This article was previously published February 15, 2018, and has been updated with new information.
Oftentimes the simplest strategies pay great dividends. Getting sensible sun exposure and grounding — walking barefoot on the ground, whether it’s sand, grass or rock — are two examples. Sleeping on an incline is another. While sleeping on a horizontal surface is a well-established norm, few may have heard that raising the head of your bed 6 to 8 inches so that you’re sleeping on an incline of varying degrees may have a number of benefits, including:1
- Improving blood circulation2
- Improving glymphatic drainage from the brain3
- Improving immune system function
- Improving respiratory function4
- Easing symptoms associated with diabetes, glaucoma, migraines, multiple sclerosis, sleep apnea,5 acid reflux,6 edema,7 varicose veins and more
The History of Inclined Bed Therapy
Inclined bed therapy was developed two decades ago by Andrew K. Fletcher,8 a British mechanical engineer said to have “an avid interest in how things work.” He stumbled upon the theory by studying the circulatory system of plants. In trees, gravity pulls the denser sap from the top of the tree downward, which then forces the more diluted sap at the bottom to rise upward.
In other words, the interplay between gravity and the varying density of fluids is what causes the sap, which delivers nutrients within the tree, to circulate up and down in a perpetual loop.
He wondered if the same mechanism applied to the human body, and experimentation and further research convinced him that it does. In the video above,9 Fletcher performs a simple kitchen demonstration to show how circulation is caused by density changes in fluids.
Proper Incline Position
Similar experimentation was used to determine the ideal incline, which he concluded was about 6 inches, or 5 degrees. In one experiment, varicose veins disappeared after four weeks of sleeping on a 6-inch incline, which he took as a sign that “a positive change in circulation” had been achieved.
Interestingly, archeological evidence suggests some Egyptians slept on inclined beds,10 and a Boston Museum curator confirmed that the incline on one of these historical beds was in fact 6 inches.
Now, it’s important to note that sleeping on an incline is not the same as sleeping on an adjustable bed that allows you to raise the head while the lower portion remains horizontal. Fletcher stresses the importance of lying straight, but on an incline. You’re not looking to sleep in a sitting position where only your torso is lifted.
In fact, sleeping on your back in a neutral position can help avoid shoulder and hip problems, according to Dr. Peter Martone, a Boston-based chiropractor and physiologist who explained the importance of proper cervical posture while sleeping in a previous interview.11
The alignment of your body is important, as you want your blood to circulate freely throughout your whole body and avoid stress on your hip joint. On his website, InclinedBedTherapy.com, Fletcher lists a number of methods for creating an inclined bed.12 For example, you can build your own wooden bed frame, or use leg risers or full-length foam wedges.
Inclined Bed Therapy for Diabetes
As you can see by the list above, people who have tried inclined bed therapy have reported improvements in a wide array of health problems. When you consider the importance of blood circulation for the healing and regeneration of your body, this isn’t entirely surprising. In a Micronesian study,13 inclined bed therapy was evaluated to see if it might benefit people with diabetes. In conclusion, the researchers stated that:
“[S]leeping on an inclined bed seems to help efficacy in reducing blood sugar levels with those who were dedicated in controlling their blood sugar levels. Inclined bed therapy may not be effective alone … [T]o be successful … it is recommended that diabetic individuals need to incorporate sleeping on inclined beds with medication, taking some alternative remedies and changing lifestyles by eating a proper diet and doing enough exercise …
Interestingly, all participants listed other problems including: back pain, edema, difficulty sleeping, frequent night urination, snoring, morning light-headedness and pain in joints. All participants claimed to have noticed improvement in all these problems.”
Acid Reflux? Consider Raising the Head of Your Bed
Acid reflux is another extremely common health problem that may be improved through inclined bed therapy. Another term used for this condition is gastroesophageal reflux disease (GERD). Two of the most common causes of acid reflux are having insufficient amounts of stomach acid and/or having a hiatal hernia — a condition in which a portion of your stomach passes through an opening in your diaphragm, which can cause complications in your esophagus.
It can also lead to GERD, a condition in which acid is coming out of your stomach, where it’s supposed to be. There’s a valve between your stomach and your small intestine called the pyloric valve. When the acid in your stomach refluxes over that valve, it causes symptoms that are very similar to that of acid reflux, heartburn being one of the primary ones. Heartburn is a burning sensation that radiates up from your stomach to your chest and throat.
It occurs when food and stomach juices reflux up into your esophagus, which is the tube that leads from your throat to your stomach. It’s typically most bothersome at night, and tends to occur in connection with certain activities, such as eating a heavy meal, bending over or lifting a heavy object and lying down, especially when laying on your back. While inclined bed therapy will not cure acid reflux, it may reduce the pain associated with lying down.
On his website, Fletcher has a list of dozens of testimonials from people who have tried inclined sleeping with great success for all kinds of issues, from digestion to mobility to fatigue to burn recovery. According to Fletcher, results also seem to suggest sleeping on an incline helps boost both metabolism and immune function, which could help explain some of these success stories.
Potential Brain Benefits
According to anthropologist Sydney Ross Singer,14 sleeping on an incline may also benefit other brain conditions, including ADHD and Alzheimer’s. Indeed, while not mentioned, it’s possible by altering the intracranial pressure you allow for improved glymphatic drainage. It was long believed that the brain was unable to clean itself out, as the lymphatic system does not include the brain.
More recent research has proven this to be incorrect, showing the brain actually has its own lymphatic system that gets into your brain by piggybacking on blood vessels. Amyloid beta deposits and other toxins are cleaned out of your brain nightly during deep sleep. This waste-removal system is now known as the glymphatic system.
By pumping cerebral spinal fluid through your brain’s tissues, your glymphatic system flushes waste from your brain back into your circulatory system and onto your liver for elimination. Just about anything that hampers the efficient function of your glymphatic system promote Alzheimer’s, by allowing waste to accumulate in your brain, and it stands to reason that improving this brain detoxification would help prevent Alzheimer’s and other neurological dysfunction as well.
Are You Ready to Try Sleeping on an Incline?
In addition to sleeping on my back with a pillow to support my neck (opposed to my entire head), as recommended by Martone, I also changed my bedframe to one that allowed me to elevate the head of my bed to achieve a 5-degree incline. While I have no health problems that would call for this, I find it helps improve my sleep.
When you first start out, you may want to ease into it by raising the head of your bed just 3 inches. Once you’re used to that, raise it to the recommended 6 inches. Going up to 8 inches, which is the maximum recommended elevation, can be tricky, as you’ll start sliding quite a bit. Also, be aware that in some cases you may experience muscle soreness and/or a stiff neck for the first week or two until your body has adjusted to the new position.
Fletcher also recommends drinking more water than usual, as the elevation will decrease fluid retention and enhance urination. This also means your body’s waste removal will be enhanced, so more water is needed to help flush out toxins. Overall, I believe inclined bed therapy can be of all-around benefit for your health and is well worth a try.