Did you fall asleep sitting up again? Whether intentional or not, you’ve probably done it on a recliner while watching TV or during long flights, train rides or car trips.

Although your body is designed to sleep in a horizontal position, sleeping sitting up isn’t always bad for you. There are instances when this sleeping posture benefits your health.

We wrote this article to help you understand when it’s advisable to sleep sitting upright and its drawbacks. We’ll also provide tips for achieving this sleep position correctly.

Key Takeaways

• Sleeping sitting up is a viable yet temporary option for easing symptoms of certain health situations, like sleep apnea, cardiac failure, acid reflux, breathing issues or late-stage pregnancy.

• Sleeping in a seated position has its drawbacks, including less time spent in restorative sleep stages (slow-wave and REM sleep), neck and back strain, muscle stiffness and an increased risk of deep vein thrombosis (DVT).

• When sleeping upright, use pillows for support, maintain an incline of 30- to 45-degrees, stretch every hour, and consult your doctor for more tailored recommendations.

Table of Contents

• Is Sleeping Sitting Up Good or Bad?

• Benefits of Sleeping While Sitting Upright

• Drawbacks of Sleeping in a Sitting Position

• How to Sleep Upright if You Need to

• Conclusion

Is Sleeping Sitting Up Good or Bad?

The answer to this question isn’t absolute. There are benefits and downsides to sleeping upright. It helps alleviate symptoms of certain medical conditions, aiding in better sleep.

However, it can also lead to fragmented sleep due to brief periods of heightened brain activity. This fragmentation reduces time spent in the slow-wave and rapid eye movement sleep stages, impacting your sleep quality.

It’s important to note that sleeping at a gentle incline is healthier than sleeping fully upright. A study published in ResearchGate found that participants who slept fully upright experienced shorter sleep duration, more frequent awakenings, and spent less time in restorative sleep stages compared to those who reclined.⁽¹⁾

Sleeping upright can offer targeted relief. However, it should be a temporary solution. The goal is to return to a fully horizontal position on a bed as soon as possible.

Benefits of Sleeping While Sitting Upright

Sleeping in an upright position has its advantages. Here are several:

Helps With Obstructive Sleep Apnea

Obstructive sleep apnea (OSA) is a condition characterized by the repetitive collapse of the pharyngeal airway to the back of the throat, causing breathing pauses and loud snoring.

Sleeping upright may help prevent your tongue from collapsing to the back of your throat, reducing airway blockages. A study published in the National Library of Medicine says that for this position to be effective, your head should be at a 30-degree angle.⁽²⁾

However, sleeping in a fully upright position may limit the movement of your diaphragm, reducing the amount of air you inhale. It also doesn’t provide your throat’s soft tissues with even support. The pressure on your airways can make inhalation difficult.

So, if you decide to sleep sitting up to relieve your sleep apnea symptoms, ensure your head and torso are at a minimum of a 30-degree angle. It’ll help keep your airway open and allow you to rest comfortably.

Eases the Symptoms of Acid Reflux

Sleeping upright also helps alleviate acid reflux and gastroesophageal reflux disease (GERD).

Gravity prevents gastric contents from flowing back to the esophagus due to the elevation of your head and chest. When you sleep sitting upright, it reduces your likelihood of experiencing heartburn.

This posture also makes it easy to clear saliva or regurgitated stomach acid that makes its way up the esophagus, preventing coughing or choking. That said, it also reduces the risk of throat inflammation due to chronic acid exposure.

May Help Individuals With Heart Failure

Sleeping in a reclining position is a common practice for people with heart failure.

When you sleep lying on your back (or in the supine posture), gravity helps blood from your legs and abdomen to easily flow back to your heart. This flow increases the volume of blood that your left ventricle needs to pump. However, when your trunk is reclined at a 30- to 45-degree angle, some of that blood moves downward, decreasing the workload on your heart.

Patients with cardiac failure experience breathlessness because of fluids that back up into the lungs. Sleeping at an incline prevents these fluids from pooling in your airway and instead in the base of your lungs, making it easier to breathe and fall asleep.

Helps You Breathe Easier When Sick

Tilting your torso at a 30- to 45-degree angle allows gravity to clear mucus from your sinuses and nasal passages. This angle makes breathing easier when you’re congested or have a post-nasal drip.

It also helps with lung expansion compared to when you sleep flat on your back, where the abdominal organs press upwards. Sleeping semi-upright prevents your diaphragm and chest walls from overworking against the organs, allowing you to breathe more easily.

While sleeping in a sitting position isn’t the best sleeping position for breathing problems, it may offer temporary relief.

Provides More Comfort in the Late Stages of Pregnancy

It can be challenging to rest comfortably, let alone get a good night’s sleep during the third trimester.

Sleeping with the upper body and torso at a 30- to 40-degree angle helps reduce heartburn and acid reflux. The uterus grows during pregnancy, and it can push stomach acid back up into your esophagus. Gravity helps keep stomach acid down.

This sleeping posture when pregnant also puts less strain on the diaphragm, resulting in deeper and fuller breaths. It’s also beneficial for blood circulation as it eases the weight off the inferior vena cava, the vein responsible for returning blood from the lower body. Sleeping in a reclined posture also helps prevent leg and foot swelling.

The baby’s weight can strain the pelvis and lower back. Sleeping upright with supportive pillows helps maintain a neutral spine alignment.

