Is it good to sleep without a pillow? A sleep experts reveals whether it's a healthier option

Are neck pain, poor sleep or a health condition forcing you to consider sleeping without a pillow?  

Even the best pillows don't guarantee a great night's sleep. Sleeping well is linked with improved health – both mental and physical – and can set you up for a successful day. But while there are some benefits for some of us for sleeping without the support of a pillow, there’s no one-size-fits-all answer. 

And, Dr. Wendy Troxel, a sleep scientist at the RAND Corporation and author of the book Sharing the Covers: Every Couple's Guide to Better Sleep cautions that when it comes to sleeping without a pillow, 'there is limited systematic research on this topic, so most of the evidence is anecdotal.'

However, it can work for some of us. This is what to know.

Is it okay to sleep without a pillow?

Everyone has a distinct sleeping style: some are prone to sleep on their stomachs, some their backs, some their sides, and some toss and turn through several positions each night. Similarly, some people sleep hot, some sleep cold, some can’t sleep at all without an eye mask and sound machine. Essentially, we all have our own highly personal approaches to sleep. But while we spend a lot of time researching the best mattress for our sleep position, we give less thought to pillows – or lack of.

Keeping those individual sleep preferences in mind, however, Dr. Troxel sees no issue with sleeping without a pillow – as long as it works for you and your sleep style. 

'As with all things when it comes to sleep, it is about comfort for the individual – which is an entirely subjective, and individual experience,' she says. 

However, you do need to bear in mind the role of the bed pillow, which is to keep the natural curvature of your neck and spine in line. Disrupt that by sleeping without a pillow and you may find you suffer neck and back pain as a result. 

Is it healthier to not use a pillow?

As we said above, evidence is largely anecdotal, but for some of us, sleeping without a pillow can be 'healthier' in as much as it can reduce back and neck pain. Whether this works for you will largely depend on your sleep position, plus any health conditions you may have. Stomach sleepers, for example, are more likely to find neck or back pain reduced by sleeping without a pillow, while back and side sleepers are much more likely to suffer neck and back pain by sleeping pillow-free.

Can sleeping without a pillow cure neck pain?

It is unlikely that side or back-sleepers will find neck or back pain cured by sleeping without a pillow, though for stomach sleepers, it may be the solution. This is because  pillows support the curvature of the neck and spine for side and back-sleepers but can force the neck and spine into a contorted position for those who sleep on their fronts. The solution? Try it for a night and see how you feel in the morning.

Will sleeping without a pillow work for my sleep position?

Your sleep position can definitely affect whether you can comfortably sleep without a pillow. There is some evidence that stomach sleepers may benefit from pillow-free sleep, according to Dr. Troxel.

'For some people, particularly while sleeping on their stomachs, sleeping without a pillow can reduce soreness in the neck and back by helping to keep the neck and spine in better alignment,' she says. 

She explains that some stomach sleepers encounter neck and back discomfort when their head is elevated by pillows, so attempting to sleep without a pillow at all can provide some relief.

When should you not sleep without a pillow?

First and foremost you should not sleep without a pillow if that doesn’t feel comfortable to you – crafting a bed set up that works for you and makes sleep easy to come by is the number one secret to good sleep. 

But there are a few medical conditions that may be exacerbated by pillow-less sleep as well. 

'For people who are prone to sleep apnea, gastric reflux, or sinus congestion, having the head slightly elevated (e.g., by a pillow) can sometimes reduce symptoms,' Dr. Troxel says. 'Therefore, eliminating the pillow in these situations may make matters worse.'

Even if there are no health issues to keep in mind, Dr. Troxel underscores the importance of honoring your own personal preferences when it comes to deciding how to approach your use of pillows. 

'It's all about individual comfort, so if sleeping without a pillow is uncomfortable to a given individual and disrupts their sleep, then it is best to be avoided,' she says. 

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