Gina Johnson
Sleeping upright is a common practice in the animal kingdom, but humans often struggle with it. While it is neither inherently healthy nor unhealthy, it can be beneficial for certain medical conditions. For example, it can help ease symptoms of sleep apnea, reduce acid reflux, and provide relief for heart failure patients. However, sleeping upright for long periods can lead to health issues such as neck and back pain, stiffness in the joints, and an increased risk of deep vein thrombosis (DVT). As such, it is generally recommended as a temporary measure.
| Characteristics | Values |
|---|---|
| Is it healthy? | Sleeping upright is neither inherently healthy nor unhealthy. |
| When is it recommended? | For patients with morbid obesity, chronic obstructive pulmonary disease, or those recovering from shoulder surgery. |
| When is it not recommended? | For patients with osteoporosis or arthritis. |
| Benefits | Can help with sleep apnea, acid reflux, heart failure, respiratory issues, digestion, and pregnancy discomfort. |
| Drawbacks | Can cause neck issues, increased stress on the neck and back, and stiffness in the joints. |
| Tips | Use a good chair, practice good posture, avoid leaning on objects, use a neck pillow, and try a wedge pillow. |
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What You'll Learn
Sleeping upright can help with sleep apnea
Sleeping upright is neither inherently healthy nor unhealthy. However, for those with sleep apnea, it can be beneficial. When a person sleeps flat on their back, gravity can close or narrow the space at the back of their mouth and upper throat, restricting airflow. Sleeping upright can reverse these effects of gravity and move structures in the mouth away from the back of the throat, thereby improving breathing.
Positional Therapy
Sleeping upright or on the side is often referred to as "positional therapy", an anti-snoring solution for people whose sleep apnea worsens when they lie flat on their backs. Research has found that people with positional obstructive sleep apnea (POSA) who are treated with positional therapy experience less daytime sleepiness and have fewer symptoms than those with untreated POSA.
Studies on the Effects of Upright Sleeping on OSA
A 2011 study published in Respiratory Care showed that sleeping in an elevated position can reduce the severity of sleep apnea. The study found that participants experienced higher symptoms when sleeping flat but felt better in an upright position, with the apnea-hypopnea index (AHI) reduced by 50% in an hour. Similarly, a 2014 study published in the Journal of Clinical Sleep Medicine showed that OSA patients who slept in an inclined position experienced a 50% to 60% reduction in AHI.
Drawbacks of Sleeping Upright
Sleeping upright may not be comfortable or feasible for some people. Additionally, prolonged sitting can increase the risk of developing blood clots in the legs, so it is important to consult a doctor before changing your sleeping position, especially if you have a history of blood clots, will be undergoing surgery, or take medication that increases the risk of blood clots.
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It can reduce acid reflux symptoms
Sleeping in an upright position can help reduce acid reflux symptoms by keeping the gut aligned and using gravity to keep stomach acid in place. This is especially helpful for people with gastroesophageal reflux disease (GERD), where stomach acid flows back into the oesophagus. Sleeping upright can also aid digestion by allowing gravity to help move food through the digestive tract.
Research from 2020 found that people who slept with their head elevated 20 centimetres above their feet had improved acid reflux symptoms compared to those who slept flat. A 2021 review of studies on the effect of head-of-bed elevation on gastroesophageal reflux disorder (GERD) also indicated that elevation improved symptoms, although the studies were of low quality.
Sleeping upright is also recommended for people with respiratory issues, as it can help keep the airways open. However, it's important to note that slumping can actually reduce lung capacity.
While sleeping upright can be beneficial for certain conditions, it is not recommended as a long-term solution. Sleeping in a sitting position for long periods can lead to health issues such as neck and back pain, and stiffness in the joints. It can also be dangerous for people with osteoporosis or other medical conditions.
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It may help with heart failure
While sleeping upright is not harmful to your health, it can be difficult for humans to achieve due to the mechanics of our sleep cycles. During the REM stage of sleep, most of our muscles become paralysed, which can make sleeping upright uncomfortable.
However, sleeping with an elevated upper body can be beneficial for people with heart failure. Sleeping on your side, left or right, can decrease sleep apnea, a condition that affects 50-75% of heart failure patients. Sleeping on the left side is generally recommended for pregnant people or those with gastroesophageal reflux disease (GERD). On the other hand, sleeping on the right side may be more comfortable for people with an implanted defibrillator, as most of these are placed on the left side.
Sleeping on your back may also be an option if you don't have sleep apnea or breathing problems. However, sleeping on your stomach may worsen sleep apnea and cause neck or back pain. Untreated sleep apnea is associated with an increased risk of heart failure.
