Do Cooling Pillows Help Hot Flashes? What They Can and Can't Do at Night

A cooling pillow can make hot flashes at night easier to live with, but it won't stop them. Gel layers and "cool-touch" covers feel cold when you first lie down, then warm up to your skin temperature. What actually helps is keeping your whole sleep setup cool: a pillow that breathes, a cooler room, air moving across your face, and bedding you can throw off in two seconds.

Below you'll find what the research says about cooling at night, what to look for in a pillow if you wake up drenched, the gear worth considering, and when hot flashes are worth a conversation with your doctor.

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Why hot flashes hit so hard at night

Hot flashes are a sudden wave of heat in the face, neck and chest. They usually last 1 to 5 minutes and can come with sweating, flushing, chills and a racing heart. As many as 8 in 10 women in the United States get them around menopause, and about a third have more than 10 a day (ACOG). When they happen during sleep, they're called night sweats.

They often start in perimenopause, sometimes as soon as periods start skipping, and they tend to peak in the year after your last period. For many women they last somewhere between 4 and 10 years, and some still get them in their 60s and 70s (ACOG).

Night is a perfect storm. You're under covers, the room may be warm, and you can't just step outside. Mayo Clinic notes that even a small rise in body temperature can set off a hot flash, which is why "keep cool" is the first self-care step on its list (Mayo Clinic). And the link runs both ways: the National Institute on Aging says research now suggests that waking up may itself trigger hot flashes, not only the other way around (NIA). Fewer wake-ups can mean fewer flashes.

Do cooling pillows help hot flashes?

Here's the honest answer: I couldn't find a published study that tests a cooling pillow on its own for hot flashes. The evidence that exists is about cooling the bed.

The closest study is a 2022 pilot from Wake Forest. Fifteen perimenopausal and postmenopausal women, aged 45 to 59 and having at least four hot flashes or night sweats a day, slept on a cooling mattress pad system for 8 weeks. Their hot flash frequency dropped by 52%, and their sleep-quality scores improved from 11.14 to 7.87 on the Pittsburgh Sleep Quality Index, where lower is better (Avis et al., Menopause, 2022).

That's encouraging, with two big caveats. There was no comparison group, so some of the improvement could be expectation or time. And a mattress pad system actively pumps cool water all night, which is very different from a gel pillow that only absorbs heat for a while. So the study supports the idea that a cooler sleep surface helps. It doesn't prove a pillow will do the same job.

Why the "cool" in a cooling pillow fades

Gel, phase-change liners and cool-touch fabrics are passive. They pull heat away from your skin until they reach roughly the same temperature, and then the cold feeling is gone. Even on the listing for one of the best-selling cooling pillows, the reviews are split: some buyers say it stays cool through the night, others say it warms up within minutes.

What a good pillow can still do:

• Trap less heat. Shredded fill with air between the pieces releases heat better than one solid block of memory foam.
• Give you a cool side to flip to. When you wake up hot, flipping the pillow is the fastest relief you have in bed.
• Handle sweat. A removable, washable cover and a breathable pillowcase keep you from lying on damp fabric for the rest of the night.

What to look for in a pillow for night sweats

• Breathable fill. Shredded or "plus-shaped" foam, latex with ventilation holes, or a microfiber blend. Avoid dense, solid foam if you sleep hot.
• Adjustable loft. Pillows you can unzip and add or remove fill from fit more sleepers, and less fill means less material holding heat.
• Two different sides, ideally one with a cooler fabric or pad.
• A washable cover. If you sweat at night, you'll wash it more often than you think.
• The right pillowcase. The case sits between you and the pillow, so a satin polyester case can undo a cooling pillow. Cotton percale, linen or rayon made from bamboo all feel cooler.
• A real return window. Pillows are personal. Check the return policy before you buy.

Cooling pillows and gear worth a look

These are based on what each product listing says. None of them treat hot flashes; they're comfort tools.

Coop Home Goods Cool+ Pillow

The Coop Cool+ is an adjustable pillow: you unzip it and take fill out or add it from the extra bag until the height is right. It has two sides, a softer one and a firmer side with a cooling pad, so you have somewhere to turn when a night sweat wakes you. The listing says it's CertiPUR-US and GREENGUARD Gold certified. It's not cheap, and the reviews on cooling are mixed, so buy it for the breathable, adjustable fill rather than expecting it to stay icy.

Bedsure PureWoven pillowcases

If you'd rather not replace your pillow, start with the case. These bamboo-rayon pillowcases come in a set of two, use an envelope closure so the pillow doesn't slide out, and are machine washable. Keep the spare one on your nightstand so you can swap to a dry case in the middle of the night.

