Sleeping Without a Pillow: Is It Bad For You?

January 21, 2022 | Casper Editorial Team

Sleeping without a pillow is not necessarily bad, but it can be. It depends on your sleeping position and personal comfort.

Disclaimer: This article is for informational purposes only and should not be taken as medical advice.

If you wake up sore but you know you have the perfect mattress, it’s a logical next step to blame your pillow. Some people claim there are benefits of sleeping without a pillow — but is it really a good idea?

Pillows aren’t just unnecessary fluff on your bed. The purpose of a pillow is to keep your spine aligned, support the natural curvature of your neck, and prevent pain while you sleep. So, is sleeping without a pillow bad? That depends on your sleep position and preferences.

Before you ditch your pillow, we’ll help you weigh the pros and cons to determine the right type of pillow (if any!) for your sleep setup.

At Casper, we set out to design pillows that can accommodate all sleep positions. Whether you sleep on your back, front, or side, Casper pillows are designed to support you.

Potential Benefits of Sleeping Without a Pillow

Like sleeping on the floor or sleeping in the car, going pillowless works for some and not for others. Here are the commonly cited benefits of sleeping without a pillow. These are all potential benefits, as research on the effects of going pillowless is limited.

1. May Help With Alignment for Stomach Sleepers

Generally, stomach sleeping isn’t great for your sleep posture due to the way it forces your neck to turn and your spine to sink. However, it is the one position that may benefit from sleeping without a pillow. 

For some stomach sleepers, a pillow that’s too firm may cause the neck to arch and the lower back to sink. If your spine isn’t aligned, you can experience neck and back aches when you wake up.1 In contrast, your neck and spine may appreciate the straighter sleeping position that forgoing a pillow provides. 

Stomach sleepers can also achieve better spinal alignment with a thin, soft pillow that lets the head sink lower into the mattress.

2. Might Reduce Neck Tension for Stomach Sleepers

As mentioned above, a firm pillow can make a stomach sleeper’s neck arch uncomfortably. If you sleep with your belly against the mattress, you can try removing the pillow to achieve a position that feels better on your neck. However, it’s likely that you just need a softer pillow to reduce neck tension. 

3. Possibly Improves Wrinkles and Hair

Some studies suggest that your face compressing against your pillow during sleep may eventually contribute to wrinkles.2 However, further research is needed to know if removing your pillow can prevent wrinkle formation altogether. 

It’s true that your pillow absorbs body oils over time (gross, we know). That’s why regularly washing your whole pillow every two to six months can help keep everything clean for your skin.

Some people also theorize that pillows damage their hair by rubbing against it in the night. There’s currently little research to support this.3 However, if you think tossing and turning against your pillow is the culprit behind frizzy or tangled hair, we recommend switching to a silk pillowcase to reduce tension on your hair.

 4. Potentially Reduces Allergies

Pillows, especially older ones, can become a haven for dust mites, allergens, and other microscopic irritants over time. These tiny creatures thrive in the warm, moist environment that our heads and faces provide during sleep. As we continue to use the same pillow, dead skin cells accumulate, providing a rich food source for dust mites. Breathing in these allergens night after night can lead to allergic reactions, including sneezing, nasal congestion, and itchy eyes[4]. By choosing to sleep without a pillow, or by regularly replacing or cleaning your pillow, you can significantly reduce your exposure to these allergens. This can result in clearer breathing, fewer nighttime allergies, and an overall improved sleep quality.

Our Casper silk pillowcase is luxuriously smooth, protecting hair and skin from friction damage.

Problems With Sleeping Without a Pillow

Thinking pillows might be just a sham (pun intended)? Here’s why pillows are so important, and why snoozing without one can be bad for your sleep health.

1. Can Lead to Poor Spinal Alignment

If you’re a side or back sleeper, pillowless sleeping probably won’t help with your spinal alignment. In fact, it has the potential to cause hurt. 

  • Side Sleepers — When you sleep on your side, there’s a gap between your neck and shoulders. If that space isn’t supported by a pillow, your neck can arch downward and misalign, falling out of that optimal neutral position. That’s why it’s not recommended for side sleepers to sleep without a pillow. In fact, side sleepers benefit most from a thick pillow with lots of support.
  • Back Sleepers — If you sleep on your back without a pillow, there’s potential for your head to tilt back and unnaturally arch your spine. Instead, a medium-firm pillow keeps back sleepers’ heads slightly elevated and keeps the spine straight. 

2. Can Increase Back Pain

Due to poor spinal alignment, hitting the hay without a pillow can cause back pain. When your spine is misaligned and your sleep posture is thrown off, you can experience a stiff or sore back in the morning.1

3. May Cause Neck Pain

Proper sleep posture is important to prevent neck and shoulder musculoskeletal pain. Abandoning your pillow and aligned sleep posture can cause or worsen neck pain.5 Especially if you’re a back or side sleeper, the lack of a pillow can cause your neck muscles to overextend or crane. This can cause anything from a sore neck to tension headaches.6

4. May Cause Shoulder Pain or Numb Arms 

When you discard your pillow, you may be tempted to sleep on your arm instead. However, your head weighs around 10 pounds (about the size of a medium bowling ball) — so you run the risk of waking up with numb arms or stiff shoulders from supporting it all night.

5. Can Make Breathing Harder

A pillow elevates your head slightly above your body at night, allowing for an open, unobstructed airway. Getting rid of your pillow may cause your head to sink into your mattress and make breathing harder. For those with sleep apnea, elevating the head slightly can help promote better sleep.7 Learn more about the best sleeping position for sleep apnea.

