No Pillow? The Pilates Perspective on Sleep Alignment
When clients ask us about sleep posture at SOMA Movement Studio, they’re often surprised to learn that Joseph Pilates himself had strong opinions on the matter—especially regarding pillows. In his book Return to Life Through Contrology, Joe advocated for sleeping on a firm mattress and without a pillow to maintain proper spinal alignment and avoid what he described as “neck strain and abnormal spinal curvature.”
It’s a bold claim—but does it hold up?
Let’s take a closer look at Joe’s sleep philosophy, what we now know from modern science, and how you might adapt these ideas to better support your own rest and recovery.
Joe’s Original Argument: Less Is More
Joseph Pilates believed that modern habits—like sedentary lifestyles and overuse of props—weakened the natural strength and alignment of the human body. Pillows, in his view, were one such prop.
He felt that elevating the head too much during sleep pulled the neck out of alignment with the spine, disrupted breathing, and contributed to long-term postural problems. Instead, he recommended sleeping flat on your back, on a firm surface, without a pillow. This, he believed, allowed the spine to rest in its natural curves and supported full-body regeneration.
His advice was part of a larger philosophy: train the body during the day, support it simply at night, and rely on nature’s rhythms—not excessive supports—for optimal health.
What We Know Now: Mixed Support
Today, we know more about sleep biomechanics and individual anatomical differences. While sleeping without a pillow might work for some people—particularly those with very neutral posture and no history of neck pain—for most modern bodies, it’s not so straightforward.
We live in a world filled with forward head posture, tech neck, and tight hip flexors. Many of us spend our days fighting gravity, stress, and screens. That means our sleeping position has to help us recover, not just align.
Sleep research and physical therapy now suggest that the right head and neck support during sleep can help reduce strain, improve breathing, and promote deeper rest. But Joe wasn’t entirely off—his concerns about neck position, excessive head elevation, and collapsed posture are still valid.
Finding the Right Support for You
Here’s where Pilates meets sleep in a modern, personalized way. Instead of eliminating pillows completely, think about using one intentionally—to restore alignment, not fight it.
Here’s what we recommend based on your sleep style:
Back Sleepers
A very thin pillow or cervical roll can support the natural curve of the neck without pushing the head forward.
Optional: Place a pillow under the knees to help maintain a neutral pelvis and reduce lumbar strain for those with hip flexor tension.
Side Sleepers
Use a medium-loft pillow that keeps your neck aligned with your spine (not tilting up or down).
Add a pillow between your knees to align the hips and reduce pressure on the low back.
A small pillow in front of the chest can also support the top shoulder.
A small pillow under the lower ribs to bring the spine into alignment and reduce pressure on the shoulder under you.
Stomach Sleepers
Joe Pilates would want you to stop! This position can wreak havoc on the spine, shoulders, and neck.
If you can’t yet change the habit, use a very flat pillow or none at all—and consider a pillow under the hips to reduce lumbar compression.
Movement Matters More Than Mattress
Joseph Pilates always emphasized daily, intentional movement—and that still holds true. The best sleep position in the world won’t help much if your spine is chronically compressed or your muscles are locked in stress patterns.
By practicing Pilates regularly, you:
Build the awareness to feel when your body is out of alignment
Strengthen the muscles that support posture—even while you sleep
Improve circulation and breath quality for more restful sleep
So whether you use a pillow or not, remember: how you move during the day is just as important as how you rest at night.
At SOMA, we believe better sleep starts with better alignment—and that starts with you.