How to Sleep Comfortably After Bariatric Surgery

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Sleep after bariatric surgery is one of the most underrated parts of surgical recovery. Your body does a lot of its healing work while you’re asleep, and getting enough of it in the first few weeks makes a real difference to how quickly you recover and how you feel during the day.

The problem is that after abdominal surgery, sleep gets complicated in ways you probably didn’t think about before your operation.

Why it’s difficult

A few things hit at once. Your abdomen has surgical wounds – even small laparoscopic ones – that make certain positions uncomfortable. Reflux risk is higher in the early post-op period and lying completely flat can make it worse. Pain and discomfort wake you. And if you were using CPAP for sleep apnoea before surgery, the settings may need adjusting as your weight changes.

Most people find weeks one and two the hardest, with things improving noticeably by weeks three and four.

The positions that work

On your back, propped up. This is what most bariatric teams recommend for the early weeks. Raising your upper body 30 to 45 degrees reduces pressure on your incision sites, helps manage reflux, and takes the load off your abdomen. Extra pillows stacked behind you, a wedge pillow, or raising the head of your bed slightly all work.

A pillow under your knees takes the lower back strain out of lying on your back, which matters if you’re not used to this position.

On your side, with support. A lot of people simply can’t stay on their back through a whole night regardless of how many pillows they use. Side sleeping is generally fine after laparoscopic bariatric surgery. Put a pillow between your knees to keep your hips aligned, and hug one to your abdomen – it provides comfort and stops you rolling forward onto your stomach while you sleep.

Left-side sleeping is usually better than right-side for people with reflux, as it keeps stomach contents lower.

Not on your stomach. This puts direct pressure on your abdominal incisions. It’s painful in the early weeks. Even if you were a front-sleeper before surgery, this one needs to be put on hold for four to six weeks minimum.

Practical things that actually help

Buy a body pillow before surgery, not after. Full-length body pillows are used by a huge number of post-op patients and people almost universally wish they’d got one beforehand rather than trying to arrange three separate pillows at 3am.

A small rolled towel or pillow over your incision site helps with the jolt of getting in and out of the car and getting in and out of bed.

Get in and out of bed properly. Roll to your side first. Then push yourself up to sitting with your arms. Then stand. Going from lying to sitting in one motion uses your abdominal muscles in a way that’s uncomfortable and potentially harmful in the first two weeks.

Keep water and anything you need within easy reach. Getting up repeatedly in the night is uncomfortable. Set yourself up before you go to sleep so you don’t have to.

If you use CPAP

Keep using it during recovery, even as your weight starts to change. Weight loss can improve sleep apnoea significantly but this happens gradually. Don’t adjust your CPAP settings yourself, arrange a follow-up with your sleep team to have them reassessed as recovery progresses.

When to contact your team

Some discomfort during sleep is expected and normal. But if you’re having significant pain that isn’t improving, pain that wakes you sharply, shortness of breath, or any difficulty breathing in any position, contact your surgical team. Don’t wait until morning if something feels wrong.

Barry the Bariatric Buddy mascot

“Nobody warns you about how strange sleep is in those first few weeks. You find a position that works and then get woken up the second you roll over. It gets better faster than you think. Set your sleep environment up before you get home from hospital – pillows sorted, water close, whatever you need within reach. And give yourself permission to rest. That is literally what you’re supposed to be doing right now.”

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