Sleeping upright is just one of several sleeping positions while pregnant. Sleeping on the left side is considered the safest and best sleeping position.

Drawbacks of Sleeping in a Sitting Position

Now let’s discuss the downsides of sleeping in an upright posture.

May Cause Neck and Back Problems

Sleeping in a sitting position requires you to hold your head upright while sleeping, which keeps your neck extensor muscles engaged when they should be relaxed. Over time, sleeping in the same position can cause them to lose muscle tone, which increases the risk of waking up with a sore neck.

A sitting position flattens the natural curve of your lower back. The lumbar vertebrae flex, which overstretches the surrounding muscles and ligaments. Done frequently, this may cause chronic back pain, potentially harming your sleep quality.

Might Result in Muscle Stiffness and Soreness

It’s challenging to shift positions when sleeping in a seated posture. Holding the same pose throughout the night slows down blood circulation in the muscles. It reduces the delivery of blood and nutrients to muscle fibers, causing discomfort.

Maintaining the same posture also affects the joints in your spine, shoulders and hips. Without movement, synovial fluid can’t lubricate the surfaces of these joints, which causes them to lock in place. With the first movement upon waking, your muscles stretch too quickly, resulting in that stiff feeling.

Sleeping while sitting upright can make maintaining a neutral spine alignment difficult. Often, your head tilts forward or to one side due to insufficient support. This misalignment can strain facet joints and ligaments, leading to stiffness upon awakening and radiating shoulder pain.

Sitting shifts your weight onto the sit bones and tailbone. The muscles around these areas must remain tense against the constant pressure, leading to soreness in the lower back, lat muscles and glutes.

Increase Your Risk of Deep Vein Thrombosis

Deep vein thrombosis (DVT) is a blood clot that forms in a deep vein in your body (usually in the legs or pelvis). This blood clot can impede the blood flow in your vein either partially or entirely.

The Cleveland Clinic states that deep vein thrombosis can become life-threatening in cases where the blood clot travels to the lungs, causing a pulmonary embolism.⁽³⁾

Sitting for long periods, including when asleep, reduces the efficiency of the calf muscle’s pump, decreasing the flow of blood back to the heart. Your veins are compressed further when your knees are sharply bent without foot support. Blood pools in your lower extremities, increasing the risk of blood clot formation. The pooled blood can also irritate your vein’s inner lining, which can speed up blood clot growth.

How to Sleep Upright if You Need to

If you must slumber sitting upright, here are some general tips to make it a practical and comfortable position for sleep:

• Use a 10- to 12-inch wedge pillow or an adjustable bed for a gentle incline. Experts recommend a 30- to 45-degree angle.

• If you use a recliner, the backrest should be firm to support your torso but cushioned to maintain the natural curve of your lower back.

• Use a contoured cervical pillow to prevent your head from tilting forward and support your neck’s natural curve. A lumbar roll placed under the small of your back helps maintain spinal curvature and reduce slouching.

• Elevate your legs at about 4 to 6 inches to ensure a healthy flow of blood from your legs back to your heart. This can also help prevent swelling.

• Stabilize your head and shoulders with an adjustable head strap or headrest to prevent your head from tilting forward. You can also use a pillow that wraps around your neck, such as Manta Travel Pillow, to prevent your head from falling sideways.

• Get up to move and stretch every 60 minutes. While this may interrupt your slumber, it will help reduce muscle stiffness and soreness.

• Hydrate before going to bed. It keeps your tissues pliable and prevents cramping.

• Maintain good sleep hygiene. Establish a consistent sleep routine and schedule, and keep your bedroom cool, quiet and dark. If you’re wondering how to make your bedroom darker, an excellent light-blocking sleep mask should do the trick. Meanwhile, earplugs or a white noise machine can block disruptive environmental sounds.

• Consult your doctor if you have medical conditions, especially heart issues, circulation problems, GERD or chronic pain. A sleep medicine specialist can help with obstructive sleep apnea (OSA). Both can offer personalized treatment and advice.

Conclusion

Sleeping sitting up can be beneficial when horizontal sleeping on a bed isn’t possible or advisable.

Sleeping upright helps in certain situations like congestion, sleep apnea, acid reflux, heart failure, and late-stage pregnancy. It can also cause muscle soreness and stiffness, as well as neck and back issues, and deep vein thrombosis (DVT). However, with guidance from your doctor and our tips, sleeping in a sitting posture can help you stay comfortable while getting a good night’s sleep.

We hope this article gave you the information you need to make sleeping in a sitting position work for you. Let us know if it did by commenting below.

Sources:  

(1) “Flat-out napping: The quantity and quality of sleep obtained in a seat during the daytime increase as the angle of recline of the seat increases.” ResearchGate, www.researchgate.net/publication/325704619_Flat-out_napping_The_quantity_and_quality_of_sleep_obtained_in_a_seat_during_the_daytime_increase_as_the_angle_of_recline_of_the_seat_increases. Accessed 06 June 2025.

(2) “The Potential Effect of Changing Patient Position on Snoring: A Systematic Review.” National Library of Medicine, pmc.ncbi.nlm.nih.gov/articles/PMC11277951/. Accessed 06 June 2025.

(3) “Deep Vein Thrombosis (DVT).” Cleveland Clinic, my.clevelandclinic.org/health/diseases/16911-deep-vein-thrombosis-dvt. Accessed 06 June 2025.

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