split image of woman sleeping with a pillow and without a pillow
Julie Hambleton
Julie Hambleton
January 4, 2024 ·  5 min read

What Might Happen to Your Body If You Start Sleeping Without a Pillow

If you often find yourself waking up with neck or back pain, chances are you’ve been told it’s because of your sleeping position, mattress, or pillow. What you probably haven’t been told is that sleeping without a pillow might be the solution you’ve been looking for to finally get a good night’s sleep.

Sleeping Without a Pillow To Stop Neck and Back Pain

Whether or not you should or shouldn’t be sleeping without a pillow entirely depends on your sleeping position. There are three different sleeping positions and each of them has its own pillow requirements. (1) These positions are (1):

  • Stomach
  • Side 
  • Back

Knowing what your preferred position is and what kinds of pillows you should and shouldn’t be sleeping with can have a strong impact on your sleep quality and musculoskeletal alignment. (1)

Sleeping Without a Pillow: Stomach Sleepers

If you are a stomach sleeper, however, this could be beneficial. According to researchers at the University of Rochester Medical Center, stomach sleepers should still use pillows, but in a different way. (1)

The majority of your weight is in the center of your body when you sleep on your stomach. This causes the spine to be in an unnatural position and puts stress on the lower back. Stomach sleepers should either use a thin pillow for their head or be sleeping without a pillow there at all. What’s more important for this sleep style is a flat pillow under your stomach or pelvis area to prevent your back from sagging and keep the spine in alignment. (1)

Sleeping on your stomach, also known as the prone sleeping position, can also be largely beneficial for those who suffer from sleep apnea. For this issue having a pillow and mattress that optimize sleep in this position is hugely important. (3)

The Problems With Stomach Sleeping

The biggest problem with stomach sleeping is that whether or not you are sleeping with or without a pillow, your head has to be turned to one side. You then have your neck turned this way for several hours at a time. (2)

Keeping your head turned in one direction for such a long time stretches out your neck muscles on one side and causes soreness. Often in this position, people tend to bring one leg up, which torques your hips and lower back and also causes soreness. (2) This position can also cause (2):

  • Numbness and tingling in one arm
  • Spine compression

Ultimately, unless it is necessary for some other condition, it is best to avoid sleeping on your stomach. Teach yourself to sleep on your side by using a body pillow. This will not only support your knees and hips, but it will also give something to press into your stomach to mimic the sensation of sleeping on your tummy. (2)

Side Sleepers

If you sleep on your side then you most definitely want to use a pillow. If you don’t, your neck will be out of alignment with your spine for hours at a time each night. (2)

The goal is to support your neck and spine and keep it in a neutral position. The pillow under your head should be the right thickness so that your head isn’t dropping down or being propped up too high. (1)

In this position, another important pillow is one between your knees to keep your hips in alignment and prevent pulling on your spine from the upper leg. (1) Again, this is where a good body pillow can do wonders for your sleep quality. (2)

Back Sleepers

Sleeping on your back is a very natural position for many people. That being said, it can cause stress on your spine if you don’t use the right pillows. (2)

Placing a pillow under your knees will help reduce spinal stress in this position. You’ll also want a pillow that provides proper neck support. Memory foam or latex pillow should allow your neck to maintain its normal banana-like curve. (1)

Best Sleep Positions to Reduce Back Pain

According to the Mayo Clinic, the three best positions to reduce back and neck pain are (4):

  • On your side, with your legs drawn up towards your chest, with a pillow between the legs.
  • On your back with a supportive neck pillow and a pillow under your knees. You may want an additional small pillow or rolled towel under the small of your back for extra support.

If you absolutely can’t fall asleep in any other position than on your stomach, they suggest sleeping without a pillow or with a thin pillow under your head as well as a thin pillow underneath your pelvis. (4)

Other Potential Benefits to Sleeping Without a Pillow

There are other reasons why some people opt to ditch the pillow other than back and neck pain. Two of the most common of these are hair and skin. (5)

There is a certain amount of pressure that your face and skin are under when you sleep at night. Also, the material of your pillowcase can affect the amount of pulling on the skin as well as cause your hair to become frizzy overnight. (5)

There are no studies, however, that actually show that going pillow-less will help with any of these issues. What has been looked at is the material of your pillowcase. In general, those with concerns regarding wrinkles and hair quality should look at getting a silk pillowcase. Silk absorbs less oil out of your hair, preventing frizz. It also causes less friction when you are moving around in your sleep, reducing wrinkles and again, frizzy hair. (6)

In terms of skin health, the most important factor is that you wash your pillowcase often to prevent grime and oil buildup in the material from affecting your skin. (6)

Should You Start Sleeping Without a Pillow?

Unless you suffer from sleep apnea or you just can’t possibly fall asleep in any other position besides your stomach, then, no – keep your pillow. If you ever do find yourself in a situation where you don’t have a pillow to sleep with, sleep in this way (1):

  • On your stomach
  • Fold up a sweater or towel or something soft underneath your stomach and pelvis
  • If you have more sweaters or towels, you can fold yourself a thin pillow if you wish.

Again, the best practice for back and neck health is to avoid sleeping on your stomach altogether.

Keep Reading: Sleeping Next To Someone Who Snores Could Be Damaging Your Health