A ventilated adjustable headrest may include an adjustable metal insert, a nozzle fixedly attached to the adjustable metal insert. The nozzle may be in fluid communication with a perforated covering and one or more cushion elements. The nozzle may be telescopically coupled to one or more ventilation ducts. The one or more ventilation ducts may be configured to receive forced air from a ventilation system at an air inlet, and may be configured to deliver the forced air to the nozzle.