Is It Better to Sleep Without a Pillow? When you Should and Shouldn't

Your overall health is very closely tied to the amount and quality of sleep you get each night. Waking often due to discomfort interrupts the sleep stages your body needs to function correctly, and our first priority should be to remove or replace anything that doesn’t support our sleep.

Primary to our body support is our mattress and pillow choices, and although many people spend the time it takes to find the correct mattress that fits their sleep position best, they often choose a pillow based on store availability, and this in itself could be a bad decision. This can lead to obvious neck and back strain, making one wonder: Is it just better to sleep without a pillow?

Check out our article about How Many Pillows Should You Sleep With?

Your Sleep Position

To answer this question, you have to first analyze your sleep position because the answer is not a simple yes or no. Your natural sleep position, meaning the one you naturally turn to while you sleep through the night, needs to be properly supported by both your mattress and pillow combination.

The most important thing you need to take into account is your body posture and how it affects your spinal alignment. Since your spine is literally the bridge of your nervous system, compromising it through misalignment and surrounding soft tissue strain can lead to long-term aches and pains as well as chronic health issues through poor sleep.

Which Sleep Position Requires a Pillow for Health Reasons?

If you know your pillow is causing a restless night and discomfort, don’t be so quick to get rid of sleeping with a pillow altogether. Side sleepers and most back sleepers require a pillow to help keep their back aligned and their neck properly supported. If you wake with a sore neck or back and sleep in either of these positions, then you need to consider researching a pillow that will best fit with your needs and personal comfort preferences.

Back Sleepers

Back sleepers are most likely to support your spine the best as many mattresses, barring an extremely soft one, will allow the spine to fall into its natural curve without placing stressors upon the soft tissues. The head should be kept level with the shoulders, and the neck should be gently supported by a pillow that fills the gap between the head and shoulders.

Usually, thinner and more contouring pillows best support back sleepers. Too thin, or soft, of a pillow may let the head settle too far back, and thicker pillows will lift the head too far forward, placing a strain on the neck and lower back.

Side Sleepers

Although sleeping on your side is also considered a healthy position, it is only considered so if you have both a mattress and pillow that supports your body in such a way that your spine is able to be kept naturally straight. Unlike the back sleeping position that supports the natural curve of the spine, side sleepers need to choose a sleep surface that conforms to their body’s natural shape and curves and give in to pressure to keep their spine elongated.

Thicker, gusseted, and more supportive pillows are most often the most comfortable choice for this position- this is because it will better keep the head between the shoulders and fill the large space caused by the elevation of the head and shoulders to allow a proper rest of the neck and surrounding soft tissues.

Which Sleep Position Is Best Supported Without a Pillow?

If you’ve ever had the thought that throwing out your pillow might be a good idea, you may be on the right track – IF you are a stomach sleeper or back sleeper. These positions often place strain upon the lower back due to inconsistencies with the cervical alignment due to mattress choices, injury, or health reasons. Supporting the spine in a way that it helps elongate it and stretches it out influences a more natural position.

Stomach Sleepers

Many stomach sleepers have trouble with personal comfort preferences without a pillow and prefer the cushioning of an extra layer between their head and mattress. The problem with a pillow as a stomach sleeper is that no matter what you do, you will always compromise the spine in some manner due to having to turn the head in one direction or another. This is actually the least healthy position to sleep in, but one can hardly control what position they naturally fall into when asleep. Therefore, you need to consider what best supports your body.

Stomach sleepers who need a pillow for personal comfort will best be supported by a very thin and/or a very soft pillowthat places their head as close to the mattress as possible. And if you can do without a pillow, then you should. Placing your head on the same level as your mattress can actually help straighten your spine, and it takes the strain off your neck and shoulders as well as your lower back.

Back Sleepers

Some back sleepers will also benefit without the use of a pillow. This is not only dependent upon personal comfort preferences, but also how your body is built. Broad shouldered or large-bodied individuals may find this to be very uncomfortable and require the correct thin support for their head and neck as described above. But sleeping without a pillow for back sleepers has proven to be very comfortable for those suffering from back pain as it helps to stretch out the spine and release tension. This is especially true if you have a firm mattress.


If you have been considering getting rid of your pillow for comfort reasons, first take into account the position you sleep in to determine if this is true in your best interest. Side sleepers should always have some sort of head and neck support, but back sleepers may have a variable response to sleeping without a pillow, and you may want to try it out to see how you feel.

If possible, stomach sleepers are best to sleep without a pillow. This is to better support the length of the spine and help keep it in alignment. But you may also want to consider the use of a pillow elsewhere, such as below your hips or lower back to provide soft tissue relief as well.