Sleep. Diet. Exercise. Those are the three cornerstones of a healthy lifestyle. According to Alon Avidan, MD, Director of the UCLA Sleep Disorders Center, “a good night’s sleep” (seven to eight quality hours) is necessary for our cells to rejuvenate, getting rid of toxins and undergoing repair. “We presume that sleep is also allowing the immune system to function well,” he says. “People with pimples, eczema or other skin conditions will see improvement if they get good sleep.” Can there be a downside, then? Some experts think so. 


Lisa Donofrio, MD, an Associate Clinical Professor in the Department of Dermatology at Yale University School of Medicine, says, “Sleeping on your face can not only pool edema, but can restrict lymphatic flow leading to puffy eyes.” Translation: puffy everything. Therefore, dermatologists recommend that patients sleep on their backs to reduce under-eye swelling. Jamie Sherrill, RN, founded Beauty Park Medical Spa in Santa Monica, Calif., as well as the Nurse Jamie line of skincare products. She knows all about the downsides of deep sleep and implores her patients to sleep on their backs. “When you sleep on your back, you prevent the intense weight of your head from pressing on the delicate skin and causing the visible signs of aging to set in,” she explains. 

However, Avidan argues that people move all night long, so even if you go to sleep on your back and wake up that way, you cannot assume you stayed still all night. “Sleeping is a very active process in the brain and we constantly change positions,” he says. What about wrinkles? “We do see ‘sleep lines’ on the aging face,” says Donofrio. She defines these as forehead wrinkles above the brow or on the cheek that don’t appear to come from typical facial muscle movements. At the same time, it’s unclear if the repeated folding of the skin due to repetitive sleep patterns alone is enough to cause these permanent creases. It’s possible, she says, that the sleep creases are ‘set in’ by a secondary factor like sun exposure. 

As we age, the connective tissue and collagen in our face and neck aren’t as strong or supportive as they once were, explains Sherrill, so the sleep lines become increasingly etched. After administering laser and injectables for 20 years, she routinely sees increased lipoatrophy (loss of fat) on the side of the face that her patients sleep on. “Your skin is like silk fabric and your head weighs as much as a bowling ball,” explains Sherrill. “In addition, the angle of your neck allows for wrinkles to form as you compress the skin between the neck muscles.” There are even pillows designed to better distribute the weight of the face so that wrinkles are less likely to form. Donofrio usually recommends the brand enVy, but acknowledges that it’s purely speculative whether they prevent sleep lines or not. 

In fact, Sherrill firmly believes the right pillow can make all the difference—so much so that she designed her own, the Beauty Bear Age Delay Pillow. She was inspired by the wrinkles she got after having to sleep on her side when she was pregnant with triplets. The pillow features a unique ‘U-shape’ design to cradle the face and neck, as well as a satin finish. “Everyone wants to sleep on what I call a big fluffy wrinkle-maker,” says Sherrill, who has fans in Kirsten Dunst, Jennifer Love Hewitt, Maria Menounos and Jessica Alba (who we spotted at Sherrill’s spa). “But cotton is absorbent, so it robs your skin of its natural oils and the expensive moisturizers you applied before bed.”

Is sleeping on your side the sole cause of a lined forehead or crow’s feet? Donofrio is not convinced. “In general, most patients have more or deeper wrinkles on whichever side of their face the sun hits when they’re driving,” she says, “meaning on the left in the United States and on the right in the U.K.” Sherrill, however, is a believer, citing the fact that poor sleep position is the number three cause of premature aging (behind UV rays and smoking).

Regardless of the position you sleep in or the type of pillow you use, medical practitioners like Avidan believe that getting enough sleep should be your number one skincare objective­—along with limiting alcohol consumption. “Even one or two drinks cause your body to dehydrate,” he explains, “which will put you at greater risk of wrinkles than sleeping in one position.” Likewise, people who have sleep disorders like sleep apnea or insomnia look much older than their actual age. “When we treat these disorders,” says Avidan, “a lot of the cosmetic issues improve.” So basically, staying awake at night worrying about it is probably worse than the compression effect of getting your z’s. 


  1. UCL Sleep Disorders Center
  2. Yale University Department of Dermatology
  3. Nurse Jamie
  4. enVy Pillow
  5. Beauty Bear Age Delay Pillow