a woman walking on a path of pillows trying to choose between a pile of feather pillows and synthetic pillows

Choosing A Pillow When You Have Asthma

Several years ago, I bought one of those allergy and asthma-friendly certified pillows on sale for Boxing Day, which I’ve at this point replaced a couple times, though likely not as often as I should! Each time I’ve replaced them, though, the new pillows have never been as good as those ones - even if I don’t know of their helpfulness for my asthma. The ones I have now are ready to be replaced, and I’ve only had them 9.5 months, certainly shy of the 1-2 years at which they should be replaced!

What’s in a pillow?

I think the main issue around pillows is what’s inside (I mean… duh, right?). First, of course, is the density—the softness or firmness and AMOUNT of stuff inside said pillow (I’ve since learned the tall-/poofy-ness of a pillow is known as its loft)—and second is what, precisely, they shove in there.

I was surprised when reading a review published in 2011 to find, "There is now considerable epidemiological evidence […] that synthetic bedding is associated with asthma and allergic diseases while feather bedding appears to be protective."1 However, I take this to mean protective against DEVELOPMENT of asthma and allergies, not protective against development of their symptoms when you have a pre-existing diagnosis.

More on this topic

So with that said, here are the main pillow stuffers, and their suitability for people with asthma, generally. As always, your asthma may vary.2

  • Down and Feather

    While I think it's a popular belief that people with asthma should avoid down or feather pillows, I didn’t find any compelling evidence for either of these from reputable sources (ie. not pillow manufacturers, but rather journals or academic websites).

    Pertinent to the quote above, as well, I’d certainly not purchase any household items simply based on that they might be protective against developing asthma alone unless there is great evidence to do so. Remember, even the hygiene hypothesis is still a hypothesis!

    A 20-year-old Cochrane Review suggests insufficient evidence to recommend feather bedding in managing asthma.3 I was unable to find a more recent study or literature review on this topic.

    Verdict: No verdict.

  • Polyester fiberfill

    Polyester fiber or fiberfill is often marketed as hypo-allergenic or “down alternative", and is used primarily in pillows and stuffed animals. I was unable to find any specific studies from the past 10 years on polyester fiberfill and its impact on asthma or dust mite allergy.

    Verdict: The University of Rochester Medical Centre Gosilano Children’s Hospital recommends using synthetic fibrefill pillows.4 It recommends to “put pillows in zippered, dust-proof covers”, and not to use foam, feather or down pillows.4 However, some studies still state preference for feather or down over polyester.

  • Foam (non-latex)

    Foam pillows are not suggested for use by people with asthma.4 This could be due to greater possibility of mold growth on these pillows, or as dust may become trapped inside depending on “pore” size.5 However, I was unable to truly substantiate the reasons in academic works behind this recommendation.

    Verdict: No verdict; maybe better to avoid if you have a mold allergy.

  • Latex foam

    The same considerations generally apply as with non-Latex foam pillows. It goes without saying, though, that if you have a latex allergy, you should avoid use of latex pillows even if they are in casings, as repeated exposures can worsen future reactions to latex.

    Verdict: Avoid if you are allergic to latex. Maybe better to avoid if you have a mold allergy.

What pillow is best for asthma?

Really, all that information wasn’t exactly helpful, was it? Verdict? No real verdict exists here—at least not in the few hours of research I’ve done into the literature!

With that said, many articles did recommend the use of dust-proof encasements for pillows to be used regardless of pillow type. Without going into detail, this certainly seems to be a recommendation that can do little harm and may help keep pillows freer of dust mites.

On the quest for a pillow - online

Of course, on top of a lot of non-information about fill materials, the only thing more difficult than pillow shopping is, of course, pillow shopping during a pandemic. Not only am I not going to waltz around stores, I’m sure as heck not going to do so to put my head on things other people have maybe put their heads on and breathed on! (Though, I suppose it has been more than 72 hours since our mask mandate finally began months too late!)

I’m looking for a soft-ish pillow. I think I used to have medium-somethings but the barcodes on my current ones are not leading to useful information! I’m a side-sleeper but generally sleep with two pillows and, of course, want something of an apparently better material for asthma and allergies!

In the absence of the typical in-store pillow buying experience, I have asked for advice on Twitter (and may soon consult my people on Facebook). I have tried pillow finder quizzes—heck, I just did another one while writing the section above this one!. I have googled for many configurations of pillow-related search terms and read the round-up lists for 2020.

I’m leaning in a certain direction at this point, but still am undecided on my quest to finding my next pillow or two!

What type of pillow do you use? Did you research your choice ahead of time or did you just buy what felt right? Let me know in the comments!

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