Best Sleeping Position for Peripheral Artery Disease

How Peripheral Artery Disease Affects Sleep

Some people with peripheral artery disease find that leg pain wakes them up at night. They may also find that moving their leg or sleeping in a different position helps relieve the pain. 

Researchers have also found associations between PAD and short sleep. Trusted Source PLOS ONE PLOS ONE is an inclusive journal community working together to advance science for the benefit of society, now and in the future. Founded with the aim of accelerating the pace of scientific advancement and demonstrating its value, we believe all rigorous science needs to be published and discoverable, widely disseminated and freely accessible to all. View Source Although more research is necessary, some researchers believe that PAD and short sleep have a bidirectional relationship. This means that a lack of sleep may increase a person’s risk of developing PAD, while having PAD may also cause a person to sleep less. It is believed that, at least for some people with PAD, pain disrupts sleep, leading to lower sleep quality and more time spent in bed trying to obtain quality sleep.

Finally, some steps to help minimize PAD may have secondary effects on sleep. For example, using tobacco can worsen PAD Trusted Source Cardiology Clinics View Source , leading some people with the condition to use nicotine replacement therapy, such as a gum or patch, to quit smoking. However, some evidence suggests that nicotine replacement products may worsen sleep in people with PAD Trusted Source Medline Plus MedlinePlus is an online health information resource for patients and their families and friends. View Source . However, as noted by Dr. Dustin Cotliar, M.D., MPH, nicotine interferes with sleep for people in general – not just those with PAD.

Peripheral Artery Disease and Sleep Disorders

Research shows that obstructive sleep apnea (OSA) is more common among people with peripheral artery disease. Trusted Source Cureus Journal of Medical Science View Source People with OSA  have recurring lapses in breathing during sleep because of narrowing and blockage of their airway. Common symptoms of OSA include loud snoring and daytime tiredness.

More research is needed to understand what links these two disorders. Some experts suggest that having OSA makes a person more likely to develop cardiovascular conditions like PAD. The lapses in breathing associated with OSA can lead to reduced levels of oxygen in the blood, and, over time, may cause inflammation and harm to the blood vessels and arteries. Dr. Cotliar notes that untreated OSA can lead to or increase the risk of many comorbidities of PAD, such as diabetes, obesity, and hypertension.

Other research has found that among people with PAD, those who also have OSA tend to have worse health outcomes with time. Trusted Source PLOS ONE PLOS ONE is an inclusive journal community working together to advance science for the benefit of society, now and in the future. Founded with the aim of accelerating the pace of scientific advancement and demonstrating its value, we believe all rigorous science needs to be published and discoverable, widely disseminated and freely accessible to all. View Source People with both PAD and OSA are also at a greater risk for mental health conditions, like depression. Future research can help determine if treating OSA improves health measures among people with PAD.

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Sleeping Positions and Peripheral Artery Disease

Researchers haven’t specifically studied how different sleeping positions impact people with peripheral artery disease. That said, some positions may make it easier to reduce leg pain. Trusted Source Medline Plus MedlinePlus is an online health information resource for patients and their families and friends. View Source

In general, doctors recommend that people with PAD try keeping their legs below their heart when lying down to sleep. Trusted Source Merck Manual|MSD Manuals View Source Elevating the head of the bed by four to six inches may improve blood flow and decrease pain.  

Because body positioning affects blood flow, Trusted Source Anatolian Journal of Cardiology View Source it may be helpful to avoid any leg posture that pinches or otherwise limits circulation.

Back Sleeping

Back sleeping may be a comfortable position if you have peripheral artery disease. In this position, you are less likely to put pressure on your legs in a way that may reduce blood circulation. 

When back sleeping, it is often easier to comfortably sleep with the head of your bed elevated. Many people with PAD report that a few inches of elevation offers some pain relief. 

An important caveat, though, is that if you also have obstructive sleep apnea, back sleeping might not be the best sleeping position for you. In some people, back sleeping causes or worsens sleep apnea symptoms by making it more likely the airway will become blocked. Trusted Source Medline Plus MedlinePlus is an online health information resource for patients and their families and friends. View Source “Back sleeping could be OK if the person is already being adequately treated with CPAP,” notes Dr. Cotliar, “although this may not uniformly apply to everyone.”

Side Sleeping

Sleeping on your side may also be a good option if you have peripheral artery disease, especially if you also have OSA. 

You can experiment with modifications, such as raising the head of your bed or putting a pillow between your legs, to try to optimize blood flow to your legs when lying on your side. 

If you continue to experience leg pain while side sleeping, try other sleep positions instead to see if they are more comfortable.

Stomach Sleeping

If you have PAD and feel comfortable stomach sleeping, it is not necessary to switch your sleep position. You can also try raising the head of the bed to try to decrease leg pain from PAD. 

However, studies suggest that stomach sleeping can lead to neck or back pain because this position can put extra pressure on the spine. Trusted Source BMJ Journals The BMJ, a is one of the world's oldest general medical journals and is published by the British Medical Association. View Source If you already experience regular pain from PAD, you may not want to adopt a sleeping position that could cause additional discomfort. 

But if you sleep on your stomach without undue spinal stress, you don’t need to avoid this position simply because you have peripheral artery disease.

Tips for Sleeping Better With Peripheral Artery Disease

Practicing healthy sleep habits can help improve sleep, which could be useful for people with PAD. If you want to sleep better, try these tips: Trusted Source Medline Plus MedlinePlus is an online health information resource for patients and their families and friends. View Source  

• Maintain a consistent sleep and wake time each day, even on weekends 
• Avoid consuming caffeine late in the day
• Quit smoking
• Avoid alcohol near bedtime
• Try to go outside and receive sunlight exposure every day
• Exercise regularly, but not close to bedtime
• If you nap, try to wake up by mid-afternoon so it doesn’t interfere with sleep at night
• Engage in relaxing activities before bed
• Lower your bedroom temperature before you go to bed
• Remove devices like a computer, TV, phone, or tablet from your bedroom and avoid looking at these near bedtime

Additionally, Dr. Cotliar recommends elevating the head of your bed, keeping your legs below heart level, and avoiding pillows below your knees. Sleeping on your left side may promote healthy sleep for people with PAD, as well.

When to See a Doctor

If you are experiencing leg pain without a clear cause or if you are having other leg-related symptoms, like unusual sensations or trouble walking, talk to your doctor. Your doctor can ask questions about your symptoms and health history to determine if there’s a chance peripheral artery disease or another disorder could be causing your symptoms. Dr. Cotliar adds that you should also see your doctor if you have PAS and your nighttime symptoms are poorly controlled with numbness and tingling.

Similarly, talk to your doctor if you are regularly having trouble sleeping. Your doctor can help you figure out the cause and identify treatments or other approaches that may help you sleep better.

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