Sleeping Without a Pillow:
Is It Right for You?

Many sleepers consider their pillow an integral sleep accessory. For some, it can be as essential as a comfortable mattress. Different sleepers require different types of pillows to achieve their best sleep posture. Most use traditional pillows of the appropriate loft and firmness to help support their heads and necks, but that isn’t always necessary. It may seem counterintuitive, but the optimal sleep posture for some individuals may call for skipping a pillow altogether.

We’ll discuss who should consider sleeping without a pillow, the potential benefits and drawbacks, and how to make the transition to pillow-free sleep.

Pillows help cushion your head and support the natural curvature of your neck. Most sleepers need a pillow to maintain neutral spine alignment.

However, some sleepers find that a pillow negatively affects their posture and overall comfort. For stomach sleepers, a lofty pillow can force the neck into an unnatural angle that can cause neck pain and interfere with quality sleep. Research on this topic is limited, but anecdotal reports suggest sleeping without a pillow may benefit some stomach sleepers.

Improves Posture

Each sleep position has unique implications for posture, and this also affects whether or not you need a pillow. Sleeping without a pillow may improve the posture of stomach sleepers, but it often has the reverse effect for back and side sleepers.

Sleeping on your stomach frequently leads to poor sleep posture and strain on the neck and shoulders. Even a relatively low-loft pillow may elevate the head too far, putting stress on the neck. Since stomach sleepers also often turn their heads to the side while sleeping, the combination of twisting your neck and then forcing it back can be especially uncomfortable. Forgoing a pillow can help a stomach sleeper’s head, neck, shoulders, and upper back remain in a more neutral position.

Sleeping without a pillow is unlikely to improve the posture of those who favor other sleep positions. Back sleepers may be able to sleep without a pillow, though the head is likely to fall into a downward tilt in this position that puts pressure on the neck. Side sleepers generally need a pillow to support their neck and fill the larger gap between their head and the mattress.

Relieves Neck and Back Pain

For some sleepers, a pillow may lead to improper spinal alignment and cause back or neck pain. Stomach sleepers need their heads to be nearly flush with the bed to limit strain on the neck and upper back. For stomach sleepers, sleeping without a pillow can help relieve neck and back pain to an extent. However, sleeping with the head turned to the side can still cause pain.

Prevents Wrinkles and Hair Damage

Stomach and side sleepers often sleep with one side of their face pressed into their pillow. More research is necessary, but this is thought to compress the skin on the face and create wrinkles. Lying directly on the mattress limits conforming, which may reduce skin impressions. However, sleeping on your back eliminates facial skin compression, so it’s the most effective choice for preventing wrinkles.

Some also theorize that pillows cause hair damage through friction and the absorption of natural oils, but scientific research on the topic is lacking. That said, tossing and turning in your sleep may lead to tangles, knots, and frizziness. Choosing a smoother material, such as cotton with a sateen weave or silk, may help more than ditching your pillow.

People with acne may also worry that their pillow is to blame. However, using a pillowcase and washing your pillow frequently should prevent bacteria, dirt, and oil buildup that could clog pores.

Sleeping without a pillow may have benefits for certain types of sleepers, but it’s not the right choice for everyone. If you sleep on your side, giving up your pillow may cause more harm than good. That’s because side sleepers typically need the most support to keep their heads, necks, and upper backs aligned.

Impairs Posture

Good sleep posture relies on maintaining neutral spine alignment from the lower back up through the shoulders, neck, and head. Side sleepers typically rest on one shoulder, creating a large gap between the neck and the surface of the bed. Without ample support from a lofty pillow, a side sleeper’s head sags, forcing the neck into a harsh angle.

Back sleepers generally need a medium-loft pillow to promote proper spinal alignment. Sleeping without a pillow creates a gap at the neck and allows the head to fall backward, impairing posture.

Worsens Neck and Back Pain

Without the support of a pillow, side and back sleepers may wake up with pain in their necks and upper backs. The unnatural position can also lead to joint and muscle tension that could contribute to more widespread pain, including headaches and lower back pain.

Sleeping without a pillow may reduce pain for stomach sleepers, though they still may experience discomfort. Lying on your stomach with your head turned to one side may strain your neck with or without a pillow.

Hinders Breathing

A pillow raises your head slightly. For side and back sleepers, this can help open up the airway and make breathing easier. Without a pillow, your head and neck can sag, constricting your airways. This can make breathing feel more labored, increase the risk of snoring, and aggravate symptoms of sleep apnea.

Shop the Best Pillows

Sleeping without a pillow can be a game changer for some sleepers, but not everyone benefits from getting rid of their pillow. Before you decide to try it, consider your sleep style, mattress, and overall health.

Your Sleeping Position

There are three sleep positions: side sleeping, back sleeping, and stomach sleeping. Most people favor side sleeping. However, the best position for sleeping without a pillow is on your stomach.

Stomach sleepers require minimal head support to achieve neutral spine alignment, and excessive elevation is bad for their posture. Some back sleepers also enjoy sleeping without a pillow, but they’re likely to experience some discomfort from their head sagging and putting pressure on their neck.

Side sleepers generally need a relatively lofty pillow to maintain good posture and sleep comfortably. Lying on your side elevates your head above your mattress more than any other position. As a result, side sleepers need robust support to keep their head and neck aligned with their shoulders and back.

Your Mattress Support

Your mattress’ firmness and support also influence the comfort of sleeping without a pillow.

Firmer mattresses have less yielding surfaces. Some sleepers enjoy the support and minimal contouring of a firm mattress, but they may also want a pillow to cushion their head. In contrast, a softer mattress can provide adequate cushioning for your head in the absence of a pillow.

Additionally, the level of mattress contouring impacts spinal alignment. Selecting the right firmness for your body type and sleep position is always important, but it may be especially critical if you don’t plan to use a pillow.

Your Health

Consider any health conditions before making changes to your sleep environment. Sleeping without a pillow could cause poor sleep posture, neck and back pain, and hindered breathing in certain sleepers. You should probably avoid sleeping without a pillow if you experience sleep apnea, acid reflux, joint issues, or serious back pain. If you’re unsure whether sleeping without a pillow is right for you, talk to your doctor.

Approach pillow-free sleep with care. Plan your transition ahead of time to maximize the benefits and limit potential drawbacks.

Ease Into It

Even if sleeping without a pillow is right for you, the initial change can seem extreme. Ease into the transition over several weeks to gently introduce your body to this new way of sleeping.

You can start by using a lower-loft pillow or a folded blanket or towel and observing how your body responds to the change. If your neck and back are pain-free and you’re still sleeping well, you might try sleeping without a pillow.

Use Pillows Elsewhere

While you may not need a pillow to support your head, some sleepers aren’t comfortable lying completely flat. Using pillows for other parts of the body can enhance comfort and improve alignment.

Stomach sleepers sometimes use a pillow under their hips to improve their spinal alignment. A body pillow may be particularly useful. Back sleepers might tuck a pillow under their knees to reduce pressure on their lower backs. Many side sleepers use a pillow between their knees to improve their posture.

Try a Different Sleeping Position

If you want to try sleeping without a pillow, consider adjusting your position. Side sleeping is usually uncomfortable unless you have the support of a pillow. However, side sleepers can experiment with sleeping on their stomachs without a pillow.

Choose the Right Mattress

Your mattress is a critical component of your sleep setup. Whether you choose to use a pillow or not, your sleep may suffer without the proper support of a quality mattress. Make sure you understand which mattress type and firmness level work best with your sleep style, body weight, and comfort preferences.