How to Sleep After Hip Replacement

Total Hip Replacement Sleeping Positions —

One of the final factors leading hip replacement patients to ultimately getting the surgery performed is the inability to sleep due to their constant hip and groin pain.  Sleep pattern and comfort in bed will improve immediately after your hip is replaced, so you would think. 

how to sleep after hip replacement

While some may get lucky, most tend to have some continued sleeping issues in the initial phase for 3-4 weeks.  This is the unfortunate norm for this stage of your recovery but not a long term issue to worry about.  

You should make sure to do all of the proper preparations before bedtime to ensure the best chance of quality sleep.  This would include proper taking pain medications as prescribed by your surgeon as well as using ice before bed to reduce your new hip pain and swelling. 

I recommend to my patients to ice the hip region 25-30 minutes with a thin pillow cover to protect the skin.  Be sure you do feel the cold ice temperature at work or you will not be receiving the pain and swelling reduction benefits you’re looking for.  

Sleeping after hip replacement will require you on your back with 1-2 pillows between the legs for the first 4-6 weeks after the surgery date to reduce the chance of dislocation.  Other sleeping considerations after hip replacement include using a recliner chair, placing 1-2 pillows under your surgery leg and timing your pain medications to assist with sleep in your early rehab phase. .

Can I Sleep on my Side After Hip Surgery?

If you are a side sleeper, this could be bad news and make your first few weeks a little more difficult.  The reality is most people have trouble figuring out how to sleep after hip replacement and this should not be a concern if it occurs in your recovery  But there may be a solution that you hadn’t thought of and that is the use of a recliner chair for sleeping.

Can You Sleep in a Recliner After Hip Replacement?

can I sleep in a recliner after hip replacement

Sleeping in a recliner is a common solution to the side sleeping limitation once your hip is replaced.  I would recommended checking with your surgeon on whether or not you can sleep in a recliner chair. From my experience the answer is almost always ‘Yes’. 

The only potential objection would be if your recliner seat is extremely old and soft where your backside would sink deep into the chair however remember, you will be sleeping fully or partially reclined thus you will never come close to the 90 degree hip limitation precaution.  

Also make sure that there is an easy access to a manual pull handle or electronic up and down buttons to assist in returning to the seated position.  Some older model recliners require you to push backwards with good force in order to return to the seated positions.  For these older model recliners I would recommend avoiding due to safety issues.

Why a Recliner Chair Helps with Sleep After Your Hip is Replaced

Why does this work so well you might ask?  The answer is that in bed when you are lying flat there is no wiggle room for movement during the night.  If you happen to move body positions in bed even slightly, your entire body will likely move and often times there will be some pain and now you’re wide awake. 

The recliner chair allows you to separate movement in your torso and maintain a quiet lower body.  When you wake up and move your arm to scratch an itch, falling back to sleep will be easier.  In addition, your legs will be slightly elevated in many recliners allowing your legs to maintain above your head and torso. 

What this does is help to reduce the swelling in your leg and provide improved comfort at rest.  Swelling of the surgery leg can be a big hinderance to movement and comfort so a recliner does provide some additional help with this issue.

As to how long you should consider sleeping in a recliner after hip arthroplasty, a solid 2 weeks would be the best timeframe.  Of course this will vary from person to person. Based on my experience you will get much more consistent sleep in a recliner. Your sleep pattern will be affected negatively by returning to bed too early.

Should I Buy A New Bed or Recliner Lift Chair Before Hip Replacement?

If you’re asking this question then you are likely already on your way to answering it.  New beds and recliners are not cheap and would be a substantial investment however it might be worth your while to make your recovery easier in the short term. 

If you are looking into a recliner you may want to highly consider a mechanical lift chair recliner which can bring you up into a fully standing position with zero effort on your part. 

lift chair recliner hip replacement

Highly rated lift chair recliners will cost $1000+ however medical some providers can assist you in reducing the cost. Medicare coverage can often times cover the cost of the power lift mechanism in the chair. 

Please check with your insurance provider or call Medicare directly if you are in that age bracket.  Bottom line is that it comes down to a personal financial decision of whether to upgrade your home setup. Purchasing a recliner is not a necessary piece of your recovery.

When Can I Sleep on My Side After Hip Replacement?

The all important question of when one can return to sleeping on their side after surgery might not be what one would expect.  Most surgeons want their patients to stay flat while sleeping for 6 weeks to allow proper healing and lessen the chance for dislocation. 

sleeping on side after hip replacement

However, the one aspect of this return to side sleeping is that many surgeons will suggest or prefer their patients to sleep on the surgery leg itself rather than the opposite.   The reason for this is if you sleep with the surgery leg on top there is a greater chance of that leg crossing over the midline and increasing the chance for dislocation.  

