Have you ever thought about if you can sleep without a pillow? Did someone tell you that sleeping without a pillow is better for your back or neck? Or are you just looking to change it up a little? It might seem a little crazy—who doesn’t have at least one pillow on their bed?—but how comfortable is it sleeping without a pillow? Is it healthy? Let’s take a look at the advantages and disadvantages, and everything in between, about the experience of sleeping without a pillow.
Sleeping without a pillow is not an all-or-nothing experience. It depends upon how you sleep, what your body needs, even the type of mattress you’re dealing with. For some people, going pillow-less reduces problems with the neck and results in better posture; for others, it’s the opposite, leading to aches and strains. We’re going to present the data simply from who should NOT be sleeping without a pillow to those who it’s recommended and how to proceed cautiously. By the end of the article, you’ll have the answer to your question: can you sleep without a pillow?
So Why Do We Use Pillows Anyway?
Pillows are everywhere, but what’s their actual purpose? Pillows are designed to keep the spine aligned while a person sleeps. The spine has natural curves, meaning when a person lays down, they need support for their head and neck to stay in a neutral position. Neutral means that the person isn’t bending or twisting their spine into a weird position. This means that people won’t wake with discomfort in their neck, shoulders or back.
When you sleep on your back or side, your head is elevated relative to the rest of your body. Yet if there’s no pillow, the head drops down too far and therefore, there’s a lot of space between the neck and the mattress. This creates overstressed muscles and pain. Pillows fill that divet and encourage aligned positioning of the head, neck and spine. Sounds pretty simple, right? Yet not everyone needs the same positioning and support levels which complicate matters.
There are different needs based on sleeping position. For example, side sleepers need a thicker pillow to account for the distance between the shoulder and the head on one side while back and neutral sleepers need more of a neutral/thinner pillow so as not to push their head forward. Then there are stomach sleepers who may not need a pillow all—or at least, a much thinner one. Which brings us to the question: should some people sleep with no pillows at all?
Who Should Sleep Without a Pillow?
Certain populations would benefit from not using pillows—even though it may not be beneficial for everyone. Here are the people who could benefit and why.
To start, stomach sleepers could greatly benefit from not having pillows in their sleep routine. When someone sleeps on their stomach, their head does turn to one side to allow for breathing so adding a thicker pillow puts their head at a weird level and angle, stressing the neck and adding pressure to the spine also. Therefore, over time, sleeping this way can encourage neck or low back pain. Sleeping without a pillow helps keep the head flush with the mattress to encourage better spinal alignment while some stomach sleepers report reduced neck stiffness from sleeping without.
Who might benefit from this new approach? Certain populations. For example, those who have sleep apnea—where breathing stops and starts during sleep—may find this less of a concern when they sleep pillowless. With pillows, sometimes the head can droop forward—which closes the airway even more—and creates more issues. Sleeping flat helps keep airways open. Similarly, those with acid reflux may prefer this option as well since not allowing one’s neck to droop in a position where more stomach acid can come up is a good thing.
Who else would appreciate a pillowless sleep? Those who want better posture. Pillows sometimes push your head forward or to the side—especially thicker pillows—and can contribute to poor slouched posture over time. Not sleeping with a pillow encourages your spine to sit straighter, which could lead to better posture when standing and sitting during the day. Finally, some people find that it’s a more natural position, like sleeping on the ground—which is how people slept for hundreds of years.
The Benefits of Not Sleeping with a Pillow
So what are the benefits? Here are the implied benefits. Increased spinal alignment for certain sleepers. For example, stomach sleepers often find that their neck bends incorrectly when they sleep with a pillow. Laying flat helps their heads stay in line with their spines to reduce strain. This means less stiffness or pain when waking up in one’s neck or upper back. And even if you are not a stomach sleeper, pillows that are too high or too yielding make it more difficult to keep alignment, so this might help from that perspective as well.
