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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.
Sleeping upright is neither inherently healthy or 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. “I have had a number of physical therapy patients after various shoulder surgeries tell me that sleeping in a recliner is the only way they can get comfortable,” says Dr. Jenny Iyo, a Doctor of Physical Therapy and member of the SleepFoundation.org medical review panel. “I think this is likely due to the fact that while sleeping in a recliner, it is harder to roll over onto your side, which can cause post-operative shoulder patients a lot of pain.”
However, Dr. Iyo stresses sleeping upright should be a temporary measure until the patient is able to sleep comfortably in bed. She adds 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. A healthy cycle consists of four distinct sleep stages. 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 prevents you from acting out on dreams, which primarily occur during REM sleep.
This temporary paralysis also makes sleeping upright less comfortable compared to sleeping prostrate on your side, back, or stomach. Keeping your head upright is especially difficult, as any airline passenger can attest.
