Sleeping without a pillow can help posture only if you sleep on your stomach, because it keeps your head and spine more level. Back and side sleepers usually need a pillow for spinal alignment. Without one, their neck can overextend for hours. No study has tracked how sleeping without a pillow changes posture over time. The NHS suggests a low, firm pillow that keeps your head at the same height as the rest of your body.
Key takeaways
- Sleeping without a pillow can help posture only if you sleep on your stomach.
- Back and side sleepers usually need a pillow to keep the head level with the spine.
- No study has tracked how sleeping without a pillow changes posture over time.
- Switch gradually with a folded towel, and see a doctor if neck pain lasts over a week.
Is it better to sleep without a pillow?
Sleeping without a pillow is better only for stomach sleepers. Back and side sleepers need a pillow to fill the gap between the head and the mattress. The Sleep Foundation says that for most sleepers, leaving out the pillow is likely to harm sleep posture.
| Sleep position | Pillow or no pillow? | Why |
| Stomach | No pillow, or a flat one | A pillow pushes your head back and arches your spine, which stresses your lower back. |
| Back | A pillow that supports the curve of your neck | Without one, your neck can overextend all night. Add a small pillow under your knees. |
| Side | A firmer, thicker pillow | Side sleeping leaves the biggest gap between your head and the mattress. Add a firm pillow between your knees. |
Is sleeping without a pillow bad for your neck?
Sleeping without a pillow is bad for the neck in most back and side sleepers, because the neck loses its support. Uneven pressure on the neck muscles may cause:
- neck pain
- neck stiffness
- headaches
- lower back stiffness in back sleepers
Stomach sleepers still turn the head to one side, which can strain the neck joints and muscles. A pillow that's too high or too stiff causes a similar problem. It keeps your neck bent overnight, which Harvard Health links to morning pain and stiffness. An awkward position and the wrong pillow height are common causes of neck pain from sleeping.
What is the healthiest sleeping position for your neck?
Side and back sleeping are the healthiest positions for your neck, according to Harvard Health. Stomach sleeping is the hardest on the neck, because your back arches and your head turns to one side. The NHS advises not sleeping on your front to prevent neck pain.
- Side sleepers: use a pillow that is higher under your neck than under your head.
- Back sleepers: use a rounded pillow under your neck and a flatter one under your head.
Sleep habits are hard to change, so Harvard Health suggests starting each night on your back or side. On your side, hug a pillow so your top shoulder doesn't roll forward, as in our guide on how to sleep to fix rounded shoulders.
What are the benefits of sleeping without a pillow?
The main benefit of sleeping without a pillow is a flatter neck for stomach sleepers. The Sleep Foundation says stomach sleepers are the best suited to sleeping without a pillow. Without a pillow, a stomach sleeper's head stays flat, which may reduce neck stress.
The evidence for these benefits is limited. A 2025 systematic review found 5 trials with 239 people who had chronic neck pain. The review compared pillow types, and no type clearly beat the others. A 2021 study filmed 53 adults over 2 nights. People who woke with neck symptoms spent a median of 185 minutes in postures the researchers rated as provocative. People without symptoms spent 84 minutes.
Is sleeping without a pillow good for forward head posture?
Sleeping without a pillow has not been shown to improve forward head posture. A 2015 X-ray study tested 16 healthy adults aged 20 to 30. Each lay on no pillow, a 10 cm pillow and a 20 cm pillow. The researchers judged the 10 cm (about 4 inch) pillow the best fit for the neck's normal curve. To work on head position while you're awake, try these forward head posture exercises.
How to sleep without a pillow
To sleep without a pillow, switch gradually, and only if you sleep on your stomach.
- Check your position. Try it only if you spend most of the night on your stomach.
- Start with a folded towel or blanket. Unfold it a little at a time until it is flat.
- Put a flat pillow under your stomach and pelvis. URMC says this keeps your spine in better alignment.
- Check your mattress. It should support the natural curves of your spine; URMC suggests replacing it every 6 to 8 years.
- Go back to a low, firm pillow if your neck hurts. The NHS recommends a low, firm pillow to ease neck pain.
For neck tightness during the day, the Thera Pillow is a cervical pillow with air-powered neck traction, heat and vibration massage. It is made for short sessions while you're awake, not for sleeping on overnight. It has 3 traction heights and 3 heat levels: 104°F, 111°F and 118°F.
A cervical pillow with air-powered neck traction, heat and vibration massage.
$189.00Who should not sleep without a pillow?
Back sleepers, side sleepers and people with neck or spine conditions should keep a pillow.
- Back and side sleepers need a pillow for spinal alignment.