However, there are situations where going pillowless may not be the best option. Certain individuals depend on pillows for restful sleep and neck support. For instance, side sleepers need more cushioning to ensure their heads and necks are appropriately aligned to spines; otherwise, waking up with stiff necks and tension headaches becomes common. The same applies to stomach sleepers—although stomach sleepers may be more accustomed to sleeping with less loft. Though sometimes it’s a comfort thing for personal preference, other times, it’s a requirement.
When Is Sleeping Without a Pillow a Bad Idea?
But before you toss your pillow away, there are circumstances in which sleeping pillow-free is not the answer. When it comes to sleep positions or medical reasons, not using a pillow can do more harm than good.
For example, side sleepers should always keep a pillow to stay comfortable. Side sleeping creates an air gap because the space of the head and mattress differences, the width of the shoulder. Without a pillow, the head angles down, meaning the rest of the body has to follow. This is because spinal alignment is critical. The only thing that can happen is a negative reaction in the neck, tight shoulders, or even headache triggers. They say that most side sleepers require a medium to a thick pillow to keep their heads in line with the rest of their spines.
Similarly, back sleepers will also benefit from having a pillow. Yet thinner options are better. Back sleeping without a pillow may create excess space with a head tilt more toward the back than one imagines. This stresses neck musculature and can make someone wake up in discomfort or stiffness. Yet back sleepers can survive with a thin pillow (or crumpled-up towel) just to have enough height without pushing the head down into the chest too far.
Additionally, those with certain medical conditions associated with the spine should also be careful of sleeping without a pillow. If you experience herniated discs, scoliosis, or chronic neck pain, sleeping without a pillow can exacerbate already negative symptoms. Usually, these conditions require added support to remain properly aligned, so a pillow will assist comfort levels in the long run. However, it’s best to check with a doctor or chiropractor for any needed sleeping changes with spinal issues.
Yet another downside? The comfort factor. Many hate the idea of not using a pillow while sleeping. It seems too hard, too unorthodox, especially for those used to having softer, plusher pillows. If you cannot get to sleep without one, it’s not worth it. A good night’s sleep comes with comfort, so avoid putting yourself in a situation that feels wrong.
Mattress Matters Too
Your mattress is almost as important as your pillow—or lack thereof. Without a pillow, your mattress needs to support enough to keep the spine aligned. If it’s too soft, it creates sinking which makes the spine flex (potentially even without a pillow); if it’s too hard, it’s uncomfortable without the relief a pillow provides.
For stomach sleepers who want to sleep with no pillow, a medium-firm mattress is generally recommended. It prevents hip and stomach sagging, yet provides adequate support. For back sleepers, this is the same scenario; however, side sleepers may want it a little bit softer to compromise for the no pillow cushion. Still, support is needed; if someone hasn’t had a new mattress in years, perhaps they need one; if someone has a mattress that is sunken or sagging, trying to forgo a pillow might worsen the problem.
Also, the type of mattress matters; if someone has a memory foam mattress, that’s better than an innerspring design. A memory foam mattress sags into the body creating more efforts for alignment without assistance from a pillow. An innerspring might need a comfortable topper to allow for extra comfort without a pillow. Either way, everyone has to see what’s best for them because just as a mattress and pillow should coexist, so should a mattress and no pillow. They need to be harmonious to prevent discomfort.
How to Safely Try to Sleep Without a Pillow
Want to try? Don’t start by not sleeping with a pillow. Instead, your body can transition to this new reality gradually, especially if you’ve been using a pillow for the last couple of years. Here’s how to do it safely.
For example, you can reduce the height of the pillow you’ve been sleeping with gradually. If you have a bad habit of sleeping with a thick pillow, use a thinner one for a week or two. Or you can try folding a towel or a blanket to provide just a little bit of support; after a few days of adjustment, unfurl the blanket or use a thinner towel until you’re sleeping flat. This will minimized strain to the neck and back as these areas take time to adjust after realizing, over time, that not using a pillow may have been the wrong choice after all.
For stomach sleepers, make sure there is still some support—use a super thin towel under your pelvis or stomach to relieve pressure on the lower spine and prevent hips from sinking too far into the mattress. For back sleepers, a small pillow under the knees may help relieve pressure on the lower back. For side sleepers, at least to get away with not using a pillow under the head, they can place a pillow between the knees to keep their hips aligned.
