In the search for the best sleep, people often focus on the perfect mattress or blackout curtains, but your pillow—or lack thereof—can also make a surprising difference. While most people rely on pillows to support their head and neck during sleep, a growing number of individuals are questioning whether ditching the pillow altogether might actually be better for spinal alignment, posture, and even skin health. So, is sleeping without a pillow good for you? The answer depends on your sleep position, health conditions, and personal comfort.
The primary role of a pillow is to keep the spine in a neutral position while you sleep. When your neck and head are supported properly, it reduces strain on your muscles and joints. According to the National Sleep Foundation, using a pillow that matches your sleep style—whether you sleep on your side, back, or stomach—is key to reducing neck pain and improving overall sleep quality. But for stomach sleepers, in particular, going pillow-free may actually be beneficial.
Stomach sleeping tends to force the neck into an awkward, rotated position. Using a pillow can exaggerate that angle, potentially leading to strain in the cervical spine. A small 2017 study in Work Journal found that stomach sleepers using no pillow had reduced forward head posture and reported less neck discomfort. By eliminating the elevation of the head, the neck can stay more aligned with the rest of the spine, reducing stress on the muscles and joints.
Back sleepers might also benefit in some cases, especially if their mattress already provides good support. Sleeping without a pillow can help keep the neck in a more natural curve, particularly for those experiencing lower back pain, according to a clinical trial published in the Journal of Physical Therapy Science. However, this approach can backfire if the sleeper’s head sinks too far back, which can flatten the cervical spine and create more discomfort than relief.
For side sleepers, though, skipping the pillow is generally not recommended. Sleeping on your side without head support can lead to misalignment between the head and spine, increasing the risk of waking up with stiffness or tension headaches. A higher-loft pillow is often needed to fill the space between the shoulder and neck in this position, according to Harvard Medical School’s sleep guidelines.
Beyond posture, some believe sleeping without a pillow could help improve skin health. The idea is that pillow pressure may contribute to facial wrinkles and acne due to constant friction and the build-up of oils and bacteria on fabric. While there’s limited clinical evidence, anecdotal reports suggest that going pillow-free might reduce facial compression, especially for stomach and side sleepers who press their faces into their bedding. A 2012 article in Aesthetic Surgery Journal discussed how mechanical pressure from pillow contact may influence facial aging over time, though more research is needed.
On the other hand, skipping a pillow might not be ideal for those with specific medical conditions. People with obstructive sleep apnea, acid reflux, or chronic neck issues are usually advised to elevate their head slightly to relieve pressure on the airway or reduce reflux symptoms. In such cases, going without a pillow could worsen their condition. Always consult a healthcare provider if you suspect underlying sleep disorders or spinal problems.
Ultimately, whether sleeping without a pillow is good for you comes down to personal needs and body mechanics. It may be worth experimenting with or adjusting pillow height gradually to observe how your body responds. Just remember, better sleep isn't just about what’s under your head—it’s about what works for your whole body.
Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult a physician or healthcare professional before making changes to your sleep routine, especially if you have a chronic medical condition or are experiencing persistent discomfort.
References
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National Sleep Foundation. “Choosing the Right Pillow.” [sleepfoundation.org]
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Gordon, S. J., et al. (2017). "Effects of pillow height on the biomechanics of the head-neck complex." Work.
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Park, S., et al. (2015). “The effect of sleeping position on lumbar lordosis and intervertebral disc pressure.” Journal of Physical Therapy Science.
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Harvard Medical School. "Healthy Sleep: How to Sleep Better." [health.harvard.edu]
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Swift, A. (2012). “Facial Aging and Sleep: The Science of Wrinkle Formation.” Aesthetic Surgery Journal