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Sleep is a vital physiological state that significantly impacts overall health. Continuous monitoring of sleep posture, heart rate, respiratory rate, and body movement is crucial for diagnosing and managing sleep disorders. Current monitoring solutions often disrupt natural sleep due to discomfort or raise privacy and instrumentation concerns. We introduce PillowSense, a fabric-based sleep monitoring system seamlessly integrated into a pillowcase. PillowSense utilizes a dual-layer fabric design. The top layer comprises conductive fabrics for sensing electrocardiogram (ECG) and surface electromyogram (sEMG), while the bottom layer features pressure-sensitive fabrics to monitor sleep location and movement. The system processes ECG and sEMG signals sequentially to infer multiple sleep variables and incorporates an adversarial neural network to enhance posture classification accuracy. We fabricate prototypes using off-the-shelf hardware and conduct both lab-based and in-the-wild longitudinal user studies to evaluate the system's effectiveness. Across 151 nights and 912.2 hours of real-world sleep data, the system achieves an F1 score of 88% for classifying seven sleep postures, and clinically-acceptable accuracy in vital sign monitoring. PillowSense's comfort, washability, and robustness in multi-user scenarios underscore its potential for unobtrusive, large-scale sleep monitoring.