Reviewed By: Pramod Kerkar, MD, FFARCSI

Pericarditis is the inflammation seen in the pericardial layer, which is often associated with sharp and stabbing pain. The patient always feels discomfort in the heart while sleeping on the left side. Some patients also show shortness of breath, particularly when lying flat. This condition may ease immediately if the sleeping position is changed to sitting up or leaning forward. While sleeping, the head part of the patients must be kept in bed in an elevated position. This helps the heart to pump the blood and function normally. A heating pad or warm compress may help to alleviate the pain and discomfort in pericarditis patient.

What is The Best Sleeping Position for Pericarditis?

Sleeping on the right of the heart causes the sympathetic nervous system to relax. This psychological response reduces the high blood pressure and keeps the heartbeat in control. But this assumption has not been proved in clinically and no evidence available that right side sleep is better than left side sleep. It is not fully understood why there are changes in the sympathetic nervous system. Studies are inadequate to individuals with chronic heart diseases. One of the fascinating research on right lateral decubitus position (right side sleeping) is it increase the level of cardiac vagal activity.

Left-side sleeping may have certain benefits to people who experience severe heartburn may find relief from symptoms. But in case of pericarditis and other heart disease, the hemodynamics get disturbed and may lead to a blood clot or plaque formation easily. The reason for such complication is not clear although several research studies have been conducted. One of the main explanation is the development of dyspnea in the left lateral decubitus position, called “trepopnea” which is thought to reflect elevation of pulmonary venous pressures, resulting in pulmonary edema. This assumption is made by several patients and needs clinical evidence another reason for uncomfortable is due to the enlarged heart beatings against the left chest wall, which cause discomfort in the patient.

Another study associated with left side sleep with heart problem can increase the activity of the sympathetic nervous system. It is believed that it causes abnormal higher cardiac output and also increase the pulmonary capillary wedge pressure (PCWP). Because of this critical effects, the manifestation of the uncomfortable sensation of the apex heartbeat happens. Hence, the patients with heart problems spent a significantly smaller percentage of sleep period time in the left lateral decubitus (left side sleeping) position than the right lateral decubitus position.

Recently, some studies have been conducted on 58 healthy individuals to check their heart rate and the effect of left lateral decubitus position. It was found that the heart rate was significantly lower in the left lateral position than in the supine position. The reduction in heart rate in the left lateral decubitus position is because of anatomical changes, especially in the shape of the inferior vena cava.

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Pramod Kerkar

Written, Edited or Reviewed By:

, MD,FFARCSI

Pain Assist Inc.

Last Modified On: June 13, 2018

This article does not provide medical advice. See disclaimer

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