- People with neck pain, back pain or scoliosis should talk to a doctor before they stop using a pillow.
- People with heartburn or obstructive sleep apnea may find a pillow helpful, according to the Sleep Foundation.
See a doctor if
- your neck pain doesn't improve after 1 week of self-care
- you have numbness, tingling or weakness in your arm or hand
- the pain gets worse when you lie down or wakes you at night
- the pain started after a fall, blow or injury
- you have a fever and headache, and your neck is too stiff to touch your chin to your chest: call 911
This article is for general information and isn't medical advice. Talk to your doctor or a physical therapist before starting a new exercise routine, especially if you have an injury or a health condition.
FAQ
Is sleeping without a pillow good for back pain?
Sleeping without a pillow may ease back pain in stomach sleepers, because a pillow arches the spine and stresses the lower back. A flat pillow under the stomach and pelvis can also help. Back sleepers with lower back pain at night can put a small pillow under the knees to reduce stress on the spine.
Is sleeping without a pillow good for a neck hump?
No study has tested sleeping without a pillow for a neck hump. A low pillow that keeps your head level avoids bending your neck forward overnight. Our guide on how to get rid of a neck hump covers the daytime exercises.
Does sleeping without a pillow reduce wrinkles?
No trial shows that sleeping without a pillow prevents wrinkles. A 2016 review describes how pressure on the face during side and stomach sleep can form sleep wrinkles. The Sleep Foundation says skin and hair claims need more clinical studies.
What happens if you sleep without a pillow for 30 days?
No study has followed people who sleep without a pillow for 30 days. Stomach sleepers may notice less neck strain. Back and side sleepers are more likely to wake with neck pain, stiffness or headaches.
Sources
- Healthline, "Sleeping Without a Pillow: Benefits and Effects on the Body" (Kirsten Nunez; medically reviewed by Helen Chen, MCMSc, PA-C; updated 4 Nov 2026). https://www.healthline.com/health/sleeping-without-a-pillow (accessed 11 Nov 2026)
- Sleep Foundation, "Sleeping Without a Pillow" (Jeremy Klein; medically reviewed by Heather Wright, MD; updated 31 Jan 2023). https://www.sleepfoundation.org/best-pillows/sleeping-without-a-pillow (accessed 11 Nov 2026)
- Medical News Today, "Sleeping without a pillow: Benefits and risks" (Amanda Barrell; medically reviewed by Deborah Weatherspoon, PhD, MSN; 11 May 2020). https://www.medicalnewstoday.com/articles/sleeping-without-a-pillow (accessed 11 Nov 2026)
- University of Rochester Medical Center Health Encyclopedia, "Good Sleeping Posture Helps Your Back" (reviewed by Michelle Anderson, DNP, and Mike Murphy; no date shown on page). https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=1&ContentID=4460 (accessed 11 Nov 2026)
- Harvard Health Publishing, "Say good night to neck pain" (2 Feb 2022). https://www.harvardhealth.org/pain/say-good-night-to-neck-pain (accessed 11 Nov 2026)
- NHS, "Neck pain" (last reviewed 27 Apr 2023). https://www.nhs.uk/conditions/neck-pain/ (accessed 11 Nov 2026)
- MedlinePlus Medical Encyclopedia, "Neck pain" (U.S. National Library of Medicine; reviewed 14 Jan 2026 by Linda J. Vorvick, MD). https://medlineplus.gov/ency/article/003025.htm (accessed 11 Nov 2026)
- Kim HC, Jun HS, Kim JH, Ahn JH, Chang IB, Song JH, Oh JK. "The Effect of Different Pillow Heights on the Parameters of Cervicothoracic Spine Segments." Korean J Spine. 2015;12(3):135-138. PMID 26512267. https://pubmed.ncbi.nlm.nih.gov/26512267/
- Cary D, Jacques A, Briffa K. "Examining relationships between sleep posture, waking spinal symptoms and quality of sleep: A cross sectional study." PLoS One. 2021;16(11):e0260582. PMID 34847195. https://pubmed.ncbi.nlm.nih.gov/34847195/
- Ghosh S, Goyal M, Goyal K. "Effect of pillow on pain, disability and sleep quality in patients with chronic neck pain: A systematic review." Rehabilitacion (Madr). 2025;59(3):100922. PMID 40633255. https://pubmed.ncbi.nlm.nih.gov/40633255/
- Anson G, Kane MA, Lambros V. "Sleep Wrinkles: Facial Aging and Facial Distortion During Sleep." Aesthet Surg J. 2016;36(8):931-940. PMID 27329660. https://pubmed.ncbi.nlm.nih.gov/27329660/
