So a week or so ago I posted the below on Instagram regarding an article I'd read about sleeping on an inclined bed. We all love sleep, even those of us who don't get as much as we need and being someone who use to very rarely get a good night's sleep I'm always happy to find new tips/tricks that may help in that endeavor.
If you'd like to read the original article that sparked off this little interest of mine, then you can follow this link: https://www.bulletproof.com/sleep/sleep-hacks/inclined-bed-therapy-sleep/
So what's with all this slanted sleeping malark?
It began in recent history with a man named Andrew K Fletcher who was a mechanic with a love for problem solving and the natural world. He came up with the therapy Inclined Bed Therapy (IBT) and I recommend reading more about him and his theory on his website. It's all a very interesting look on circulation and it certainly made me rethink some of my own personal assumptions about how our circulatory system works. Heck when I was at school in Biology it was merely mentioned as an effect of the heart pumping and I'll admit I never really looked into it anymore after that. It's a relatively new term, and subject matter to me so I hope I can do it some justice here.
Gravity and sleep
As noted by Andrew and others gravity effects a purely mechanical role on the circulation of blood around our body and brain. When we are standing up with our heads above our hearts, blood must pump against that force of gravity. Drainage of said blood from the brain to the heart would be helped by the force of gravity. When we are laid horizontally, however, with the heart and the head on the same plane, this effect would be cancelled out and would increase pressure towards our brains. Thankfully, our bodies are rather intelligently designed and have their own gyroscope sensor built in that knows our bodies position and controls the pressure of our blood to suit. If it didn't, there would be far too much build up of blood pressure going towards the brain, causing a back-up of blood in the brain. This could lead to a rupturing of a blood vessel (stroke) or causing a cerebral aneurysm which is a ballooning out of the arterial wall. This is why our blood pressure is a lot lower when we are laid horizontally, it's just our body's natural mechanisms accounting for the pressure changes gravity has on us in different positions.
Even with these mechanisms, though the pressure in the brain increases throughout the night and is always highest in the morning after a night's sleep. The lack of gravity assistance to drainage would cause a back up of blood in the venous system (Veins that deliver deoxygenated blood back to your heart) causing it to become stagnant. This can be seen in how your neck veins protrude more on a morning after sleeping flat. As well as a groggy feeling this can have an effect on your sinuses, gums and pretty much the entire head. This goes a long way for me to explain why we feel groggy after sleeping in more than we should on a morning, it's because we spent too long horizontal.
What the Studies Say
There are quite a few varying studies done from different angles on IBT and I'll go through a few here.
One study focused on migraine sufferers had reasoned that due to the build up of pressure laying horizontally a migraine was actually the body's defense mechanism to get new blood, sugar and oxygen as it's only possible way to get what it needs is from the bloodstream. It stands to reason that interrupting that in some fashion would cause the body to try and work around the issue, making it do some form of 'brain flush' to refresh the brain's blood supply. The study had 100 volunteer migraine sufferers sleep with the heads of their beds elevated from 10-30 degree's. They had theorized that raising the head would improve the brain circulation during the night by providing some gravity assistance for drainage. To the scientists amazement the majority of the migraineurs (people who suffer migraines) had no new migraines from just a simple sleep position change. The results came on very fast, taking only a couple of days to take effect and some of the participants were sufferers for 30+ years. There were also a number of other side effects that the volunteers noticed as well, like reduction in morning sinus congestion, waking up more alert and some reported certain allergies had vanished. They found that the optimal range for all this was somewhere between 10-30° of inclination of the head.
Another study evaluated the effect of elevating the head for patients with GERD (gastroesophageal reflux disease). They did a systematic review of CINAHL (Cumulative Index to Nursing and Allied Health Literature), Cochrane Library, ProQuest, and PubMed/MEDLINE for articles included certain keywords like "elevating the head of the bed", "bed position", "flat", "reflux", "gastroesophageal reflux". Finding a total of 37 articles that matched the search criteria. They finally selected three randomized studies and one quasi-experimental designed study. There results were of a similar astounding nature to the previous one I mentioned. Patients with their heads/beds elevated found their GERD symptoms lessened due to a reduction of the esophagus' exposure to an acid environment. Patients perceived this intervention to not only improve symptoms like regurgitation, and burn sensations without medication but also relieved symptoms better than taking the medications alone. This study concluded that it's an effective way to alleviate the symptoms of acid regurgitation. They also found a similar 20-28cm of incline to be the recommended amount.
