I agree with the issue about sliding down as well when using the wedge pillow. I did find a small pillow to go under you knees which helps a lot in particular if you are a back sleeper. I at least start out that way so hope to get some benefit from that. The pillow is essentially a lumbar roll type but sliced in half horizontally so round on top, flat on the flip side so it stays put fairly well. No silent reflex found but motility issues present so told to eat slowly and sip water.