I can’t speak to what style they used in Japan, but a little bit of ergonomically correct neck support is a lot more comfortable than having your head directly flat. If they are scooped into little cups that fit your skull and polished smoothly, I can imagine them being quite comfortable even without much padding. It wouldn’t take much padding to make them surprisingly comfortable if you’re a back sleeper. It’s similar to how a master carpenter can make a wooden chair that’s extremely comfortable just by shaping it and smoothing it correctly.
This is about 20 minutes of research condensed:
Soft pillows need to be replaced every 2-4 years, even nowadays, and in less sanitary times would be a nightmare to keep clean. Mold, insects, sweat and dirt discoloration, you name it.
Most Asian and African cultures historically used hard pillows made of wood or stone to support the neck. It was understood how to make a soft pillow but they weren’t very popular for practical reasons. The ancient Chinese believed they were bad for your health.
Soft pillows became popular with wealthy Greeks and Romans in Europe, but died off during the middle ages due to being expensive to upkeep and seen as emasculating. They very slowly came back around the late medieval, but it wasn’t until the Industrial Revolution that your average Joe in Europe would be consistently able to afford a soft pillow in his bed.
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