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Hackensack Today
By the People, for the People
Doctors Weigh In on Sleeping With or Without a Pillow
Experts explain the pros and cons of each approach to get the best sleep.
Mar. 14, 2026 at 4:31pm
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Sleeping without a pillow may seem like a natural way to rest, but doctors say using the right pillow is generally better for maintaining proper spinal alignment and preventing neck and back pain. While there are some exceptions, such as for stomach sleepers, most people will benefit from sleeping with a pillow that supports the natural curve of the neck and keeps the spine in a neutral position.
Why it matters
Getting quality sleep is crucial for overall health, and the position you sleep in can have a big impact. Improper spinal alignment from sleeping without a pillow or with the wrong pillow can lead to muscle pain, stiffness, and even nerve issues over time. Understanding the pros and cons can help people choose the best sleep setup for their individual needs.
The details
Doctors say that for the majority of people, sleeping with a pillow that supports the natural curve of the neck is better than sleeping without one. The right pillow can help keep the spine in a neutral position and prevent strain on the neck and back muscles. However, the ideal pillow will vary based on sleep position - side sleepers generally need a loftier pillow, while back sleepers do better with a medium-loft pillow. Stomach sleepers may benefit more from a thin or flat pillow, as a thicker one can twist the neck uncomfortably. Pillows that are too soft, too firm, or the wrong height can also cause problems by failing to provide consistent support.
- The article was published on March 14, 2026.
The players
Ari R. Berg, M.D.
A spine surgeon at Hackensack University Medical Center and assistant professor of Orthopedic Surgery at the Hackensack Meridian School of Medicine.
Jason A. Smith, M.D.
The associate medical director and chair of Physical Medicine and Rehabilitation at Atlantic Health.
Mara Vucich, D.O.
A spine specialist at the Maryland Spine Center at Mercy.
What they’re saying
“Medically, we don't really know the answer to that question.”
— Mara Vucich, D.O., Spine specialist
“For the vast majority of people, it is significantly better to sleep with a pillow.”
— Ari R. Berg, M.D., Spine surgeon
“Sleeping with a pillow allows for maintained alignment of the cervical spine.”
— Jason A. Smith, M.D., Associate medical director
The takeaway
While there is no definitive scientific answer, the consensus among doctors is that sleeping with the right pillow is generally better for maintaining proper spinal alignment and preventing neck and back pain. The key is finding a pillow that supports your individual sleep position and keeps your head, neck, and back in a neutral position throughout the night.
