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Sleeping Without a Pillow? Here’s What a Sleep Doctor Thinks

There are some pros and cons to sleeping without a pillow, but more research needs to be done. Prioritize sleep and choose what’s most comfortable for you.
Written by
Jeff Kahn, M.S., Rise Science Co-Founder
Reviewed by
Chester Wu, MD, Rise Science Medical Reviewer
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We bring sleep research out of the lab and into your life. Every post begins with peer-reviewed studies — not third-party sources — to make sure we only share advice that can be defended to a room full of sleep scientists.
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We regularly update our articles to explain the latest research and shifts in scientific consensus in a simple and actionable way.
Man sleeping without a pillow

Sleeping Without a Pillow: Pros, Cons, & How To Do It

  • Benefits of sleeping without a pillow include potentially less neck pain if you sleep on your stomach, better spinal alignment if you sleep on your back, reduced allergies, less acne and frizzy hair, and fewer sleep wrinkles.
  • Downsides of sleeping without a pillow include potential discomfort and pain for side and back sleepers, and more snoring, sleep apnea, and acid reflux.
  • To sleep without a pillow, ease into gently, opt for a medium-firm mattress, have a pillow nearby, and keep an eye on your sleep debt. If sleeping without a pillow makes you uncomfortable and causes sleep debt to rack up, consider going back to the pillow and prioritizing sleep.
  • The RISE app tracks your sleep debt and can tell you when to do 20+ sleep hygiene habits each day to make falling and staying asleep easier — whether that involves a pillow or not.

Pillows aren’t just a nice decoration in your bedroom. The right one can help you find a comfortable position so you can fall asleep, stay asleep, and get the shut-eye you need to feel and function your best each day. 

But not everyone agrees that pillows are necessary. Ditching the pillow is said to help with everything from back pain to acne, but is there any science behind these claims? And if you already sleep without a pillow, should you be adding it back into your nighttime routine for the sake of good posture? 

Below, we’ll dive into the pros and cons of sleeping without a pillow (both for your head and body) to help you decide whether you should use them or not. Plus, we’ll share how the RISE app can help you get more sleep and energy, with or without a pillow. 

What Are the Benefits of Sleeping Without a Pillow?

There’s not a lot of research into the potential benefits of sleeping without a pillow. And the research we do have is problematic. Pillow styles aren’t standardized across studies, and the data is often based on self-reported sleep quality or subjective data on comfort. But here’s what we know about the potential benefits of sleeping without one. 

1. Stomach Sleeping May Be More Comfortable and Less Painful 

Most experts agree you should avoid sleeping on your front as it can put pressure on your neck and put your spine in an unnatural position. But if you can’t fall asleep on your side or back, front sleeping may be your only option. 

In this case, sleeping without a pillow may make the position more comfortable and improve your posture. Your neck won’t be lifted unnaturally and it’ll be better for spine alignment. 

Expert tip: While you might skip the pillow for your head, consider using pillows elsewhere. Placing a thin pillow under your hips can promote spinal alignment. 

Stomach sleepers may also wake up with neck pain as the head is twisted. Try switching which way you face during the night. Keep your arms down by your sides, instead of lifted, to avoid shoulder pain. And keep your legs straight to avoid hip pain.

2. Back Sleeping May Be More Comfortable and Less Painful 

If you sleep on your back with a thick pillow, your head will be pushed forward at an unnatural angle. You might find it hard to drift off, wake up during the night, or wake up with neck pain. 

Sleeping without a pillow could help to keep your spine aligned. But, depending on your mattress, you may find your head tilts too far back without a pillow. 

Try using a thinner pillow, rather than skipping the pillow altogether, if this is the case. You can also buy special pillows designed for back sleepers that support the head and neck. 

While there’s no one agreed-upon height, one study found 10 centimeters (or just under 4 inches) was the best pillow height for back sleepers with normal cervical lordosis, or normal neck curvature.

3. Reduced Wrinkles 

When you sleep with a pillow, your pillowcase can tug on your skin, causing creases, fine lines, and wrinkles. You might wake up with “sleep lines” where your skin has been squashed into the pillow overnight. 

Sleeping without a pillow could, theoretically, keep skin looking younger. 

But if wrinkles are a worry, getting enough sleep is more beneficial than not using a pillow. So, if using a pillow helps you get more sleep, do it. Try sleeping on your back, so your pillow can’t tug on your skin, or buying a silk pillowcase, which glides over the skin.

