In 2014, seemingly healthy 24-year-old Brittany Williams suffered sudden cardiac arrest at a Manhattan restaurant. At the hospital, doctors diagnosed her with a heart rhythm disorder called long QT syndrome. Nine years later, in 2023, she underwent open-heart surgery at St. Joseph’s Hospital in Tampa to repair a damaged mitral valve.
As if the shock of having cardiac arrest and needing open-heart surgery wasn’t enough, Williams was also surprised by the recovery.
“I found that sleeping after open-heart surgery was far more challenging than I had anticipated, and it was something no one fully prepared me for,” says Williams, 34, of St. Petersburg, Florida.
After open-heart surgery, rest is crucial for the healing process, but it’s often the most difficult part of recovery.
“I struggled to find a comfortable position due to the pain and the need to protect my healing sternum,” Williams says. “Adjusting to these limitations was frustrating, and restful sleep didn’t come easily for several weeks.”
When going through open-heart surgery, patients like Williams are often so concerned about the operation itself that they may not consider what recovery will be like.
“Many of our patients have trouble sleeping after heart surgery for several reasons, including discomfort related to healing, the effects of anesthesia and the change in routine or stress,” says Mary C. Passow, clinical care coordinator in adult cardiac surgery at the University of Michigan Health Frankel Cardiovascular Center.
Knowing what to expect after open-heart surgery and how best to handle it will help improve your recovery. Sleep may not come easily, but certain positions may offer some relief.
[SEE: 11 Pre-Surgery Tips to Boost Recovery]
How to Sleep After Open-Heart Surgery
After open-heart surgery, whatever sleeping position feels right to you is generally OK — no position is actually dangerous for your body.
“Ultimately, what is most comfortable for you is acceptable,” says Dr. Xiaoying Lou, a cardiovascular surgeon at the Cleveland Clinic.
That said, some positions are likely going to be easier to tolerate than others.
Here are five sleeping positions recommended by cardiac specialists:
1. On your back
Experts often recommend sleeping on your back after open-heart surgery.
“Sleeping on your back is generally best to allow proper alignment of your head, neck and spine, which will reduce the pressure and strain on your chest,” Lou says.
Williams found that sleeping on her back, elevated with pillows, was her best option, but it was uncomfortable at first because it wasn’t her normal sleeping position. Many people are not normally back sleepers, so this position may take a bit of getting used to.
[READ: Don’t Let a Premature Discharge Put Your Life At Risk]
2. In a reclined position
Sleeping in a recliner temporarily may be a good choice after you’ve had open-heart surgery.
“If they are sleeping on their back, we encourage them to elevate their legs and feet to promote venous return (blood flow back to the heart), reducing swelling, which is why many patients choose to sleep in a recliner after surgery,” Passow says.
Sleeping in a recliner can also help minimize coughing and breathing problems in the first few weeks after surgery, she says.
Williams found her recliner to be a “lifesaver,” she says.
“The recliner provided better positioning, allowing me to sit at an incline while keeping pressure off my chest and incision area,” Williams explains. “Although it was still difficult to feel entirely comfortable, the recliner became my go-to spot for rest and sleep for weeks.”
However, sleeping in a recliner all the time — not just post-op — could actually indicate heart problems.
“The need to sleep upright or in a recliner can be a frequent and important symptom of heart failure,” says Dr. John A. Osborne, an American Heart Association volunteer cardiologist and chief medical officer of ClearCardio, which uses 3D imaging and artificial intelligence to detect heart disease.
[READ: Your Rights as a Hospital Patient]
3. Propped up
Any aids, such as pillows or wedges, that help you lie down in an inclined position in bed can be helpful.
“Sleeping a little bit upright with your head and upper back propped up on some pillows may be more comfortable for you,” Lou says.
Because lying flat on her back in bed put too much strain on her chest, Williams used pillows to prop herself up.
“The discomfort from my sternum being cut during surgery made it impossible to relax without some form of support,” she says.
Elevating her upper body also eased breathing and prevented her from accidentally rolling onto her side during the night.
Regular pillows or large body pillows can be arranged in the following ways:
— Around your body when on you’re on your back
— Under your knees to relieve lower back pressure
— On your chest for comfort and to hug if you need to cough or sneeze
— Under the side with the incision to support your back
— Between the legs while you’re on your side
4. On your side
Early on, side-sleeping might not be feasible.
“After open-heart surgery, I quickly realized that side-sleeping was no longer an option. Lying on either side put too much pressure on my chest and incision area, causing significant discomfort,” says Williams, a natural left-side sleeper.
But side-sleeping is fine after open-heart surgery whenever it feels comfortable. And if you do choose to sleep on your side, it’s best to lie on your right side, as it takes some stress off the heart.
In addition, Lou suggests using firm pillows or wedges to position your head appropriately in alignment with your neck and spine while on your side.
5. On your stomach
Natural stomach sleepers may have to wait a bit to get back to this position.
