Peripheral artery disease (PAD) affects 6.5 million Americans over the age of 40.1 It’s typically caused by a buildup of fatty plaque in the arteries, also known as atherosclerosis. This narrows the walls of the arteries, restricting blood flow.
When the peripheral arteries narrow, it’s harder for blood to get to your legs and arms. This can lead to pain and discomfort and disrupt sleep. But adjusting your sleep position may help. In this article, we’ll cover the best sleeping position for peripheral artery disease, which ones to avoid, and other tips for managing PAD.
Causes and symptoms of PAD
As mentioned, PAD is caused by an accumulation of fatty plaque in the arterial walls. But several factors increase the risk of PAD, including:
- Smoking
- High blood pressure
- Diabetes
- High cholesterol
- Obesity
- Being over the age of 60
- Having a family history of PAD
The hallmark sign of PAD is leg pain resulting from physical activity, that improves with rest.1 Known as claudication, this pain or cramping can occur in the hips, buttocks, thighs, or calves. While most common in the legs, PAD can occur in the arms too.
Besides claudication, other symptoms of PAD may include:
- Numbness or muscle weakness in the legs
- Hair loss on legs and feet
- Smooth, shiny skin on legs
- Feet or legs that are cool to the touch
- Cold or numb toes
- Slower growth of toenails
- Sores on legs or feet that are slow to heal1
The connection between PAD and sleep
It’s no secret that sleep is crucial to your health and well-being. Your sleep quality affects your mood, energy levels, concentration, immune system, and even your weight.2
Most health experts recommend getting between 7 to 9 hours of sleep every night.3 But if you have PAD, getting restorative sleep can be challenging for a few reasons.
Pain disrupts sleep
Some people with PAD have pain, cramping, or tingling in the feet or legs even while resting. This can wake you up in the middle of the night or make it more difficult to fall asleep.
If this happens to you, try standing or hanging your legs over the side of the bed. This promotes blood flow to your lower limbs, which may reduce pain and help you fall back asleep.
Sleep apnea
People with PAD are more likely to have sleep apnea.4 This is a sleep disorder that causes your breathing to stop or become shallower while sleeping. Sleep apnea commonly occurs among people who are overweight or obese.
Each time your breathing stops, it interrupts your sleep and lowers your oxygen levels. This can lead to inflammation, which can damage your arteries and may worsen PAD symptoms.5 6
Restless leg syndrome
Restless leg syndrome is also more common among those with PAD.7 This is a condition that causes uncomfortable sensations in the legs, creating a strong urge to move them.8 These sensations usually happen in the evening and tend to be most intense while sleeping.
Often, walking or moving the legs relieves restless leg discomfort. But this also disrupts sleep and can make it harder to fall back asleep.
Recommended sleeping positions for PAD
If you have PAD, your sleeping position may improve your symptoms or aggravate them. Here are the best sleeping positions for PAD:
Sleeping on your back
Sleeping on your back with your legs slightly elevated is the best sleeping position for peripheral artery disease. When you sleep on your back (supine), your weight is evenly distributed. This allows for better circulation. But it also makes it easier to elevate your legs.
Elevating your legs above your heart helps prevent blood from pooling in the legs. If you have an adjustable bed, you can do this by raising the lower section. You can also invest in a foam wedge pillow, or simply prop your legs up on a few pillows.
If you’re not a regular back sleeper and tend to turn over in the middle of the night, no worries. You can train yourself to become a back sleeper. Simply surround your body with pillows to keep you nestled snugly on your back.
Sleeping on your side
Side sleeping is a close second for best sleeping positions for PAD. But there is a caveat. You’ll want to avoid the “fetal position,” where your legs are tucked into your chest, as it restricts blood flow.
To prevent this, if you sleep on your side, keep your legs straight. Putting a pillow between your knees while side sleeping can help you maintain proper alignment and reduce any stress on your hips.
Sleeping on your side can also be helpful for those with PAD and sleep apnea. It keeps your airways more open compared to sleeping on your back.