Honeywell TurboForce fan

The National Institute on Aging suggests turning on a fan if hot flashes keep you up (NIA). A small fan aimed at your head and shoulders often does more than any pillow, because moving air keeps carrying heat away instead of stopping once a material warms up. The HT900 is small enough for a nightstand or dresser and has a pivoting head and three speeds.

Chilipad Cube

This is the big-ticket option. The Chilipad Cube is a thin pad that goes on top of your mattress and connects to a small unit that circulates cooled or warmed water through it. You set the temperature, and the half-queen size means a partner who runs cold can keep their side as is. It's the same general idea as the pad in the Wake Forest pilot, though that study didn't name or compare brands. The listing notes that it isn't meant to replace air conditioning.

A cooler bedtime routine for hot flashes

Gear works best on top of a few habits. The NIA and Mayo Clinic recommend most of these:

1. Lower the bedroom temperature, and run a fan or air conditioning if you can.
2. Drink a small glass of cold water before bed, and keep one on the nightstand to sip when a hot flash starts.
3. Layer your bedding so you can pull a layer off without fully waking up, and use breathable sheets for night sweats.
4. Wear light, loose sleepwear, and keep a dry T-shirt within reach.
5. Go easy on alcohol, spicy food and caffeine, especially in the evening. All three can make hot flashes worse.
6. If you smoke, quitting helps hot flashes as well as everything else.
7. Try slow breathing or a short relaxation routine when one starts. Mayo Clinic says the North American Menopause Society supports cognitive behavioral therapy and clinical hypnosis for hot flashes.

When to talk to your doctor about hot flashes

You don't have to just get through it. ACOG calls systemic estrogen the best treatment for hot flashes and night sweats (ACOG). It does carry risks, and Mayo Clinic notes that if you start it within 10 years of your last period or before age 60, the benefits may outweigh them (Mayo Clinic). Your doctor can help you weigh that against your own history.

If you can't or don't want to use hormones, there are prescription options without them: a low-dose form of paroxetine, gabapentin, clonidine, and newer drugs that act on the brain's temperature-control center, such as fezolinetant and elinzanetant (Mayo Clinic). Supplements are a weaker bet. The NIA says black cohosh, DHEA and soy isoflavones aren't proven to work, and some carry risks such as liver damage (NIA).

See a doctor soon if night sweats come with fever, weight loss you can't explain, a cough, diarrhea or pain in a specific spot, or if they start months or years after your menopause symptoms had ended. Night sweats can have causes other than menopause, including medications and infections (Mayo Clinic).

FAQ

Do cooling pillows stay cool all night?

No. Gel and cool-touch fabrics feel cold at first and then warm up to body temperature. Flipping the pillow, using a breathable pillowcase and running a fan help keep the cool feeling going.

What pillow material is best for night sweats?

Look for breathable fill, like shredded foam or a foam and microfiber blend, plus a washable cover. Solid memory foam tends to hold heat. The pillowcase matters too: cotton percale, linen or bamboo rayon feel cooler than satin polyester.

Can a cooling mattress pad help hot flashes?

There's early evidence that it can. In a small 2022 pilot study, women who slept on an active cooling mattress pad for 8 weeks reported 52% fewer hot flashes and better sleep. The study had no control group, so larger trials are still needed.

Are cooling pillows worth it during menopause?

They're worth it if your current pillow is a solid foam block that feels hot, or if you sweat into it every night. Think of a cooling pillow as one part of a cooler bed, not a treatment.

Does sleeping with a fan help hot flashes?

Many women find it does, and the National Institute on Aging suggests a fan along with a cooler bedroom and layered bedding. Moving air keeps carrying heat away, which passive cooling materials can't do.

How long do hot flashes last?

It varies a lot. ACOG says 4 to 10 years is typical in many studies, and some women have them into their 60s and 70s. Treatment can help at any point, so you don't need to wait them out.

This article is for informational purposes and doesn't replace advice from a healthcare professional.

Sources

• An Ob-Gyn's Top Tips for Managing Hot Flashes – ACOG
• The Menopause Years – ACOG
• Hot flashes: Diagnosis and treatment – Mayo Clinic
• Night sweats: Causes – Mayo Clinic
• Hot Flashes: What Can I Do? – National Institute on Aging
• Sleep Problems and Menopause: What Can I Do? – National Institute on Aging
• Avis NE et al. Results of a pilot study of a cooling mattress pad to reduce vasomotor symptoms and improve sleep. Menopause, 2022 – PubMed

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