6. Can Exacerbate Sleep Apnea and Acid Reflux Symptoms

When an individual lies flat on their back without the elevation provided by a pillow, the tongue and soft palate can more easily collapse backward, obstructing the airway and aggravating sleep apnea symptoms.8 This position can also cause the lower esophageal sphincter to relax, allowing stomach acid to flow back into the esophagus, leading to acid reflux or GERD symptoms.9 Using a pillow, especially one designed for these conditions, can help elevate the head and upper body, reducing the risk of both these issues.

Who Should Not Sleep Without a Pillow

Due to the potential drawbacks above, not everyone should ditch their pillow. Here’s who should keep a plush headrest as an essential part of their bed. 

Back and Side Sleepers

Your head is one of the heaviest parts of your body, and your neck has to work to support all that weight when you lie down. That’s why it’s important to keep your neck and spine aligned to avoid strain. 

If you lie down on a flat surface on your back or side, you’ll notice that there’s a gap between your head and shoulders. A pillow helps fill that gap, taking pressure off your neck and other parts of your body. That’s why it’s important that back and side sleepers don’t skip out on the pillow. 

Neck pain can ruin the quality of your sleep and leave you tossing and turning all night. With the right pillow, your neck will thank you. 

Those With Scoliosis or Other Spine Conditions

If you suffer from scoliosis or another spine condition, it could be potentially dangerous to get rid of your pillow. Make sure to speak to your doctor before making a change to your sleep setup. Learn how to sleep with scoliosis for more comfortable nights.

How To Transition to Pillowless Sleeping

It’s not recommended for everyone, but if you’re set on dozing without a pillow, here are the steps to transition from pillow to no pillow.

  • Gradually ease into it. Start with a thin pillow, rolled-up towel, or blanket instead of your regular pillow. Once you get used to sleeping with less head support, you can remove it altogether.
  • Use pillows to support other areas of your body. If you’re a side sleeper, hugging an ergonomic body pillow may help your body feel more supported once the head pillow is removed.
  • Make sure your mattress adequately supports you. If you skip the pillow, it’s even more crucial to sleep on a mattress with proper support. You can browse our Casper mattresses to find the perfect one for your needs.

How To Find a Pillow That Works For You

If you’re on the fence about going pillowless, don’t rule out pillows entirely yet. No matter what type of sleeper you are, there’s a pillow out there for you. Here’s how to choose a pillow that you’ll fall in love with. 

Side Sleepers

Side sleepers benefit from a pillow with:

  • Firmer fill and material — Side sleepers need pillows that reduce the gap between their neck and shoulders and take pressure off the shoulder. A firm material like memory foam or a heavy-duty down pillow should do the trick.
  • Low or mid loft — “Loft” refers to pillow height. Side sleepers may find either a low or mid loft pillow comfortable (thankfully, Casper pillows come in both). Your mattress firmness can also determine what loft you should get. If you have a firm mattress, get a mid loft pillow. If you have a soft mattress that sinks in, get a low loft pillow. 

If you snooze on your side, you can also benefit from sleeping with a pillow between your knees for even more comfort. 

Back Sleepers

The best pillow for back sleepers has:

  • Medium firm fill and material — A pillow with a medium thickness, like memory foam or down, is great for back sleepers. Weigh the benefits of memory foam vs. down to choose the best for you.
  • Mid loft — Medium-firm material paired with a low or medium loft is perfect for back sleepers. Make sure to sleep high enough on your pillow to fully cradle your neck. 

If you get the best shut-eye on your back, placing a pillow under your knees or lower back can also help keep your body aligned during the night.

Stomach Sleepers

Some stomach sleepers can get away with sleeping without a pillow. However, many stomach sleepers still find sleeping with a thin or small pillow more comfortable to avoid neck strain.

Stomach sleepers need a pillow with: 

  • Soft and compressible fill — Feather or down pillows are cushiony but not too firm. A firmer pillow, like foam, might prop your head up too high and cause aches.
  • Low loft — A low loft pillow keeps your head closer to the mattress and keeps the neck from craning into an unnatural alignment.

In the end, whether you sleep with or without a pillow is up to you. What’s most important is that you find the right bed setup that lets you get your best rest. 

Still need to sleep on it? Check out our Casper pillows, which are designed with every sleeper in mind. Our Original, Foam, and Down pillows are created with innovative designs and adaptive comfort. No need to ditch the pillow if you can rest your head on the best of the best. 


  1. Cherney K. Spine Misalignment Symptoms, Risk Factors, and Treatments. Healthline. Published October 14, 2019. 
  2. Anson G, Kane MAC, Lambros V. Sleep Wrinkles: Facial Aging and Facial Distortion During Sleep. Aesthetic Surgery Journal. 2016;36(8):931-940. doi: 
  3. 4 Reasons Your Pillowcase May Be Damaging Your Hair. 
  4. Dunkin MA. Dust Mite Mattress and Pillow Covers for Allergy Relief. WebMD. Published December 10, 2022. 
  5. Lee WH, Ko MS. Effect of sleep posture on neck muscle activity. Journal of Physical Therapy Science. 2017;29(6):1021-1024. doi: 
  6. Castien R, De Hertogh W. A Neuroscience Perspective of Physical Treatment of Headache and Neck Pain. Frontiers in Neurology. 2019;10. doi: 
  7. Souza FJF de B, Genta PR, de Souza Filho AJ, Wellman A, Lorenzi-Filho G. The influence of head-of-bed elevation in patients with obstructive sleep apnea. Sleep & Breathing = Schlaf & Atmung. 2017;21(4):815-820. doi: 
  8. Blaivas A. Obstructive sleep apnea – adults: MedlinePlus Medical Encyclopedia. Published January 9, 2023. 
  9. Mayo Clinic. Gastroesophageal reflux disease (GERD) – Symptoms and causes. Mayo Clinic. Published January 4, 2023.