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Sleeping Upright
- Sleeping upright isn’t inherently healthy or unhealthy, as long as you can remain comfortable and get enough quality sleep.
- Some people may find sleeping upright more comfortable because of certain health conditions or while recovering from surgery.
- Sleeping upright can be more difficult because your muscles relax during sleep, particularly during REM sleep, making it harder to maintain a comfortable seated position.
- Sitting for long periods can increase the risk of deep vein thrombosis (DVT), so it’s important to move regularly and stay hydrated when sleeping upright during long trips.
Sleeping while sitting upright — or in some cases, standing up — is a common practice throughout the animal kingdom. However, humans often struggle with sleeping upright on occasions when this position is required, such as napping on planes or during long car rides. This can be partly attributed to the way our bodies relax and lose muscle tone during certain stages of a normal sleep cycle.
Moreover, sitting upright for too long can increase your risk of deep vein thrombosis (DVT), a potentially fatal medical condition. If you need to sleep upright, there are certain measures you can take to prevent DVT and ensure an adequate amount of rest.
Is It Healthy to Sleep Sitting Upright?
Sleeping upright is neither inherently healthy nor unhealthy. As long as you’re able to rest comfortably and get enough sleep, the upright position might be the best option. Some people live with medical conditions that make sitting up more comfortable for sleeping. These include morbid obesity and chronic obstructive pulmonary disease.
Some people may also feel more comfortable sleeping in a recliner. However, sleeping upright should be a temporary measure until the patient is able to sleep comfortably in bed. Patients should consult their physician or physical therapist about the change in posturing before transitioning back to their bed.
The practice of sleeping upright is more common within certain cultural groups. For example, the BBC has profiled a Buddhist retreat in Scotland , during which monks slept upright every night for a period of up to four years.
These groups are the exception, however, as most people tend to have a hard time sleeping upright due to the simple mechanics of our sleep cycles. During the fourth stage, known as rapid eye movement (REM), you’ll experience a loss of muscle tone that causes the arms and legs to feel paralyzed. This temporary paralysis makes sleeping upright less comfortable compared to sleeping prostrate on your side, back, or stomach.
These groups are the exception, however, as most people tend to have a hard time sleeping upright due to the simple mechanics of our sleep cycles. During the fourth stage, known as rapid eye movement (REM), you’ll experience a loss of muscle tone that causes the arms and legs to feel paralyzed. This temporary paralysis makes sleeping upright less comfortable compared to sleeping prostrate on your side, back, or stomach.
What Is Deep Vein Thrombosis?
The risk of deep vein thrombosis (DVT) is also important to consider, especially during long flights. DVT is characterized by a blood clot that forms in the veins of your thigh or lower leg after long periods of uninterrupted sitting. If the clot travels to the lungs, this can lead to a potentially fatal pulmonary embolism. Taking certain medications can increase your likelihood of developing DVT, as can smoking or being pregnant .
Symptoms of DVT include the following:
- Warmth or feelings of tenderness over the affected vein
- Pain or swelling at the site of the clot
- Reddened skin
To prevent DVT, airline passengers on long flights are often instructed to stand up and stretch their legs periodically while they are in the air. You should also make sure to drink plenty of fluids in order to stay hydrated.
Another way to lower your risk of DVT while sleeping upright during a long trip is to recline your seat if possible. Some studies suggest reclining your seat at an angle of at least 40 degrees leads to healthier sleep than sitting upright at an angle of 20 degrees. Of course, this may not be possible on certain flights, in which case you may need to leave your seat and stretch your legs more frequently.
Can You Sleep Standing Up?
Sleeping while standing is even more difficult for humans than sleeping sitting up due to the loss of muscle tone that occurs during REM sleep. However, this practice has been observed in certain situations, such as soldiers on nighttime sentry duty.
Other animals are more adept at sleeping on their feet. Horses, for instance, are equipped with a system of tendons and ligaments that allow their legs to essentially lock into place while they sleep. Flamingos are another example, and can actually sleep while standing on one leg .
