This pillow does not look like what you would expect... that's because it was designed by an Ergonomic Designer in consultation with a Doctor of Chiropractic. The Therapeutica Sleeping Pillow is constructed of a non-allergenic, non-toxic foam that will not lose its shape or resilience. One of the key goals to sound sleep is Spinal Alignment which can help you to be more comfortable. Because people sleep on their backs, sides, or both, this pillow was created to work for each sleeping position. The ergonomic design offers comfortable support and stability in all sleeping postures. This results in a sounder sleep and less tendency to wake with pain, stiffness and many of the symptoms resulting from lack of support. Available in five sizes for a custom fit. Comes with a free-fitted zippered pillow cover made of a polyester/cotton blend, and is machine washable. The Child, Petite and Average sizes fit into a standard size pillow case. The Large and XLarge fit into a king-size pillow case. Purchasing this pillow is not only an investment in a pillow, but an investment in your future health. NOTE: Sizing can be tricky with this product because you need to measure for proper size, but also take into consideration the firmness of your mattress and how much you sink into it. It may be helpful to select a smaller size than you measure for, if you have a soft bed. If you feel that the pillow is too hard at first it is recommended to step on your pillow to help speed up the break-in process.