeping on your side, a body pillow will offer you the required support. When you’re sleeping on the back, a wedge pillow along with a cervical, knee, and lumbar pillow will keep the spine and hips correctly aligned.

Similarly, a pelvic pillow comes in handy when you’re sleeping on your belly. A pillow with an ear hole could be of great use to prevent a pillow ear. Of course, to each his own.


If it’s too firm, the head will rest at an awkward angle in the side and back sleeping positions, causing neck pain. It cannot be too soft either, or the head will sink too deeply into it, causing neck stress and pain.

However, if you sleep on your stomach, you will surely need a pillow that’s soft enough to prevent your spinal alignment from being thrown off. Contradictions, right? Read on to know how the right firmness for a combination sleeper’s pillow can be achieved.


As discussed earlier, the loft of a combination sleeper’s pillow cannot have a fixed measurement. It needs to be of medium to high thickness for the side sleeping position, medium thickness for the back sleeping position, and very low to low thickness for the stomach sleeping position.

A pillow with an adjustable loft does sound good. But imagine having to take out and insert a layer throughout your sleep hours. That would be insane!

Therefore, we recommend buying multiple pillows of different thicknesses or buying a single pillow that has thicker areas for side sleeping and thinner areas for back and stomach sleeping.

Fill Material

Remember our discussion about the right pillow firmness for combination sleepers? Well, it can be achieved with a hybrid pillow – one that contains a mix of different fillers and is designed to deliver blended comfort.

Our top recommendations include…

  • Latex and Down – outer layer filled with fluffy Down feathers and inner core filled with firmer shredded latex
  • Memory Foam and Kapok – outer layer filled with soft kapok and inner core filled with firm Memory Foam
  • Memory Foam and Microfiber – layers of microfiber nestling a memory foam core

See all pillow types here