It’s important to note that some sleep disorders can cause people to stand up, and even walk around, without waking up. Sleepwalking is a disorder of arousal. During sleepwalking episodes, a person may get up and walk or run away from their bed. This behavior may occur in people who experience sleep terrors, another disorder of arousal. However, this should not be seen as normal or healthy sleep since it is disorder-related.
Frequently Asked Questions
Does sleeping upright help sleep apnea?
Sleeping upright, or at least with your head, neck, and upper back elevation, can be a position that helps people with sleep apnea keep their airways more open and therefore make it easier to breathe.
In fact, some people with obstructive sleep apnea (OSA) only have symptoms when lying flat on their backs. That said, it doesn’t necessarily mean that if you have OSA you must sleep upright. Work with your sleep specialists to find different positions that work well for you.
Can sleeping upright cause back pain?
Sleeping upright, or in any one position, has the potential to cause back pain, depending on your specific positioning and if you’re prone to back pain. Ideally, spine specialists recommend that you find a position that promotes natural spinal alignment, with side sleeping a good option . If you do sleep upright, make sure your neck is properly supported and consider placing a pillow under your knees.
Can sleeping upright stop snoring?
Sleeping in an upright position or on an incline can help stop snoring. This is because when your upper body is elevated, it can keep your airways open versus the collapsing of the upper airway area that happens somewhat when you lie flat on your back.
Does sleeping upright help acid reflux?
Sleeping in an upright position or with your head and upper body elevated at night can help alleviate heartburn and acid reflux symptoms . Sitting upright makes it harder for stomach acids to flow up through the esophagus versus lying flat on your back.
Does sleeping upright help congestion?
Sleeping upright or at least with your head elevated can help relieve nasal congestion. The simple reason comes down to gravity that allows your nasal passages to drain and pull mucus away from your sinuses. This is why when you have a cold or allergy symptoms, you tend to have worse symptoms at night when trying to fall asleep in bed.
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References8 Sources
Why do Buddhist monks sleep upright? (2009, June 22). BBC News Magazine.
http://news.bbc.co.uk/2/hi/uk_news/magazine/8112619.stmU.S. National Library of Medicine. (2018, August 10). Deep Vein Thrombosis. MedlinePlus.
https://medlineplus.gov/deepveinthrombosis.htmlAmerican Academy of Orthopaedic Surgeons. (2015, June). Deep Vein Thrombosis. OrthoInfo.
https://orthoinfo.aaos.org/en/diseases--conditions/deep-vein-thrombosisRoach, G. D., Matthews, R., Naweed, A., Kontou, T. G., & Sargent, C. (2018). Flat-out napping: The quantity and quality of sleep obtained in a seat during the daytime increase as the angle of recline of the seat increases. Chronobiology international, 35(6), 872–883.
https://www.tandfonline.com/doi/full/10.1080/07420528.2018.1466801Why Do Horses Sleep Standing Up? Tikkanen, A. Britannica.
https://www.britannica.com/story/why-do-horses-sleep-standing-upAndrews, T. M. (2017, May 24). Mystery solved: How flamingos can sleep while standing one one leg. The Washington Post.
https://www.washingtonpost.com/news/morning-mix/wp/2017/05/24/mystery-solved-how-flamingos-can-sleep-while-standing-on-one-leg/Saini Y, Rai A, Sen S. Relationship Between Sleep Posture and Low Back Pain: A Systematic Review. Musculoskeletal Care. 2025;23(2):e70114. doi:10.1002/msc.70114
https://pubmed.ncbi.nlm.nih.gov/40338112/Khan, B. A., Sodhi, J. S., Zargar, S. A., Javid, G., Yattoo, G. N., Shah, A., Gulzar, G. M., & Khan, M. A. (2012). Effect of bed head elevation during sleep in symptomatic patients of nocturnal gastroesophageal reflux. Journal of Gastroenterology and Hepatology, 27(6), 1078-1082.
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