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It's no secret that a comfortable, supportive pillow is an important ingredient in a good night's sleep. But what may come as a surprise is how often you're supposed to invest in a new one. According to the Sleep Foundation, you should replace your pillow every one to two years for optimal R&R.

Curious about the reasoning behind these guidelines? Us too — so we reached out to experts for some pillow talk. Here, we reveal what can go wrong if your pillow dates back to the Bush administration, plus signs it's time for a new pillow and tips to extend that two-year lifespan a little longer.

Your Sleep Could Suffer

A squashed-down pillow can cause tense, achy muscles.

Pillows lose their loft over time, especially if you don't wash them regularly, says Ann Romaker, MD, professor of medicine and director of the University of Cincinnati Medical Center Sleep Medicine Center. As they flatten, they offer less neck support, which can lead to neck, shoulder and upper back pain.

If you're uncomfortable, you might toss and turn at night instead of falling into a deep, restorative sleep.

Sleeping on a pancake can also hinder breathing. According to Dr. Romaker, 85 percent of people are born with a deviated nasal septum, where the membrane dividing the nasal cavity is off-center to some degree. This can cause congestion, particularly when lying down.

For most people with a deviated septum, elevating your head helps with nasal drainage, she says. If your travel pillow is quite flat, your nose might clog up more.

Being stuffed up means you have to work harder to inhale and exhale. When you're congested and struggling to breathe, you wake up more frequently during the night, Dr. Romaker says. In the worst-case scenario, it can even cause snoring.

One trick that can help: Rotate which pillow you use, and flip it over so you're not sleeping on the same side every night, Dr. Romaker says. It will stay fluffier for longer and give you better support.

You Might Break Out

Think about it: Your skin and hair are constantly shedding and eliminating oils, and pillows are rubbing against your skin and hair all night long.

Pillows collect these dead skin cells and oils, along with all the products you typically add to your skin and hair, says board-certified dermatologist Cheri Frey, MD, spokesperson for the Skin of Color Society and assistant professor of dermatology at Howard University. Plus, if you drool or sweat when you sleep, that saliva and perspiration can also be absorbed by your pillow.

The upshot? You're pretty much snoozing in a cesspool of filth — and that can wreak havoc on your skin. The combination of oils, dead skin cells, saliva and sweat are a breeding ground for bacteria, Dr. Frey says. This can cause problems like clogged pores, whiteheads and even cysts.

One way to keep your skin happy while you sleep: Stick to natural, breathable airplane pillowcase fabrics such as cotton or linen. Dr. Frey says they're best for acne-prone or sensitive skin, because they reduce nighttime sweating.

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