I am a larger man with broad shoulders. I have trained myself to only sleep on my side due to breathing issues arising from my oversized uvula and the tendency for my tongue to join it at the back of my throat when on my back. Even when I’m awake, breathing on my back - much less speaking - is difficult due to my uvula in particular, as I can’t consciously control how it drapes back against my throat.
So I built my own pillow, so that my head doesn’t hang from my shoulders like an afterthought -- no normal pillow is tall enough to support my head while I am on my side. It looks kinda like a particularly narrow and deep parking curb, vaguely saddle shaped, only it’s not made out of concrete. It’s literally a tiny showroom-demo mattress on top of a very stable wooden base, with an actual pillow secured on top of it and everything wrapped up in a custom pillow case.
Looks strange AF, but it keeps my spine straight and the crinks out of my neck.