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Sleeping with, or without, a pillow may have a sneaky impact on your health.
New research suggests that skipping the pillow could help prevent the development of glaucoma, an eye disease that damages the optic nerve and can cause vision loss or blindness.
Glaucoma can be caused by elevated eye pressure, thinning of the optic nerve or fluid buildup, according to the Glaucoma Research Foundation.
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The study, published in the British Journal of Ophthalmology, found that eye pressure was higher in glaucoma patients who slept with two pillows compared to lying flat. Blood flow to the eye decreased in the high-pillow position.
This may occur due to the neck bending forward, compressing the veins, the authors suggested. Glaucoma patients may benefit from avoiding sleep postures that put the neck in this position, they concluded.
New research suggests that skipping the pillow could help prevent the development of glaucoma, an eye disease that damages the optic nerve and can cause vision loss or blindness. (iStock)
Dr. William Lu, medical director at Dreem Health, who was not involved in the study, called these findings “interesting and important.”
“It highlights how something as simple as sleep posture can influence intra-ocular pressure in people with glaucoma,” the San Francisco-based expert told Fox News Digital.
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“That said, this is still early research, and it doesn’t mean pillows are inherently harmful – it’s more about how they’re used and the degree of elevation.”
The key takeaway is “balance and personalization,” Lu said. Most people don’t need to eliminate pillows, but should avoid “extreme positions,” such as sleeping with the head sharply elevated or with the neck bent at an awkward angle, he noted.
Most people don’t need to eliminate pillows, but should avoid “extreme positions,” such as sleeping with the head sharply elevated or with the neck bent at an awkward angle, an expert noted. (iStock)
Sleeping without a pillow can help promote a more neutral neck alignment for some people, especially those who sleep on their backs, according to Lu.
“That can reduce strain on the cervical spine and may improve comfort or reduce morning stiffness,” he said. “In certain cases, it may also reduce pressure points that come from overly thick or unsupportive pillows.”
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Going pillow-free isn’t ideal for side sleepers, who often need a pillow to keep the head aligned with the spine, Lu added.
“Without one, the neck can tilt downward and create strain over time,” he said. “For others, skipping a pillow can worsen snoring or airway positioning, and people with existing neck or shoulder issues may actually feel worse without proper support.”
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For those who have glaucoma or are at higher risk, Lu recommends discussing sleep posture with a healthcare provider and aiming for a position that keeps the head and neck aligned without excessive elevation.
“Small adjustments in sleep setup can be a simple but meaningful way to support overall health,” he said.
Side sleepers should sleep with a pillow to support posture, experts recommend. (iStock)
In a separate interview with Fox News Digital, Dr. Saema Tahir, a board-certified sleep disorder specialist in New York City, said these findings align with prior research showing that “how you elevate your head matters.”
“Elevating the head of the bed itself can reduce eye pressure, but using multiple pillows may not have the same effect – and could even be counterproductive in some cases,” she said.
Tahir stressed that there is “very limited high-quality evidence” showing health benefits from sleeping without a pillow.
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“What matters most is maintaining proper alignment of the cervical spine, and that varies from person to person,” she said. “Without adequate support, especially for side sleepers, the neck can fall out of alignment.”
This can manifest as neck pain and stiffness, morning headaches, or shoulder and arm discomfort.
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“So, for many people, especially side sleepers, skipping a pillow can actually make sleep quality worse,” the expert said.
“For those with glaucoma or at risk should avoid sleeping face-down with pressure on the eyes and should be cautious with very high or stacked pillows … Be mindful of side sleeping, as the lower eye can experience higher pressure.”