If you are experiencing shortness of breath when lying flat, you should consult a doctor.
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It can aid respiratory issues
Sleeping upright can be beneficial for people with respiratory issues. For instance, those with a respiratory infection, pneumonia, or lung conditions such as asthma, chronic cough, COPD, or cystic fibrosis may find it easier to breathe and sleep when sitting up. This is because sleeping upright can help drain the nasal passages, making breathing and sleeping easier.
Sleeping on your back is considered the worst position for breathing, especially for those with sleep apnea. This is because the tongue and jaw can fall back and obstruct the airway. Sleeping on the stomach can also cause issues, such as back and neck pain.
Side sleeping is generally recommended for those with breathing problems, as it helps keep the airway open and clear. Sleeping on your side can also reduce snoring and pauses in breathing caused by sleep apnea. However, this position may result in shoulder or neck pain for some people.
For those with chronic heart or lung diseases, sleeping with the head elevated can be the most comfortable position. Elevating the head can help relieve pressure caused by fluid buildup in the lungs, which can rise to the neck when lying flat and cause breathing difficulties.
In certain cases, sleeping upright may be a better option than lying down, especially when dealing with congestion or respiratory issues. However, it is important to note that sleeping upright should only be a temporary measure, as it can increase the risk of deep vein thrombosis (DVT) and muscle strain.
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It can help with digestion
While sleeping vertically is not a common practice for humans, it can be beneficial in certain situations. One of the advantages of sleeping upright is its positive impact on digestion. Here are some ways in which sleeping vertically or on the left side can aid digestion:
Improved Digestion and Reduced Heartburn
Sleeping on the left side or in an upright position can improve digestion and reduce heartburn. The stomach's natural position is on the left side, and when we sleep on our left, gravity helps waste travel smoothly from the small intestine to the large intestine and eventually to the lower colon on the left. This position also keeps the stomach below the oesophageal opening, preventing stomach acid from flowing back into the oesophagus and causing heartburn.
Reduced Risk of Acid Reflux
Sleeping on the left side or upright can also reduce the risk of acid reflux. When lying on the left side, gravity helps keep stomach contents in the stomach, and if reflux occurs, it aids in pulling the acidic contents back down into the stomach. Sleeping on the right side or back relaxes the connecting muscles between the stomach and oesophagus, increasing the likelihood of acid reflux.
Minimized Trapped Gas
Lying on the left side can help minimize the effect of trapped gas in the stomach. According to Dr. Keith C. Summa, a gastroenterologist, there is often a gas bubble on top of food in the stomach. Sleeping on the left allows this gas bubble to be more easily released through belching, reducing bloating and discomfort.
Smoother Bowel Movements
Sleeping on the left side can promote smoother bowel movements in the morning. The small intestine naturally moves waste to the right, and gravity assists in guiding it to the large intestine and eventually to the lower colon on the left. This position can help set your body's internal clock for a smooth digestive start to the day.
Addressing Inflammatory Bowel Diseases
The left-sided sleeping position has been associated with improved symptoms of inflammatory bowel diseases such as Crohn's disease. Research has shown that people with these conditions have trouble sleeping, and maintaining a consistent sleeping position may help alleviate their sleep problems.
While sleeping vertically or on the left side can offer these digestive benefits, it is important to note that it may not be comfortable or feasible for everyone. Sleeping upright for extended periods can increase the risk of deep vein thrombosis (DVT), and most people find it challenging to sleep in this position due to the mechanics of our sleep cycles. Therefore, it is recommended to consult with a healthcare professional to determine the best sleeping position for your individual needs.
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Frequently asked questions
Sleeping upright can help ease symptoms of sleep apnea, reduce acid reflux, aid digestion, and relieve discomfort during pregnancy or illness. It can also be beneficial for people with respiratory issues and heart failure.
Sleeping in a sitting position can lead to health issues such as neck problems, increased stress on the neck and back, and stiffness in the joints. It may also be problematic for individuals with conditions like arthritis.
Sleeping upright is common in the animal kingdom, but most humans struggle with it unless they are in a condition or situation that requires it. However, it is considered a normal practice in certain cultures, such as Tibetan and Buddhist monks, who train themselves to sleep upright.
If you choose to sleep in a sitting position, it is important to create a comfortable environment, use support items like neck pillows and seat cushions, maintain a suitable angle, avoid leaning on objects, and establish a sleep routine to maximize comfort and minimize strain.
Sleeping upright can be dangerous, especially for individuals with osteoporosis or other medical conditions that may be exacerbated by this position. However, if you are sitting at an angle on a recliner, it is generally considered safe and comfortable.
