Sleeping with or without a pillow – what is healthy and what is unhealthy depending on the sleeping position?

Some cannot do without, others cannot with – the pillow is a companion in bed, which is sometimes quite questionable. Because some claim that it is better to sleep without a pillow, while others believe that a pillow is good for the spine. But what’s right now? Should you sleep with or without a pillow?

Sleeping without or with a pillow – A question of comfort and sleeping position

Sleeping without a pillow or with - advantages and disadvantages for the spine

As already mentioned, for many people it is simply more comfortable with a large, cozy pillow. Nonetheless, it proves to be unfavorable for some sleeping positions, while it is better for the spine in others. And that is exactly what the pillow serves – to support the neck and especially the spine. The University of Rochester Medical Center carried out a study on this.

Stomach sleeper

It turned out that sleeping without a pillow is healthier for those who sleep on their stomach. This is because the spine assumes a relaxed shape in this position, in which the vertebrae do not press on the intervertebral discs. The spine is in a relatively normal position. However, sleeping on your stomach is not necessarily recommended, as in this pose the neck is turned to the side, which in turn puts a strain on it.

Sleep on your stomach without pillows for a natural shape of the spine

But if you can’t do without sleeping on your stomach at all, you should at least leave out the pillow. Just imagine it figuratively: If the head is lying prone on a pillow, no matter how flat, the neck is also raised again and bent backwards, which means an unnatural position for the spine. Tendons, muscles and joints are stretched and pulled. Instead, use a pillow to lift your stomach and hips slightly. In this way, the spine is relieved.

Regardless of whether you sleep with or without a pillow, if you are in the right sleeping position, your spine must be straight

Sleep without pillows – side sleepers and back sleepers

And is it unhealthy to sleep without a pillow if you prefer a different sleeping position? The rule here that sleeping without a pillow is healthier does not apply. Especially those who sleep on their side need a support for the neck, because otherwise the cervical spine bends slightly downwards and this can even lead to neck pain. Instead, a pillow with a suitable height ensures that your spine is in a natural (S-shaped) and, above all, relaxed position. So here it is important not to choose a pillow that is too high or too low.

If you have neck pain, sleep with or without a pillow?

If you have neck pain, sleep with or without a pillow

So if you have neck pain and mostly sleep on your stomach, it could be pillow-related. If you sleep without a pillow, you might be able to relieve the discomfort. But the position itself can also cause neck pain. As already mentioned, the muscles are pulled by the side lying of the head.

The wrong pillow can also cause pain in other positions. If the neck is not properly supported, the muscles cannot relax, which in the long term can lead to pain. However, since there are no adequate studies on this (so far only the right types of pillows for each sleeping position have been investigated, but not whether sleeping without a pillow is unhealthy or healthy), you should consult your doctor before you decide to remove the pillow to banish the bedroom.

Sleeping without a pillow on your stomach – tips

Sleep on your stomach without a pillow, but with support under your stomach

If you have decided to do without the pillow in the future, you should gradually get your body used to it. This is especially true if you have always used a pillow in the past. You should pay attention to the following in order not to unnecessarily strain the spine including the neck and back:

Reduce the height step by step

Don’t leave your pillow off overnight just because you finally want to sleep without a pillow. Instead, take a blanket or towel and fold it several times. You sleep on it for a couple of nights, after which you gradually unfold it at smaller intervals. That way, the sudden difference won’t disturb your night’s sleep either.

Bad and good sleeping positions with the use of pillows for the head and body

Sleep healthy or not quite asleep without a pillow?

As already mentioned, a pillow is also recommended in the prone position – just not under the head, but under the pelvis and stomach. If you lie on your back, you benefit from not just supporting your head, but also placing another under your knees. On the other hand, if you sleep on your side, it is best to add another pillow in addition to the pillow. Place this between your legs at knee level. You will surely notice the difference immediately!

The mattress also plays a role

A comfortable and restful sleep cannot depend on the pillow alone. Especially if you sleep on your stomach (but not only), the mattress should not be too soft, because then the spine sags and this is an unnatural position. So get professional advice when buying a mattress.


Sleep healthy or unhealthy without a pillow - what is right in which position

Sleeping without a pillow is therefore not recommended, even if that means that the pillow is used in a different position. While you get advantages from the pillow in the side and supine position, the head and neck should not be additionally lifted by a pillow in the stomach position. In all cases, pillows are recommended under the stomach, pelvis and knees or between the legs, depending on the sleeping position.

Neck and back pain may or may not be a result of the wrong pillow

Neck or back pain can be caused by incorrect pillow use, but it can also be caused by other causes. In some cases, sleeping without a pillow could prove not only unhealthy, but even dangerous (including with spinal diseases). It is therefore important to talk to your doctor before avoiding the pillow.

When lying on your back or on your side, the neck should be supported with the right pillow

The study from the University of Rochester Medical Center can be found here.