What Happens To Your Body When You Sleep Upright

At the end of a long day, we all want to lay down in a soft bed swaddled in warm blankets and fluffy pillows as we comfortably drift off to dreamland. While ideal, sleeping in a horizontal position isn't always possible. Maybe you've got a long road trip ahead of you or you're recovering from a surgery that requires you to stay elevated for a day or two. If your only option is to try and get some shut-eye while seated upright, what kind of toll might that take on your body?

Whether in an airplane seat or a recliner chair, one thing that often happens to the body when sleeping upright is the head will loll to one side as the muscles relax while you snooze (per Sleep Advisor). When this happens, it becomes harder for us to keep our heads in an aligned position like we otherwise would when lying down. This can cause us to wake up with sore neck muscles the next day. Aside from a drooping head, however, there are other things that can also happen to our body when we fall asleep sitting up.

According to a small 2018 study published in Chronobiology International, sleeping upright may place the body in a state of greater physiological arousal, subsequently making sleep more difficult. The researchers explained that sleeping upright suppresses the body's "rest and digest” activity, which is regulated by the parasympathetic nervous system. Instead, it activates the body's sympathetic nervous system, which is associated with stress and heightened awareness such as when we're in "fight-or-flight" mode. This was evidenced by the fact that out of six study participants, sleeping for four hours in an upright seat decreased total sleep time by 29%, slow-wave sleep by 30%, and REM sleep by 79% in comparison to sleeping in a chair that reclined completely flat.

Another thing that can happen when we sleep sitting up is that our body may become more susceptible to blood clots, reports Sleep Advisor. Extended time spent sitting can lead to the development of deep vein thrombosis, in which blood clots form in the legs. If these blood clots make their way to other parts of the body, such as our respiratory tract, it can be life-threatening. Talk to your physician if you experience symptoms of pain, swelling, skin discoloration, or skin that feels warm to the touch.

Not all effects of sleeping upright are negative, however. An early 1986 sleep study published in The American Review of Respiratory Disease showed that proper posture may have a positive effect on those with certain sleep disorders. The researchers examined 13 male participants diagnosed with obstructive sleep apnea syndrome (OSAS). As they slept through the night, patients were positioned either flat on their backs or sitting upright at a 60-degree angle. In the seated position, participant sleep apnea symptoms were reduced and nearly eliminated in a number of patients diagnosed with obesity. However, sleeping upright was found to have no impact on sleep efficiency or patient sleep cycles.

If you must sleep upright, try to use a chair with proper lumbar support (per Sleep Advisor). Additionally, wear a neck pillow to help keep your head comfortably positioned. Be sure to maintain proper posture much like if you were seated and typing at a desk. Have your feet facing forward flat on the ground and keep your shoulders back. Just like your feet, make sure your knees and hips also stay facing forward rather than falling to one side or the other.