How to sleep after knee replacement? The infamous question. Difficulty sleeping is one of the most common complaints after a knee replacement surgery or even after any knee surgery. Over 90% of people have trouble sleeping sometimes for 6+ weeks. Night pain is very common, which causes you to struggle getting comfortable. If you want to read more about night pain, please read this blog post. 

Knee replacement surgery, also known as knee arthroplasty, is a common procedure that is performed to relieve pain and restore mobility in people with severe knee arthritis or injury. While the surgery can greatly improve quality of life, the recovery process can be challenging, especially when it comes to getting a good night's sleep. In this article, we will discuss in detail the best ways to sleep after knee replacement surgery, including helpful tips and techniques that can make your recovery more comfortable and effective.

Why is sleep important after knee replacement surgery?

Getting enough sleep is crucial for your overall health and well-being, especially after a major surgery like knee replacement. Sleep plays an important role in the healing process by allowing your body to repair damaged tissues and build new ones. It also helps to reduce inflammation and pain, which are common symptoms after knee replacement surgery. Poor sleep causes a variety of issues including poor healing, emotional distress and more pain.

However, sleeping after knee replacement surgery can be difficult due to pain, discomfort, and restricted mobility. It is essential to find ways to sleep comfortably and safely to ensure a speedy recovery and improve your overall quality of life

Before you can get comfortable in your bed, recliner or couch, try some of these tips before bedtime to help you have a longer stretch of sleep.

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1. Take your meds 

Try to time your medication schedule to include a dosage of your medication close to bed time. Make sure you are taking the pain medications, nerve pain medication, muscle relaxers, etc. if you have been prescribed them. This is one of the best ways to improve your night pain. Most of the time taking a pain pill before bed is the only way to get 6+ hours of uninterrupted sleep for the first 6 weeks post surgery. If this is not something you can do, please try the other tips listed below.

2. Get up and walk

If you wake up in the middle of night with aching and throbbing in your new knee, get up and walk. This will help distract the body and brain and send the blood flow to other areas. At night time, the body focuses all its energy on healing your knee at night time, if you can get up and use other muscles in your body, it will help the body change the focus to the other parts of the body. You body will start to send blood flow to all the other muscles of the body used to help you walk. This will improve the aching and throbbing in your knee. You can also do some of your PT exercises in the middle of the night such as:

• Seated marching

• Seated kicks

• Laying ankle pumps

• Laying leg raises

• Laying kicks to the side

3. Use ice and elevation

Ice and elevate right before you go to sleep. If you can fall asleep with your leg elevated, this will also help control the swelling at night. Swelling accumulates in your leg at night time so elevation can help reduce this. However, elevating your leg all night is unrealistic for many people. It is uncomfortable for anyone to be in the same position all night so just elevate as long as you can. You can also ice during the night, but be careful you are not overdoing it. Ice injuries can occur if you leave the ice on too long. Ice injuries can cause skin burns, which are very painful.

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4. Switch position 

When you go to sleep, start by sleeping on your back. If you wake up uncomfortable then switch to your side, then your stomach. It is okay to sleep in any position that is comfortable after you've had a knee replacement (unless you have been specifically instructed not to). There is technically no way you can hurt your knee replacement during sleep - unless you violently jerk or twist in the middle of the night. Most of the time, sleeping on your back is the best because it puts the least amount of pressure on the knee. Sleeping on your side with your surgical leg on top is the second best option. Sleeping on your stomach is generally the least desirable. 

5. Switch locations 

Having options of sleeping locations is very helpful after a knee replacement. Spend the first part of your night sleeping in your bed, then move to the couch and then recliner. This can help get your leg in different position that may be more supportive or more comfortable. Sometimes couches can be a little softer or firmer, which might be just what your knee needs at this time. When using a recliner, you will need several pillows to support your leg. 

6. Add a foam pad

Adding a foam pad on top of your mattress can really help cushion the knee. The foam pad should be 2-3 inches thick to improve the cushioning for the knee during sleep. Generally, a mattress is not soft enough to offer proper support to the knee. Supporting the knee is very important to keep the knee comfortable at night. An unsupportive knee will keep you up at night with increased stiffness, swelling/edema, throbbing, and aching. If you cannot tolerate a foam pad (sometimes it can aggravate your back if your not used to it), you can use pillows under your knee. 

Sleeping positions 

After you have tried the tips listed above, now you can focus on finding a good sleep position to keep the leg comfortable. Because sleep is so crucial to healing, there is no need to keep the leg elevated when you are sleeping (unless you have been specifically told to). Elevating your leg at night time is very uncomfortable and will cause you to wake up hourly due to too much pain. Also, another common misconception is to avoid bending the knee during sleep. It is perfectly okay to bend your knee while you are sleeping, especially if that is the only way you can get into a comfortable position.