We’ve shared more advice on how to prevent wrinkles here.

4. Reduced Acne 

Another skin-related drawback of sleeping with a pillow could include acne. Sweat, dirt, and oil can build up on your pillowcase and transfer onto your skin, triggering acne.

Ditching the pillow may help, but if you’re a front or side sleeper, your face will still be touching your bedding. 

If acne is an issue for you, try using a silk pillowcase and washing your bedding regularly. Getting enough sleep is also the best way to look after your skin, so choose the most comfortable position for you, pillow or not. 

We’ve covered more tips on how to get clear skin overnight here.

5. Less Frizzy Hair 

Some people claim that ditching your pillow can help tame frizzy hair. That’s because as you toss and turn in your sleep, your pillowcase can catch your hair and cause damage, knots, and frizz. 

Sleeping without a pillow may help, but switching to a silk pillowcase may help, too. And just as with skin, getting enough sleep will help keep your hair healthy. 

6. Reduced Allergies 

Allergies can easily impact your sleep, with a stuffy nose, sneezing, and itchy eyes making it hard to drift off. Allergies can also cause nasal congestion, mouth breathing, snoring, and sleep apnea. 

Your pillow may be causing allergies as dust mites can thrive there. Down-filled pillows in particular can trap dust mites and other allergens. 

Ditching your pillow may keep allergies at bay. But beware, dust mites can also thrive in your mattress and bedding. 

You can invest in a hypoallergenic pillow or a hypoallergenic pillow cover. Washing your pillowcase regularly can also help keep the dust mite population down. 

We’ve covered more on why your allergies are worse at night here, including how to sleep with them.

Is It Bad to Sleep Without a Pillow?

Again, there’s not a lot of research into sleeping without a pillow, but here are the potential drawbacks we know about. 

1. Side Sleeping May be More Uncomfortable and Painful 

Not all sleeping positions lend themselves to ditching the pillow. If you’re a side sleeper, sleeping without a pillow will cause your head to drop down, meaning it’s not in alignment with your spine. 

Sleeping on your side without a pillow may make it harder to drift off, you might wake up during the night in discomfort, or wake up the next morning with a stiff neck. 

But side sleeping is the best position for many health issues — including acid reflux, sleep apnea, digestion, heart health, brain function, and when pregnant — so you want to make it as comfortable as possible. 

Expert tip: As well as a pillow for your head, try tucking a pillow between your knees to create a natural position for your spine. If you experience hip or shoulder pain on the side you sleep on, try swapping sides throughout the night or buying a softer mattress. 

Research from 2021 found body pillows can take pressure off the shoulder, hip, and body as a whole. Sleeping with a body pillow also helped people spend more time sleeping on their side and prevented the segmentation of deep sleep episodes. 

We’ve covered more on the best side to sleep on and the best pillow position for each sleeping position here.

2. Back Sleeping May be More Uncomfortable and Painful 

As we mentioned above, if you sleep on your back and ditch the pillow, you may find yourself tilting your head back too much. This puts pressure on your neck and spine and can cause pain, discomfort, and sleep loss. 

3. More Snoring 

Snoring isn’t just disruptive for whoever you share a bed with, it can disturb your sleep, too. You can wake yourself up with the noise, and research shows snoring can lower sleep quality and cause daytime drowsiness. 

Sleeping with a pillow can help to reduce snoring in a few different ways. 

Firstly, sleeping with your head elevated can help to keep your airways open, reducing snoring. You can prop yourself up with an extra pillow or invest in a wedge-shaped pillow that can comfortably lift your head and upper torso. 

Secondly, pillows can help keep you on your side — another sleep position that can help keep airways open. You can place a firm pillow behind you to stop yourself from rolling onto your back in your sleep. 

You can also buy special pillows that keep you on your side, and these have proven to be successful. For example, one study asked snorers with sleep apnea to sleep with a head-positioning pillow designed to stop them from sleeping on their backs. This helped reduce both snoring severity and snoring index, or the number of snoring events per hour. Their snoring index was reduced from 218 events an hour to 115 events an hour. 

Want to sleep without a pillow, but you’re a snorer? An adjustable base bed can also lift your head up and reduce snoring. A 2021 study found when snorers slept on an adjustable base bed at an incline of 12 degrees, there was a 7% reduction in their snoring duration. Beyond snoring, they also had 4% fewer nighttime awakenings and a 5% increase in the proportion of time spent in deep sleep.