Although sleeping on your stomach — also known as the prone position — will not rebreak your healing breastbone, which is split during open-heart surgery, you may find it causes more pain and discomfort.
Stomach sleeping after open-heart surgery isn’t dangerous, but experts don’t encourage it.
“It also restricts your ability to take deep breaths, which is important after surgery to prevent pneumonia,” Passow says.
There is some research on whether early prone positioning can actually help cardiac patients in their recovery, but this would generally be done in the hospital under a doctor’s supervision.
“Prone positioning is frequently used in the (intensive care unit) as it improves oxygenation in critically ill patients,” Osborne says.
Expert Tips for Recovering From Open-Heart Surgery
Be prepared for sleep disturbances in the hospital
“The interruptions that occur around the clock due to blood draws and vital signs can, particularly in older patients, cause ‘sundowning,’ which results in delirium and confusion in the hospital,” Osborne says.
For Williams, the hospital experience was the start of her post-op sleeping problems.
“In the hospital, it was difficult to rest due to the constant interruptions for monitoring, the noise from machines and the discomfort of being confined to a specific position to avoid straining my chest,” she says.
Take your pain meds
Even if you think you’re feeling better, it’s best not to wait until you’re in pain again to take your meds.
“Be sure to be ahead of the pain rather than behind it, as it’s harder to control pain than to prevent it,” Osborne says.
Also, talk with your doctor about whether it’s OK for you to use over-the-counter sleep aids.
“Melatonin is generally relatively safe and well-tolerated in most patients,” Lou says.
However, if you’re taking opioid or prescription sleep medications, you should be careful not to overdo it; your doctor may want to eventually wean you off those medications.
Get out of bed carefully
Some pain meds can make you dizzy and lightheaded, so be careful getting out of bed and go slowly.
You likely won’t be able to sit straight up, as using your arms will put pressure on your sternum and cause pain.
A physical therapist at the hospital will likely teach you how to roll onto your side, use your legs to create momentum and slowly rise into a seated position without straining your chest.
“I had to use a combination of leg and core strength to lift myself up properly, which was both physically exhausting and challenging during those early days of recovery,” Williams says of using this method. “It required a lot of effort and patience until I built up my strength.”
You can also try hugging a pillow to help you while sitting or standing up.
Create a bedtime routine
Preparing your mind and body for winding down is also important.
“Setting a time to go to bed is helpful and also to have a regimen that starts about an hour beforehand to get ready to sleep,” Osborne says.
Here are some tips for creating a good bedtime routine:
— Take a warm shower
— Meditate or use deep breathing
— Do some light stretching
— Have a caregiver use massage
— Listen to some relaxing music
— Have a warm drink, such as milk or herbal tea (but avoid caffeine and alcohol)
In addition, make sure your bedroom is a calming space that’s cool, quiet and dark.
Go back to your normal daytime routine
You’ll have to take it easy, of course, but lying down all day isn’t healthy, mentally or physically.
“It is best to get back to your normal routine as much as is feasible after open-heart surgery, although this may be easier said than done,” Lou says.
Mentally, getting back to normal can help remind you that your recovery is a temporary problem, which can help reduce your stress.
Physically, moving around can aid in recovery.
“Try to stay active, as much as your body can tolerate,” Lou says.
Also, try not to nap too much or too late in the day, but if you feel your body needs to rest, make sure to take naps earlier in the day.
Give yourself time to heal
“Time is probably the most important therapy as you recover from the anesthesia, trauma and pain of the surgery,” Osborne says.
Even after the initial period of recovery, Williams advises having patience with yourself while trying to find comfortable sleeping positions, and not trying to rush the healing.
“Give yourself permission to rest and heal fully,” she says.
Gradually get back to your normal sleeping position
Stomach and side sleepers will eventually be able to go back to their normal positions, but how long it takes depends on the type of open-heart surgery you had, such as a bypass or heart valve repair.
For Williams, it took around 12 weeks before she felt comfortable enough to transition back to her normal left side-sleeping position.
“I started by gradually testing the position for short periods and using pillows for added support to ensure I wasn’t putting too much strain on my chest or incision,” she says.
It can feel scary at first, but Williams says she eventually built up the confidence to sleep in her normal position through the night.
However, she still experiences occasional stiffness in the mornings, particularly around her chest and shoulders.
“This reminds me that recovery is a long-term journey, and my body is still adjusting even as I regain a sense of normalcy,” she says.
Bottom Line
Remember that recovery is a process, so it may take awhile to adjust to new sleeping positions and patterns.
“Some nights will be better than others,” Williams says. “Now, over a year since my surgery, I can sleep in my preferred position most nights. I’ve learned to listen to my body and make small adjustments when needed to avoid discomfort while continuing to heal.”
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The Best Sleeping Positions After Open-Heart Surgery originally appeared on usnews.com
Update 04/23/25: This story was published at an earlier date and has been updated with new information.