While this may seem hard to fathom for most, it actually can be easier to actually sleep on the surgery leg with your body weight rather than having the leg resting on top of two pillows. 

Putting one or two pillows between the knees does help to maintain the legs in position and prevent this. However by sleeping on the surgery leg itself this greatly reduces the chance of dislocation while sleeping.  Most people are more active during sleep than they realize and we need to prevent improper positions at all times

Other Sleeping Considerations After Hip Replacement

Lifting Leg in and Out of Bed

Because of the lack of early leg strength after your procedure it can be difficult to lift your leg in and out of bed.  There are commercially made tools called leg lifters which have a long handle attached to a semi-flexible loop which can be placed around your foot to then lift up into bed with ease. 

If you don’t have a leg lifter an alternative is taking a belt or a long scarf and necktie. Forming a loop at one end using the same lifting concept as leg lifters can provide you extra support.  These lifting devices also help in keeping pain under control. This is due to the support they provide during normally painful side to side movements. 

Many patients are taught in the hospital to use their other leg to hook underneath the surgery leg for support.   While this does work and can provide that extra support, I suggest to my patients that having their ‘good leg’ available for push off and balance is the safer choice. Using a lifting tool would be the best option.

In addition, be sure not to cross your leg over your center line during these movements.  An easy way to prevent this is to lift the surgery leg into bed first thereby swinging it outside.  A rule of thumb for this is you should get into bed on the side opposite of your surgery leg.  

If you had a right total hip replacement, go to the left side of the bed and sit as far towards the pillow as possible. Do this before lifting your leg into bed so you will be in position for sleep.  Remember, no rolling in bed.  

My Bed Is Really High.  How Can I Get My Leg Up Safely?

While high beds look are a preferred choice for some, this extra height can be a big hurdle to overcome. For this setup it would first be suggested to use a leg lifter as described above.  Second, you will likely need some extra help from a relative or spouse to perform safely. 

high bed hip replacement

Using a small step stool can be tricky especially if you are using a walker. Trying to step up on the stool pushing off the walker handles and coordinating can be difficult. 

The best thing you could obtain would be a longer step aerobics type stool. This would allow you to get both feet up on a steady safe platform to get up safely. 

While these are not as popular in the exercise world anymore they are readily available online. Good chance a neighbor or friend may have one collecting dust somewhere.

When Can I Sleep on my Stomach After Hip Replacement?

For those stomach sleepers you will normally get the same response from your surgeon. The range of 6 weeks until you can attempt retuning to this position is the norm. 

From my perspective this position would be less of a concern for dislocation. This is due to the biomechanics and less torque on the hip in this prone stomach position.  It would be important to avoid turning in bed to prevent twisting or torquing for safety purposes.  

Can I Put a Pillow Under My Leg After My Hip Is Replaced?

Some people can get sleep on their backs in bed for the first weeks but are looking for a few extra tips. It may also be worthwhile to place a full pillow lengthwise under the leg for extra comfort. This pillow should be long enough to cross over the knee and support to the upper and lower leg regions. 

Placing a pillow only under your knee proper would be contraindicated. You do need to keep the leg straight during sleeping to maintain quality blood flow and prevent clot or deep vein thrombosis (DVT) formation.  In other words, if your knee is not straight during sleeping then you need to adjust your position.

Final Thoughts on Sleeping After Hip Replacement

  • Sleep on your back for the first 4-6 weeks after surgery
  • Sleeping on a recliner for the first few weeks after surgery is a potential option
  • Using a pillow under your entire leg can give you pain relief
  • Timing your pain medications prior to bedtime can assist with sleep

You probably didn’t expect sleeping after your hip replacement to be such a drag.  And to pile on, sleeping is when a lot of your early healing occurs. This is extremely important in your short term recovery.  It usually takes a few days to determine the best setup for you in your home to get good sleep.

If you are in the early recovery phase still receiving home care, which would be highly suggested in your first few weeks home, make sure to discuss all things sleeping positions with your physical therapist and/or occupational therapist as they are well educated in this matter.  

If you are well beyond into the third or fourth months of recovery still having significant sleeping issues due to pain or other comfort issues, a phone call or visit to the surgeon would certainly be warranted to ensure the joint is intact and safely set.  A successful hip replacement will eventually bring you many pain free restful nights in the very near future.  

About Jeffrey Roth MPT

Owner and operator of Roth Therapy Services in Pittsburgh, PA focusing on in home rehabilitation physical therapy services.


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