Best Sleeping Position for Peripheral Artery Disease

Peripheral artery disease (PAD) is an abnormal narrowing of arteries that reduced the blood flow most commonly affecting the legs, arms, and other organs (other than the heart or brain). The most common cause of the narrowing of vessels is atherosclerosis which takes to develop over the years. Another cause can be a vasospasm of the vessel, but only last for a short duration.

Decreased blood flow in the peripheral artery, decrease blood flow in the muscle, and muscles cannot get enough oxygen supply, leading to ischemia. Anaerobic glycolysis occurs in the metabolism which leads to the formation of lactic acid. Build up of lactic acidosis leads to muscle pain and fatigue. This pain is often called claudication, i.e., the pain felt after a workout or walking a certain distance, and relief by taking rest. At rest, there is a proper supply of blood according to the demand, a person often seems asymptomatic. But when the person is walking or exercising, the blood demand of muscles increases and leads to claudication (pain).

The location of pain in peripheral artery disease depends upon the area of the artery involved. For example, if the pain is in the hip or groin, think of the aorta or iliac artery, If the pain is in the thigh region, think of the femoral artery. If pain is in the calf muscle area, it can be the popliteal artery or superficial femoral artery, if in the foot, then it can be the tibial or peroneal artery. 

Symptoms of Peripheral artery disease 

• Pain (Claudication)
• An ulcer that usually does not heal, due to decrease blood supply.

Cigarette smoking is the most common & important risk factor for Peripheral artery disease. Other important risk factors of Peripheral artery disease are Diabetes, Hypertension, and Dyslipidemia.

Best Sleeping Position for Peripheral Artery Disease

In Peripheral artery disease, due to poor circulation, one can experience muscle cramps, tingling or numbness, and pain, especially in the lower limbs or arms. Thus, it hampers your day-to-day life, and more especially, your sleeping habits. One cannot sleep well due to muscle cramps and pain. Pain awakens them all night.

The best sleeping position for Peripheral artery disease is one can sleep with leg elevation, sleeping on the side with the pillow. But one should avoid sleeping on their stomach. Here are the details about the Best sleeping position for Peripheral artery diseases and the reasons behind them.

A. Sleeping with Leg Elevation

Elevation of the leg above the heart level while sleeping helps to prevent blood pooling in the limbs. Venous blood does not have to travel against gravity to go to the heart and make an easy venous return to the heart. When blood begins to pool in the limbs, it causes swelling, which compresses the surrounding vessels and decreases blood supply. Thus, elevating limbs helps to reduce muscle tension. So, Leg elevation while sleeping is the most recommended & best sleeping position for peripheral artery disease.

For achieving leg elevation, one can use a series of pillows or blankets. Any hard objects are not recommended to place in the bed for leg elevation. Also keep in mind, not to elevate the legs at too high a level, as it decrease the blood flow to the muscles, and deteriorates the condition more. 

B. Sleeping on your back

Sleeping on your back can effectively distribute weight evenly. Thus, results in reduced pressure on affected blood vessels aiding better blood circulation and reducing the discomfort. Using additional pillows to elevate the legs further enhances the angle, minimizing strain on the lower back.

C. Sleeping on the side

If it's not possible to lie on your back with elevated legs, side sleeping is the next best sleeping position for peripheral artery disease. However, one should avoid flexing the limbs towards the chest as like the fetal position, as this can restrict blood flow. Instead, make sure to keep your legs straight and aligned with your body. If maintaining this position is difficult, you can use a pillow between your knees for better alignment and to reduce strain on your hips.

D. Avoid sleeping on your stomach

Sleeping on your stomach is not recommended for a person with Peripheral artery disease. This position naturally lowers the extremities (legs) below the heart, leading to blood pooling in the lower limbs, which can cause significant swelling and discomfort.

Additionally, sleeping on the stomach can exert excessive pressure on the neck and spine, leading to discomfort and potentially impeding blood flow.

As a helpful suggestion, if you tend to sleep on your stomach automatically, then you can prevent rolling over onto your stomach while sleeping by using firm pillows, extra blankets, or a long body pillow on either side of your body.

Your sleep position plays a crucial role in various aspects, particularly in relation to circulation to minimize the effect of Peripheral artery disease. So, one must choose the best sleeping position for Peripheral artery disease in which they feel more comfortable and can have sound sleep. Improper sleep positions, such as sleeping with your arms above your head or having a misaligned neck and spine, can adversely affect circulation and disrupt your sleep quality.

By adjusting your sleep position, you can avoid compressing your lungs or other organs and promote healthy blood flow reducing the symptoms caused by Peripheral artery disease. Here are some recommendations on the best sleeping position for Peripheral artery disease at a glance in summary.

1. Sleep on your left side: This position can facilitate easier blood flow in and around your heart, enhancing circulation during sleep.
2. Keep your arms at your sides: Instead of placing your arms under or behind your head, keeping them at your sides can prevent potential constriction and maintain proper blood flow.
3. Ensure proper pillow support: It's important to use a pillow that adequately supports your neck and spine, ensuring neutral alignment. This helps maintain proper blood flow and prevents discomfort during sleep.

By adopting these suggestions, you can optimize your sleep position to promote healthy circulation and overall sleep quality.

As part of sleeping, for those who have peripheral artery disease, one must consult the doctor as soon as possible and need to do other interventions because maintaining a sleeping position alone cannot help in the long run.

Intervention needed to aid the sleeping position for Peripheral artery disease

A. Lifestyle modification

1. One must stop smoking. Smoking promotes peripheral artery diseases and is one of the important established risk factors.

2. Consumption of a regular healthy diet. Drink water adequately every day.

3. Engaging in regular exercise is beneficial for individuals with claudication as it promotes the opening of alternative small vessels (collateral flow) and can lead to an improvement in walking limitations. Treadmill exercise has been extensively reviewed as an effective treatment option, involving sessions lasting 35 to 50 minutes, three or four times per week. This form of exercise has shown numerous positive outcomes, such as reducing cardiovascular events and enhancing the overall quality of life. Supervised exercise programs have demonstrated the ability to increase pain-free walking time and the maximum walking distance in individuals with PAD. These programs provide valuable guidance and support to optimize the benefits of exercise for people with the condition.

B. Massage over the limb muscles can also help to some extent in maintaining blood flow.

C. Management of diabetes

D. Management of hypertension

E. Management of high cholesterol level

Medication

Antiplatelet drugs such as aspirin and clopidogrel help in thinning the blood, reducing blood clots, and thus improving blood flow. Statins reduce cholesterol levels. These medications are also helpful in preventing other cardiovascular diseases and disease progression.