We’ve covered more ways to stop snoring here.

4. More Sleep Apnea 

Sleep apnea is the much more serious cousin of snoring. It happens when you temporarily stop breathing throughout the night. And snoring is one symptom of it. 

Sleeping with a pillow, in the right way, can also help reduce sleep apnea. 

Research shows that for some people, apnea index (the measure of how severe sleep apnea is) is twice as high when sleeping on their back compared to sleeping on their side.

Side sleeping can help to keep your airways open and it reduces the likelihood of your tongue falling back and blocking your airways. Pillows can keep you here. Try placing a firm pillow behind you if you find yourself rolling onto your back in your sleep. Special pillows that help you sleep on your side can also help. 

Sleep apnea is a serious health condition, so treatment beyond the right pillow may be necessary. This may include sleeping with a continuous positive airway pressure (CPAP) machine. These machines push air into your airways to keep them open. They come as full-face masks and nasal-only machines. 

If you’re a side sleeper who needs a full-face mask, you can buy special pillows that let you sleep on your side while wearing the machine. 

We’ve covered more on the best sleep position for sleep apnea here.

5. More Acid Reflux 

Acid reflux happens when stomach acid travels up into your esophagus. It can cause heartburn, stomach pain, and a bad taste in your mouth. 

When you’re laying flat, it’s easier for acid to travel up. When you’ve got your head elevated, on the other hand, gravity can work to keep stomach acid where it’s supposed to be — in your stomach. 

Research shows acid reflux is more common when laying on your back. And pillows can help you sleep on your side — a 2022 study found the left side was best to reduce reflux. 

Elevating your head can also help. You can do this with pillows or without if you use an adjustable base bed. 

We’ve covered how to sleep with acid reflux here.

6. More Back and Neck Pain

Sleeping without a pillow can cause back and neck pain as it causes your spine to be misaligned. This is especially true if you sleep on your side or on your back. 

Back pain can be debilitating during the day, and keep you up at night, especially if you can't find a comfortable position. But using a pillow could help you get comfy, and even ease the pain. 

One small study asked participants with lower back pain to sleep on their sides with a pillow under their head and one between their knees. Those with neck or upper back pain were asked to sleep on their backs, with a pillow under their heads and one under their knees. After four weeks, 90% reported a decrease in pain.

Image showing different sleeping positions
The recommended sleeping position for lower back pain is A, upper back is B, and people were encouraged to not sleep in position C. Source: https://pubmed.ncbi.nlm.nih.gov/26835867/

As well as position, a different type of pillow could help. One study found that using a semi-customized cervical pillow for four weeks reduced neck pain more than a conventional pillow. The pillow had four different heights, depending on the position people slept in on it. 

And research shows those with neck pain can see a reduction in pain and headaches, and better quality sleep, with a supportive pillow.

We’ve covered how to sleep with lower back pain here.

How to Sleep Without a Pillow?

RISE app screenshot showing how much sleep debt you have
The RISE app can work out how much sleep debt you have.

If you’ve weighed up the pros and cons and decided sleeping without a pillow is for you, here’s how to do it: 

  • Ease into it: If you’re used to sleeping with a pillow, don’t go from using a thick memory foam pillow to a flat surface in one night. Transition slowly into sleeping without one. Try sleeping with a thinner pillow first or a folded blanket or towel, before going to no pillow at all.  
  • Keep a pillow nearby: If you wake up during the night in discomfort, being able to grab a nearby pillow can help you fall back to sleep as quickly as possible, without needing to get up and put on the light. 
  • Get the right mattress: The wrong mattress can cause poor posture, joint pain, and discomfort — with or without a pillow. Opt for a medium-firm mattress that keeps your spine in a neutral position. We’ve covered more on what mattress is best for you here. 
  • Keep an eye on your sleep debt: Sleep debt is the measure of how much sleep you owe your body. It’s compared against your sleep need, the genetically determined amount of sleep you need. The RISE app can tell you how much sleep debt you have each day. While experimenting with sleeping without a pillow, keep a close eye on your sleep debt to see if it increases. We recommend you keep sleep debt below five hours for maximum energy. If sleeping without a pillow makes you uncomfortable and causes sleep debt to rack up, consider going back to the pillow and prioritizing shut-eye. 

RISE users on iOS 1.202 and above can click here to view their sleep debt.

How to Choose the Right Pillow for You?