What to assess? What does your body say after a few nights? If your neck hurts, you’re more stiff than usual upon waking, or you find you’ve developed tensions headaches, this is not the remedy for you. Allocate a few nights for acclimation and understand that if you wake up sore, your body needs comfort as the priority. While the benefits are plenty, this is not the right step for everyone.
Another factor to consider regarding pillow use is your sleeping position. If you tend to toss and turn, if you fall asleep on your back and end up on your side or stomach, going fully pillowless might be tricky—and have something on hand, like a thinner-profile pillow, in case of repositioning.
Tips for Better Sleep Without a Pillow
In case you do decide to go without or are experimenting with it, good sleeping hygiene can help. Here are some tips for better sleep as you acclimate to going without pillows.
Sleep in a dark, cool room. The best room temperature for sleep is between 60ºF to 67ºF which helps the body relax and fall asleep faster. Have blackout curtains or a sleep mask to avoid distracting light that can disrupt sleep cycles.
Keep a consistent sleep schedule. Going to bed at the same time every night and waking up at the same time every morning helps the body regulate its internal clock, which can assist when falling asleep, pillow or not.
Minimize screen time before bed. The blue light emitted from phones and tablets halts melatonin production and makes it harder to fall asleep. Instead, read a book or listen to soothing music.
Sleep with breathable materials. Cotton or linen sheets and pillowcases (for any extra pillows) allow airflow to keep you cool and comfortable—which is especially important when sleeping flat, with your face closer to the mattress.
Finally, don’t overthink it. If you’re restless wondering if you should use a pillow or not, you won’t fall asleep. Instead, allow yourself to relax with some deep breathing or spend ten minutes meditating to take your mind off of any overthinking.
Sleeping Without a Pillow: Popular Misconceptions
There are some myths about not using a pillow when sleeping. Let’s clear them up.
For example, there is a myth that not using a pillow is good for your spine. For stomach sleepers, yes. They won’t have added height in their necks. However, back and side sleepers can sleep with a pillow that helps align the head with the rest of the spine, and without one, excess strain can be applied. Also, there is a myth that not using a pillow helps avoid wrinkles. While there may be fewer contact points on the face to the pillow, which may help crease lines, aging and sun exposure contribute to more wrinkles than anything people do on their pillows or their beds while sleeping.
There is an argument that not sleeping with a pillow is “natural” as people didn’t always have pillows. This is highly inaccurate. People also slept on rocks and hard ground. The quality of mattresses now is much better and a far cry from what people had before—and what’s better is more indicative of how people should and do sleep now.
Finally, if you read somewhere that not sleeping with a pillow helps solve your sleep issues, that’s inaccurate—it may help reduce neck pain or headaches from poor posture or the action of using a pillow, but if you’re anxious, if you drink excessive caffeine during the day, or if you have an inconsistent sleep schedule, those will all keep you awake at night.
How to Know If You Should Sleep Without a Pillow
So should you sleep without a pillow? Yes—but only if you can. If you’re a stomach sleeper, anyone with certain diagnoses like sleep apnea or acid reflux may benefit from not sleeping with a pillow. It will increase spinal alignment, breathing, maybe even skin and hair. If you’re a side sleeper or back sleeper—or someone already with spinal issues—then not using a pillow will only cause more pain.
Ultimately, try a flatter pillow and rotate your mattress as needed over time. Trust your body; if not using a pillow makes you feel better, then great! But if you don’t feel better, that shouldn’t give you any guilt. Sleeping is a personal endeavor and no one should put stock in social media buzz when all that’s needed is comfort as one attempts to use it to their advantage. Do what feels good for you, and remember, the point of sleep is to feel better when you’re awake—not to go viral.
However, if you remain unconvinced and feel like you need to know more, consult with a chiropractor or sleep specialist for an assessment based on sleeping position and any associated medical issues. They’ll be keen on which way to guide you for ideal suggestions. Until then, make small changes and assess. The best sleep situation is contingent upon you—and maybe without a pillow.