This study looked into the effects inclined sleeping had on Diabetes. The scientists theorised that sleeping on an inclined bed would eventually decrease blood sugar levels. They had 13 volunteers, of whom 12 were registered diabetic and the last was pre-diabetic. They conducted interviews over the course of a few weeks, and the first 4 weeks were raised 10 cm at the head, then later raised to 15cm which is a similar range of the majority of experiments done on this subject. They measured blood glucose levels before using IBT and also after several weeks of using IBT. The location of the participants proved an issue as they couldn't get a full range of fasting blood sugar readings, so 5 who were able received those, and the other 8 received random blood sugar tests. There were also family issues that prevented the experiment from being enacted fully. The results are interesting for the participants that stuck fully to the study guidelines, but the researchers note that the experiment is an indication that it may help with blood sugar levels and not proof. Further analysis is totally needed in my opinion as well, but it's interesting to see that in some cases it did help. One thing to note is all of the participants listed other issues prior to being in the study, which included: back pain, edema, difficulty sleeping, frequent urination, snoring, morning headaches / light headedness and joint pain. All of the participants claimed to have noticed improvements in all of these issues.
Reported Side Effects
So what other reported side effects have there been from sleeping on an incline?
- Stop Mouth Breathing
We know we are mouth breath in our sleep when we wake up with a dry mouth. This is generally caused by a cold, or just a habit we picked up as a child. It seems IBT can clear the nasal passage which allows for unobstructed breathing.
- Stop Post-Nasal Drip
Little fact, the body can create up to a quart of mucus each day. Most won't even notice this unless you deal with post-nasal drip which is where you feel a trickle down the back of your throat from your nose. This can cause coughing and other issues during sleep. Keeping the head elevated seems to help keep the throat clear for sufferers of this.
- Curb Snoring and Sleep Apnea
Snoring... Not just an annoyance for the sleeper, but also for the one sharing the snorer's bed. With all the benefits on our nighttime breathing it seems IBT has snoring seems right up there with the best of them.
- Alleviate Heart Congestion and Inflammation
Hospitals are already using adjustable beds for people with serious heart ailments due the issues that arise with these from laying flat. Sleeping on an elevation brings comfort for a lot of the symptoms the diseases have.
- Lessen Shortness of Breath
It's pretty well established that any issue with shortness of breath is increased when one is laid flat. They have been seen to worsen throughout many reports of these issues. Popping up your head seems to give some relief for these as well.
- COPD Relief
Chronic Obstructive Pulmonary Disease sufferers also have difficulty in breathing when laid flat. It can cause sleepless nights due to oxygen levels falling and carbon dioxide levels rising. COPD flattens the diaphragm which causes you to breath less effectively, this makes the neck and chest wall muscles pick up the slack. Sleeping on an incline has been shown to reduce the pressure on the neck and chest muscles, aiding in comfort and sleep quality.
- Soothe Head Stuffiness
Colds are awful to sleep through, not just the runny nose, but a stiff neck or pressure in your face makes sleeping difficult. Sleeping elevated allows the mucus to drain easily and allows better sleep quality.
- Migraine relief
Well, as we saw in the experimentation above, it could relieve migraines reducing the pressure build up of blood draining from the brain on a night.
- Improvement of Nervous System, Spine and Movement Disorders
Andrew K. Fletcher has continued his research for these disorders after a few participants in his other experiments noticed improvements in these type of symptoms as well. He worked with spinal cord injury, multiple sclerosis, cerebral palsy and Parkinson's sufferers and most of his subjects have seen noticeable improvements after sleeping inclined.
What did I think?
I've been sleeping now on my make shift inclined bed for nearly 2 weeks and I haven't managed to slip out of the bottom of my bed yet like I thought I would. I started with my bed raised around 15cm at the head of the bed with my 3D printed risers. I also made sure the middle struts of the bed were well supported due to my bed been a super king size, it's rather large to be destabilizing it in any way. All in all it cost me about £7 to raise my bed up so a pretty inexpensive little experiment.
The first few nights I didn't really notice much apart from a very slight reduction in back pain which I've been suffering from going on 6+ months now. That has not completely gone, but let me tell you it's a hell of a lot more comfortable now i'm nearly 2 weeks into IBT. I use to wake up at 3-4 am every morning and not be able to get back to sleep due to the pain I was in. Now I can at the very least manage it and sleep in till at least 5 or 6 am which is a significant improvement for me. I seem to sleep a lot deeper too, although I've not noticed much of the waking up refreshed benefits that have been mentioned by others but i wake less thoughout the night. My hips feel more aligned whilst sleeping which is helping my lazy postural issues a lot, but the main thing... I actually feel more relaxed and comfort which is making me drop off to sleep faster which has been by far the most beneficial thing for me.
All in all I like it, even from just my two week stint I don't feel like I'll be returning to flat sleeping anytime soon.
If anyone does try it, I'd be interested to hear about your results so please feel free to leave a comment below.