Sleeping positions to avoid with PAD
Just as some sleep positions work best with PAD, some should be avoided. Here are a few sleep positions that may worsen PAD symptoms:
Sleeping on your stomach
When you sleep on your stomach, your legs are lower than your heart. This is not ideal if you have PAD, as it can cause blood to pool in your lower limbs.
Stomach sleeping can also put extra pressure on your neck and spine, which can restrict blood flow and cause discomfort.9
Crossing your legs
There’s a reason you’re told to uncross your legs each time your blood pressure is taken. Crossing your legs decreases blood flow, which may lead to numbness or pain. This is true whether you’re sitting or lying down.
So if you have PAD, avoid sleeping with your legs crossed. Putting a pillow between your legs may help to keep them straight.
Other tips for managing PAD
Here are some other lifestyle habits that can also help you manage PAD symptoms:
- Don’t smoke. Smoking damages your blood vessels and increases the risk of PAD.10 So if you smoke, consider quitting.
- Exercise regularly. Moving your body keeps your heart healthy and relieves PAD symptoms.11 This is ironic, as leg pain can make people with PAD cut back on exercise. The best exercise for peripheral artery disease is walking. Start slowly and listen to your body. If the pain becomes too much, take a break; and once it fades, try again.
- Eat a heart-healthy diet. This includes nutritious foods like colorful fruits and veggies, lean protein, and healthy fats like olive oil and fatty fish. Limit foods high in saturated fats like beef, fatty cuts of meat, processed meats, fried foods, and full-fat dairy, as they can clog your arteries. Also, cut back on sugar, as diabetes is a risk factor for developing PAD.
When to seek professional help
If you have symptoms of PAD but are not diagnosed, it’s important to see your healthcare provider right away. PAD increases the risk of adverse cardiovascular events like stroke and heart attack.1 So taking preventative measures early on is crucial.
In addition, if you have a family history of PAD, but don’t have symptoms, you may want to consider getting screened. Half of all PAD patients are asymptomatic.12 Early detection and treatment can help slow the progression of the disease and improve your health and well-being.
About Mindy Palmer
Mindy Palmer is a wellness writer and certified holistic health coach. She enjoys inspiring others to live healthier lives by creating informative content for leading-edge health and wellness brands.
Sources:
1. “Peripheral Arterial Disease (PAD).” U.S. Department of Health and Human Services. CDC.gov.
2. “Get Enough Sleep.” Office of Disease Prevention and Health Promotion. Health.gov.
3. “How Much Sleep is Enough?” National Heart, Lung, and Blood Institute. Nhlbi.nih.gov.
4. AlSheikh, S. “Relationship Between Peripheral Arterial Diseases and Obstructive Sleep Apnea: A Systematic Review.” Cureus 15, no. 2 (2023): e35550.
5. Zenewicz, L.A. “Oxygen Levels and Immunological Studies.” Frontiers in Immunology 8, no. 324 (2017).
6. Zanoli, L., M. Briet, et al. “Vascular consequences of inflammation: a position statement from the ESH Working Group on Vascular Structure and Function and the ARTERY Society.” Journal of Hypertension 39, no. 9 (2020): 1682-1698.
7. “Peripheral Artery Disease (PAD) and Sleep.” WebMD. Webmd.com.
8. “Restless Leg Syndrome.” National Institute of Neurological Disorders and Stroke. Ninds.nih.gov.
9. “Best Sleeping Position for Peripheral Artery Disease – What You Need to Know.” Midwest Institute for Non-surgical Therapy. Mintstl.com.
10. “How Smoking Affects the Heart and Blood Vessels.” National Heart, Lung, and Blood Institute. Nhlbi.nih.gov.
11. Murphy, T.P., D.E. Cutlip, et al. “Supervised exercise versus primary stenting for claudication resulting from aortoiliac peripheral artery disease: six-month outcomes from the claudication: exercise versus endoluminal revascularization (CLEVER) study.” Circulation 125, no. 1 (2012): 130-9.
12. Dhaliwal, G., & D. Mukherjee. “Peripheral arterial disease: Epidemiology, natural history, diagnosis and treatment.” International Journal of Angiology 16, no. 2 (2007): 36-44.
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