Medically Reviewed by Amy Wolkin, DPT, MBA
Dr. Amy Wolkin is a physical therapist based in Atlanta, GA. After graduating from Wellesley College in 2012, she pursued dual graduate degrees at Emory University. She graduated in 2017 with her Master of Business Administration and Doctor of Physical Therapy degrees. Her clinical interests are outpatient orthopedics, women’s health, and pediatric sports medicine. She has advanced training in dry needling and pelvic floor physical therapy.
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Answering the question of is it better to sleep without a pillow isn’t exactly simple. There hasn’t been a ton of research on the topic, probably because every person is different and everyone’s preferences are different. If you’re experiencing neck or back pain, though, your pillow could be the problem. Ahead, we’ll break down the benefits of sleeping without a pillow — including sleeping without a pillow for neck pain — as well as any drawbacks of sleeping this way. Plus, we’ll even provide recommendations for those who might benefit from a pillow-less night.

What are the benefits of sleeping without a pillow? 

Spinal alignment

Depending on how you sleep, going without a pillow can help your spine keep in alignment. Especially for stomach sleepers, not having anything under your head keeps your body in a more neutral position. When your body is completely flat, your spine can stay more straight, meaning less potential for posture concerns. However, there is little research on this, and it will vary from person to person.

Fewer aches and pains

When your body is out of alignment, which can happen when you sleep with pillows, you might experience a neck strain or backaches. This can be due to you using muscles in your sleep to help keep your body comfortable. When you wake up, you might feel those aches and pains from the muscle strain. Sleeping without a pillow can potentially help keep your body in a more comfortable position during the night.

Better skin

Unless you’re washing your pillowcases every day, there’s potential for bacteria to build-up on the pillowcase and contaminate your face. Plus, pillows are not very breathable, and putting your face against them doesn’t allow your pores to breathe. However, it’s worth noting that sleeping without a pillow will still require you to keep your sheets clean for when your skin is touching those as well. In addition to the bacteria transfer on the skin, pillows have been shown to increase wrinkles on the face due to compression at night.  

Tips for sleeping without a pillow 

Gradually go down to no pillow

When it comes to how to sleep without a pillow, you might have some trouble getting there if you’re not careful. After all, you’ve most likely slept with a pillow for many years. Gradually work your way down to sleeping with no pillow by decreasing the thickness of your pillow. Start with two pillows and allow yourself to get used to that before moving down to perhaps one thinner pillow and then no pillow.

Listen to your body

Sleeping with no pillow is not for everyone. If you’re primarily a side sleeper but want to try the no-pillow route, listen to your body if it’s in pain after trying. Most likely, side sleepers will not be comfortable without a pillow, so if your body tells you that, listen to it.

What are the health risks of sleeping without a pillow? 

Spinal discomfort

For some people, sleeping with no pillow can cause quite a bit of pain. Without a pillow under your head, it can throw your spine out of alignment. This can lead to not just pain but also posture issues.

Neck pain

Similar to spinal discomfort, sleeping with no pillow can cause neck pain rather than alleviate it. If your body is out of alignment because you aren’t using a pillow, you could be putting a lot of stress on your neck, leading to a greater amount of pain. And just like sleeping with a pillow can cause pain for some people, it can equally cause pain without it.

Recommendation for each sleeper type 

Stomach sleepers

Stomach sleepers are the most likely to be comfortable with no pillow. Because your spin is more neutral when you’re on your stomach, your head flat on the bed is most likely to ease any discomfort in your neck and spine. It could cause a little bit of stress on your neck to have your head turned to the side, but it is still most likely going to be more comfortable than using a pillow.

Side sleepers

Side sleepers will probably be uncomfortable with no pillow. When you’re on your side, your head is quite a bit elevated from the mattress because your shoulder is under it. A pillow will cradle the head to keep the neck and spine neutral. Without a pillow, your head has nothing to rest on and can feel a good amount of pain through the night. A softer mattress that absorbs your body can help this, but a pillow will provide the most support. It is recommended that side sleepers utilize pillows.

Back sleepers

Back sleepers could go either way. According to the University of Rochester’s Medical Center, what’s important to consider here is your mattress. With a more plush mattress, your body will be more sunk in, putting less stress on your neck if you have no pillow. If you’re on a firm mattress, though, your spine will already be very straight, meaning your head is raised off the mattress. A pillow would provide support under your head to keep everything in line.

Final Thoughts

If you’re asking yourself, “Should I sleep without a pillow?” there are several things to consider. Sleeping without a pillow can be helpful for some people. It can ease some spinal and neck discomfort and make sleeping a more pleasant experience. However, going without a pillow isn’t for everyone. Listen to what your body is telling you, consider your sleeping arrangement, and do what feels best for you.