You may find you don’t need to ditch the pillow, you just need to find the right pillow. Here are some tips on finding the best pillow for you.

Get the Thickness Right

If you sleep on your side, you may need a thicker pillow to keep your head in line with your spine. If you sleep on your back, you may need a thinner pillow to stop your head from being pushed forward too much. And if you’re a front sleeper, consider a very thin pillow to reduce strain on your neck. 

Research shows thicker pillows can increase pressure under the head and neck, but side sleepers need thicker pillows than back sleepers. 

How thick should your pillow be? There’s no easy answer to that. 

One small study looked at 16 people without any spinal problems. They tried lying on their backs with no pillow, a 10-centimeter pillow (about 4 inches) , and a 20-centimeter pillow (about 8 inches). The researchers analyzed the position of their neck and spines and concluded: “From the data obtained in this study, we recommend that the most suitable pillow height is 10 cm considering the normal cervical lordosis” (reminder, that’s the natural curve of your neck).

Another study compared 5-centimeter (about 2 inches), 10-centimeter (about 4 inches), and 14-centimeter pillows (5.5 inches) when people were on their sides. The participants rated the 10-centimeter pillow the most comfortable, and this height also resulted in the least neck and upper-back muscle activation. 

While it looks like 10 centimeters is the winner when it comes to pillow height, research from 2021 says there isn’t enough evidence to recommend an optimal height. 

Experiment with a few different heights to see which you find most comfortable and easiest to sleep with. 

Get the Shape and Material Right 

Beyond the thickness of your pillow, think about the shape and material. 

Research shows for side sleepers without chronic neck pain, a standard-shaped rubber pillow can reduce morning neck pain, while a feather pillow can increase pain, compared to their usual pillows. For those with chronic neck pain without nerve impingement, water-based pillows are better than roll-shaped pillows and standard down or foam pillows for reducing morning neck pain. 

Research from 2020 states: “Neck fatigue was rarer among users of pillows filled with plastic capsules, latex or memory foam than among those using pillows filled with feathers or cotton.” The researchers said this may be because plastic capsules, latex, and memory foam are more elastic and less fluffy, so they keep their shape and support better over time.

And finally, a 2023 study looked at sleepers without neck pain. It found that a neck support foam pillow caused the most head and neck pressure, so may cause discomfort. A standard microfiber foam pillow, on the other hand, may push your head forward too much with prolonged use. 

The study concluded: “We established the importance of pillow selection to have a high-quality sleep. Specifically, pillow design that combines cervical support and comfort provides even pressure distribution, which induces high-quality sleep by adjusting position of cervical spine closer to a normal alignment.”

Or, in simple terms, opt for a pillow that keeps your head as in line with your spine as possible.

Opt for a Hypoallergenic Pillow and Pillowcase

Keep allergies at bay with a hypoallergenic pillow and pillowcase. And remember to wash them regularly to prevent a build-up of dust mites as well as other allergens like pollen and pet dander. 

Consider a Specially Designed Pillow

If you have a health condition or chronic back or neck pain, consider a pillow designed to encourage a certain position, or one that can elevate your head, depending on your needs. 

A body pillow can also be helpful to keep you in a sleeping position or take pressure off your joints. 

Smart pillows also exist. Some can detect sleep apnea episodes and adjust in shape to kickstart your breathing, and others can measure sleep patterns and health data. 

Speak to your healthcare provider and get medical advice if you have any pain when sleeping or a health condition to see what pillow they recommend. 

Beyond your pillow, experiment with different sleeping positions and invest in the right mattress to get the most restful night’s sleep. We’ve covered more on how to choose the best mattress here.

Is it Better to Sleep Without a Pillow?

RISE app screenshot showing when to limit caffeine intake
The RISE app can guide you through 20+ sleep hygiene habits.

The final verdict? There’s simply not enough research to say whether sleeping with or without a pillow is best. There are some benefits and drawbacks to both, depending on the position you sleep in and any medical conditions you have. 

When trying to decide for yourself, think about what you find most comfortable. Comfort can be hard to come by, especially as we grow older or if we have a health condition, and getting enough sleep should be the priority. So, if you find sleeping without a pillow is more comfortable and it helps you get more sleep, do it.

If, on the other hand, you find sleeping with a pillow more comfortable and you get more sleep this way, ignore the claims online, and keep the pillow. 

And your pillow isn’t always to blame. If you’re suffering from back pain or acne, for example, changing your sleep position or using a silk pillowcase may help more than ditching the pillow altogether. 