1. On your back

The most common position to sleep in after a knee replacement is to sleep on your back. I prefer to use pillows over a wedge pillow. Placing a pillow or 2 under your surgical leg can help cushion the leg for better comfort. Place the pillow long ways so it can support the whole leg. The pillow should be positioned from the bottom of your thigh to the foot. Placing the pillow starting at your calf will be too uncomfortable and cause the knee to stretch. (Stretching is good, but not all night long!) Sleeping with the leg straight is also very helpful for your recovery process. Sleeping on your back is probably the best sleeping position.

2. On your non-surgical side

After a knee replacement, it is okay to sleep on your side, surgical or non-surgical side. If you sleep on your non-surgical side, you will need a sleep with one pillow positioned long ways in between your legs and one pillow position horizontally under your ankle of the top leg (surgical leg). If you do not use a pillow under your ankle, the outside of your knee will begin to hurt. It is important to keep the knee aligned while sleeping on your side. If the knee is not aligned, this is when discomfort occurs. 

3. On your surgical side

Sleeping on your surgical side (or operative side) can be uncomfortable at first. this position is mostly used between week 3-6 post-surgery. If this position does not feel good when your first try it, wait a week and try it again. It is very helpful to have a foam pad on your bed when trying this position. The foam pad will cushion and support your leg during the night. If you do not have a foam pad on your leg, you can use 2 pillows to help. To try this position, place one pillow long ways on the bed and place your leg on top. Then you will need one more pillow on top of your leg to reduce any discomfort from your other leg resting on top. 

4. On your stomach 

Another position that may not be tolerated until 3-6 weeks post surgery is sleeping on your stomach. This is generally the least desirable position because of the increased pressure on your knee cap and on the surgical site when sleeping on your stomach. However, many people have slept on their stomach pre-surgery so returning to this position may be very helpful for your sleep. If you don't have a soft, cushioned bed or a foam pad, you will need a 1-2 pillows positioned long ways under your knee to reduce pressure. 

5. Recliner

Sleeping in a recliner is often a very good option for the first few weeks post surgery. Again, you will need a pillow under your surgical leg positioned long ways. Because recliners a generally not as soft as mattress with a soft mattress pad, using pillows under your arms and head can help you get more comfortable. Make sure your recliner is comfortable and provides enough support for your back, neck, and legs. Look for a recliner with adjustable settings, including the angle of the backrest and footrest. Use pillows to support your back, neck, and legs while sleeping in the recliner. Place a pillow under your head and neck for support and another under your knees to elevate your legs and reduce pressure on your knee joint. Adjust the recliner position to find the most comfortable angle for sleeping. You may need to experiment with different positions to find the right one for you.

6. Couch

Sleeping on the couch is another option that seems to work well directly after surgery. Generally, the couch is easier to get on and off of compared to a bed that may be too tall. The firmness or softness of the couch might be exactly what you need to get a good nights sleep. You can use any of the positions listed above when sleeping on the couch (on your back, side or stomach) 

There is no wrong way to sleep. Whatever position works for you is the best position. There is also no way to hurt your knee replacement while you are sleeping — unless you violently twist or jerk. 

 Alternative treatments

Herbal supplements are a popular alternative treatment for improving sleep after knee replacement surgery. It is important to ask your surgeon or primary care doctor if you can take these herbal supplements because they could interfere with prescribed medication. Here are some examples of commonly used herbal supplements and their many benefits for sleep:

1. Valerian root

Valerian root is a herb that has been used for centuries to promote relaxation and improve sleep. It has a mild sedative effect and may help improve sleep quality in people with knee replacement surgery. Valerian root is available in supplement form, but it is important to talk to your doctor before taking it, as it can interact with other medications.

2. Chamomile

Chamomile is a herb that has been used for centuries to promote relaxation and reduce anxiety. It has a mild sedative effect and may help improve sleep quality in people with knee replacement surgery. Chamomile is available in tea, supplement, and essential oil form.

3. Passionflower

Passionflower is a herb that has been used for centuries to promote relaxation and reduce anxiety. It has a mild sedative effect and may help improve sleep quality in people with knee replacement surgery. Passionflower is available in supplement and tea form.

4. Lavender

Lavender is a herb that has been used for centuries to promote relaxation and reduce anxiety. It has a mild sedative effect and may help improve sleep quality in people with knee replacement surgery. Lavender is available in essential oil, supplement, and tea form.

It is important to talk to your doctor before taking any herbal supplements, as they can interact with other medications and may not be appropriate for everyone. Additionally, some supplements may not be regulated by the FDA, so it is important to choose reputable brands and sources