These Are the Best Sleeping Positions for Peripheral Artery Disease

If you’re one of the millions of people living with peripheral artery disease (PAD), getting quality sleep can be a challenge. PAD occurs when arteries become narrowed or blocked, restricting blood flow to your arms, legs, and organs. Atherosclerosis, or buildup of cholesterol deposits in the arteries, is the primary cause of PAD. 

Reduced blood flow with PAD can cause cramping or pain in your legs and feet. Sometimes, leg pain happens when you’re resting, making it difficult to fall asleep. It's important to talk with a healthcare professional about any recurring leg pain. Adjusting your sleeping position can also help. 

What are the best sleeping positions for peripheral artery disease?

You might have a favorite sleep position. But when you’re dealing with leg pain at night due to PAD, some sleeping positions may be more helpful than others. Let’s take a closer look at the best sleeping positions for peripheral artery disease.

Sleep on your back with your head elevated 

The reduced blood flow that occurs in PAD can cause pain in the legs, especially at night. Lying on your back with your head elevated might reduce discomfort.

When you sleep with your head elevated, your heart is higher than your legs. Gravity then works in your favor by assisting blood flow down to your feet, Trisha Roy, MD, a vascular surgeon at Houston Methodist, told GoodRx Health. Elevating your head and heart above your legs can also ease the pain associated with poor blood flow, Roy said. 

To achieve this position: 

• Lie on your back.

• Use extra pillows to prop up your head and upper body. 

A wedge pillow may also work well because it creates a gradual slope to raise your head and upper body while you sleep. You might also consider investing in an adjustable bed that lets you raise the top half of the mattress. Experiment with different heights to find the most comfortable position.

If a new mattress isn’t in your budget, you can also place a block under the head end of the bed frame or mattress. 

Sleep on your back 

If sleeping on your back with your head elevated is uncomfortable, lying flat on your back may help. 

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Lying on your back evenly distributes your body weight across the surface. This equal distribution helps you avoid putting excess pressure on any part of your body, which is particularly important for people with PAD. Too much pressure can compress your blood vessels and reduce blood flow to the affected areas.

Here’s what to do:

• Lie on your back. 

• Tuck a pillow under your knees to support your spine’s natural curve.

• Try putting a pillow under your lower back for extra support.

“People with peripheral artery disease typically benefit from sleeping positions that avoid pressure on the heels,” Roy explained. Constant pressure on the heels can cause skin injuries and sores. And it’s hard for them to heal without good blood flow. Placing a cushion under your legs can help raise your heels off the mattress and avoid pressure. 

However, some people with PAD may develop other diseases related to plaque buildup, such as sleep apnea. Sleep apnea is a common condition where your breathing repeatedly stops and starts during sleep. You should avoid sleeping on your back if you have sleep apnea. In this sleep position, your soft palate and tongue can block your airway, worsening the condition. You’re also more likely to snore, which can disrupt your sleep. If you have PAD and sleep apnea, try sleeping on your side instead.

Sleep on your side with a pillow between your legs 

If you’re a side sleeper, you may not have to change your sleep habits to manage PAD symptoms. “This position helps align the spine and improves blood flow,” Chelsea Perry, DMD, owner of Sleep Solutions, told GoodRx Health. 

However, there’s a downside. When you sleep on your side with one leg directly on top of the other, the weight of the top leg can put pressure on the bottom one. The pressure can constrict the blood vessels in your legs and limit blood flow.

To prevent this, place a pillow between your legs while sleeping on your side, Perry said. The pillow cushions the legs and keeps your spine in a neutral alignment. It also allows blood to flow more freely through your legs and feet, which can help alleviate symptoms of PAD, such as pain, numbness, and tingling.

To sleep in this position: 

• Lie on your side.

• Keep your legs straight or slightly bend your knees. 

• Tuck a pillow lengthwise between your knees and ankles. 

• You may also want a supportive pillow for your head and neck.

EXPERT PICKS: WHAT TO READ NEXT

• PAD vs. CVI: Peripheral artery disease (PAD) is often confused with chronic venous insufficiency (CVI). Learn about the differences between PAD and CVI and how to tell them apart. 

• Benefits of walking: Walking is the best exercise to prevent peripheral artery disease and improve its symptoms. Find out how to add walking to your routine.

• Sleep and PAD: Good sleep hygiene is helpful for quality sleep when you have peripheral artery disease. Try these tips for better rest.

Should you elevate your legs when you have peripheral artery disease?

It depends on the severity of your PAD and whether you experience certain symptoms. “People with mild or moderate PAD can safely sleep in any position without concern for aggravating their condition,” said William P. Shutze, MD, a board-certified vascular surgeon based in Texas.

However, for those with severe PAD, elevating the legs during sleep may worsen their condition, Shutze told GoodRx Health. The position may limit already poor blood flow to the legs. 

Severe PAD may cause you to wake up at night with one or both feet hurting. This can happen even if your legs were resting neutral on the bed, without being elevated, he said. 

Symptoms of severe PAD include:

• Intense pain, tingling, or numbness in your feet or toes, even from light touch

• Pain that worsens when you raise your legs but improves when you dangle them over the side of the bed

• Darkening or bluish color of your skin

• Sores on your feet that won't heal

• Erectile dysfunction

In this case, try sleeping with your legs in a dependent position. This means keeping them lower than your heart, Shutze said. You can do this by sleeping on your back and elevating the head of your bed.

Severe foot pain at night may indicate that your blood flow is critically low. This could put you at risk of serious complications like losing your leg. In this case, Shutze advised consulting with a vascular surgeon immediately.

Leg swelling is another factor to consider. Most people with swollen legs and feet are told to sleep with their feet elevated. However, Shutze said PAD itself usually doesn’t cause swelling unless you constantly keep your feet in a dependent position due to pain. 

Other tips to alleviate discomfort from PAD

Managing PAD requires more than just finding the ideal sleep position. Here are some additional tips to help improve your comfort, especially when sleeping.

• Try heel protectors. Roy recommends using heel protectors to reduce pressure on your heels. She also suggests regularly checking your feet and seeking medical attention if any wound develops, as PAD can make healing difficult.

• Be careful with heating pads and heating blankets. These warming devices can easily cause burns on your feet when you have PAD and reduced blood flow, Shutze said. 

• Avoid certain positions. “Avoid sleeping in positions that compress blood vessels, such as crossing your legs,” Perry said. Other examples include sleeping on your stomach or in a fetal position. This sleep position can restrict blood flow and worsen PAD symptoms.

Additional steps to manage PAD include: 

• Maintain a comfortable weight. 

• If you smoke, quit smoking.

• Manage your blood pressure and cholesterol.

• Take your medications as prescribed.

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Written by:

Maggie Aime, MSN, RN

Maggie's writing brings health topics to life for readers at any stage of life. With over 25 years in healthcare and a passion for education, she creates content that informs, inspires, and empowers.

Edited by:

Lauren Savage, MA

Lauren Savage, MA, is a health editor at GoodRx, where she focuses on movement, exercise, and healthy aging. She aims to provide readers with the information they need to live healthier, more active lifestyles.

Reviewed by:

Karen Hovav, MD, FAAP

Karen Hovav, MD, FAAP, has more than 15 years of experience as an attending pediatrician in a variety of clinical settings. She has worked in a large academic center in an urban city, a small community hospital, a private practice, and an urgent care clinic.

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