A much more important thing to focus on is sleep debt and keeping it as low as possible to maximize your energy, health, and wellness. And when it comes to getting the best sleep possible, good sleep hygiene is proven to be beneficial for your sleep.

Sleep hygiene is the name for the healthy sleep habits you can do to help you fall and stay asleep at night and get a good night’s sleep. 

Here’s what to do: 

  • Get bright light first thing: This resets your body clock for the day, making sure you feel sleepy at bedtime. Aim for at least 10 minutes of light as soon as possible after waking up, or 15 to 20 minutes if it's overcast or you’re getting light through a window. 
  • Avoid light close to bedtime: Light suppresses the sleep hormone melatonin, so it can keep you up in the evening. Dim the lights and put on blue-light blocking glasses about 90 minutes before bed (we recommend these).
  • Avoid caffeine, large meals, intense exercise, and alcohol too late in the day: All four can keep you up or wake you up during the night, but you don’t have to give them up altogether. RISE can tell you when to avoid each one daily.
  • Keep your bedroom dark, cool, and quiet: Aim for 65 to 68 degrees Fahrenheit, use blackout curtains, and wear earplugs and an eye mask

The RISE app can guide you through 20+ sleep hygiene habits each day and tell you the ideal time to do each one to make them more effective.

RISE users on iOS 1.202 and above can click here to set up their 20+ in-app habit notifications.

For some straightforward advice, we asked our sleep advisor and medical reviewer, Dr. Chester Wu, for his take on the topic. Here's what he had to say: 

"If you're a side or back sleeper, you're probably better off sleeping with a pillow to keep your head and spine in alignment. If you're a front sleeper, sleeping without a pillow may help you do this. But the most important thing is getting enough sleep each night, pillow or no pillow, so do what's most comfortable for you." Rise Science Medical Reviewer Dr. Chester Wu

To Pillow or Not to Pillow? 

There are pros and cons of both sleeping with a pillow and sleeping without one. But the research we have on the topic is limited, and the data is inconclusive. It also depends on the position you sleep in and whether you have any pain or health conditions. And a lot of it comes down to personal preference. 

We say: getting enough sleep should be your priority, so sleep with a pillow if that helps, and without one if that’s a more comfortable sleeping position for you. Focus on keeping your sleep debt low to maximize your energy and health, and maintaining good sleep hygiene to get better sleep.

The RISE app can work out how much sleep debt you have and keep track of it as you pay it back. RISE can also tell you when to do 20+ sleep hygiene habits each day to make falling and staying asleep easier — whether that involves a pillow or not. 


Is it better to sleep with or without a pillow?

There’s not enough research to say whether it is better to sleep with or without a pillow. Getting enough sleep is essential, though. So, if you find sleeping with a pillow more comfortable, do it. If you find it easier to sleep without one, ditch it. In general, side and back sleepers will probably benefit from sleeping with a pillow, whereas front sleepers may be better off without one, or with a thin pillow.

Is sleeping without a pillow good for neck pain?

There’s not enough research to say whether sleeping without a pillow is good for neck pain. In general, side and back sleepers may experience less neck pain with a pillow as it can help to keep their head and spine aligned. Front sleepers may experience less neck pain without a pillow, or with a thin pillow, however.

Does sleeping without a pillow help posture?

Sleeping without a pillow can help posture if you sleep on your front. Using a pillow may push your head and neck back into an unnatural position. Try ditching the pillow or using a thinner pillow instead. For side and back sleepers, sleeping without a pillow may make posture worse as it causes the head to come out alignment with the spine.

Is sleeping without a pillow bad for your neck?

Sleeping without a pillow can be bad for your neck depending on the position you sleep in. For side and back sleepers, sleeping without a pillow can cause your head to be out of alignment with your spine, causing neck pain. For front sleepers, sleeping without a pillow may help to keep your spine in alignment, however.

Sleeping without a pillow side effects

Sleeping without a pillow can cause side effects depending on the position you sleep in. For side and back sleepers especially, sleeping without a pillow may cause neck and shoulder pain and sleep deprivation.

Sleeping without a pillow benefits

The benefits of sleeping without a pillow include better posture for stomach sleepers, and potentially better posture for back sleepers, depending on their mattress. Sleeping without a pillow may also lead to reduced wrinkles, acne, and frizzy hair, but there’s not much research backing this up.

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