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There would be more chiropractors. Beds would be faster to make, and probably look better - nice and flat. The whole pillow placement issue would be gone - do you stand them up, do you lay them flat? Pillow fights wouldn't be a thing - and neither would the enduring male fantasy of nubile females in pyjamas jumping on beds hitting each other - sorry about that. Snoring levels would increase dramatically, leading to a higher divorce rate, a plummet in the sale of double beds, and earplugs being sold at a premium.
Hay would be back on top
Hard to say, pillows would naturally be something that arises in this world as it is because of their utility/the need for them. So, if they didn't exist, the world would have to have been different in such a way that they wouldn't naturally arise. And there are endless possibilities for how it could possibly be different, and the hypothetical doesn't narrow it down at all.
But besides that, just not thinking about all the indirect implications, I think if there were no pillows, umm...there would be no pillow fights, and pillow fights aren't that common irl afaik, but the idea of them is iconic as a way of fighting without violence, just being silly, which is important in the world as an anti-violence staple. Also, people might have a lot of neck problems from sleeping without their heads being propped up. I don't know if that causes neck problems or not. It seems like it would be uncomfortable. I think I've done it before, it wasn't that great.
You can use little wooden supports like in old Japan, which after a short while can replace your pillow. But people refuse to adapt to change and want stubbornly back into the fifties or whichever area they deem to be "best". For me the 50s is an era where Tyrannosaurus Rex stomped through people for dinner, so nothing I'm looking back to in desire.
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