VIDEO: Sleeping on Your Back with Paralysis

Clinical Expertise

May 30, 2021

Medical Reviewer: Amy Jo Rohe, MSOT, OTR/L, CBIS
Last Updated: June 18, 2021

Video Transcript

Hi, my name is Amy Jo Roche and I’m an occupational therapist at Brooks Rehabilitation and an outpatient clinic at Mandarin. And I specialize in neurologic rehabilitation.

Paralysis in the arm, also known as hemiparesis is a common effect of a stroke or brain injury. In this series, I’m going to share strategies and important information about managing an arm that has been affected by a stroke or brain injury.

Sleep is important for your recovery after a stroke or brain injury. Today, I’m going to show you some sleeping positions that help support the weaker side of your body if you have paralysis after a stroke or brain injury.

When laying on your back, you will want to have your arm with paralysis supported on a pillow. Ideally, you will want to have your arm positioned out to the side and away from your body with your palm facing up towards the ceiling if possible.

Since we spend a lot of time with our arms right next to our bodies during the day, especially if that arm is not moving very well, it places many of our muscles in a shortened position and puts those muscles at risk of contractures or getting stuck in those positions. Positioning your arm like I’ve showed you gives those muscles an opportunity to lengthen, to help prevent contractures.

Also, when laying on your back, place a pillow under your knees and calves. Keep an eye out for your knees or ankles deviating either inwardly or outwardly. You may need to add additional pillows to help keep your knees and ankles in midline.

You want to have enough pillows under your calves to help keep your heels off of the bed, especially if you can not move your legs very well. Heels are a common place for bedsores, also known as pressure injuries to develop. So using this technique helps prevent your heels from pressing into the mattress and developing pressure injuries.

If you are unable to roll yourself into different positions on your own, and you’re spending a lot of time in bed, it is important that someone periodically helps you reposition yourself in order to avoid pressure injuries.

A general recommendation is to be repositioned every two hours. However, your health care team may recommend that you do so more frequently. Be sure to follow the guidelines provided to you by your team. Remember, these are general recommendations.

Everyone is unique.

So talk to your physical or occupational therapist about how you may need to modify your sleeping position for your greatest comfort and safety. In some cases, splints or braces may be necessary to help maintain the proper alignment of your joints.

Your physical or occupational therapist can help determine if these are necessary.

For more healthy living tips, visit our YouTube Playlist.

Medical Reviewer

Amy Jo Rohe, MSOT, OTR/L, CBIS

Occupational Therapist