Sleep can be difficult after hip replacement surgery. Your usual sleeping position may no longer feel comfortable, getting in and out of bed can take more effort, and pain or swelling may make it harder to settle at night.
If you are wondering how to sleep after hip replacement, the most important thing to remember is that there is not one sleeping position or timeframe that applies to everyone.
Your surgeon or physiotherapist may give you specific instructions based on your operation, recovery and any hip precautions you have been given. Following those instructions should take priority over general advice you find online.
For many people, sleeping on the back is the easiest position during the early stages of recovery. Pillows can also provide support and help you avoid unwanted twisting or crossing of the legs.
Why is sleeping difficult after hip replacement?
It is common for sleep to be disrupted during the first few weeks after hip replacement.
Your hip may feel sore, swollen or stiff, particularly when you change position. You may also be adjusting to sleeping differently from how you did before surgery.
Getting into bed and getting back out can feel awkward initially, especially if you are still using crutches or a walking frame.
The NHS explains that recovery from hip replacement can take several months. Pain and swelling are common during the early stages and should generally improve as you recover.
Interrupted sleep does not necessarily mean something is wrong with your replacement. However, severe or worsening pain, increasing swelling, redness, warmth around the wound or feeling generally unwell should be discussed with your healthcare team.
What is the best position to sleep after hip replacement?
For many people, sleeping on your back is a comfortable option during the early part of recovery.
You can place a pillow between your legs if this is recommended by your healthcare team. This can help you maintain a comfortable position and reduce the temptation to cross your legs while asleep.
However, there is no single NHS rule that says every hip replacement patient must sleep on their back for exactly the same number of weeks.
This is because advice can differ according to the type of operation, the surgical approach and whether you have been given specific hip precautions.
For example, one NHS hospital advises patients following hip precautions to sleep on their back for the first two weeks with a pillow between their legs, while another NHS orthopaedic service advises remaining on the back for the first month.
Other NHS guidance states that some patients may sleep on either side if it is comfortable, with a pillow between the legs potentially making side sleeping more comfortable.
This variation is why your own surgical team’s instructions should take priority.
Can I sleep on my side after hip replacement?
Possibly, but when you can sleep on your side after hip replacement depends on your individual surgery and your clinical team’s advice.
Some NHS guidance allows side sleeping when it is comfortable. Other guidance recommends avoiding certain side positions for a specified period when hip precautions apply.
For example, the Royal National Orthopaedic Hospital advises patients following specific hip precautions to remain on their back for the first month and then says they may sleep on the operated side if it is no longer too tender.
Cambridge University Hospitals provides different advice for patients following its particular hip-replacement pathway, recommending sleeping on the back initially and allowing operated-side sleeping after two weeks.
This means you should not use a general timeframe from another hospital as permission to change your sleeping position.
If your consultant has specifically told you to avoid sleeping on your side, follow that advice even if another NHS source gives different guidance.
Can I sleep on the operated side?
Some patients can eventually sleep on the operated side once it is comfortable and their clinical team has confirmed that it is appropriate.
You may find the operated side is initially too tender to lie on. The wound and surrounding tissues may also feel sensitive.
If your healthcare team has allowed you to sleep on the operated side, move into the position carefully and avoid forcing the hip into an uncomfortable angle.
Some NHS guidance allows patients to sleep on the operated side once it is comfortable, while other guidance gives a specific period before doing so.
Your own postoperative instructions are therefore more important than a general timeframe.
Can I sleep on the non-operated side?
Sleeping on the non-operated side may be comfortable for some people, but this is another area where advice varies.
Some NHS guidance recommends using a pillow between the legs when lying on the non-operated side to support the operated hip.
However, if you have been given hip precautions, you may have been specifically instructed to avoid the non-operated side for a period after surgery.
The Royal National Orthopaedic Hospital notes that, for patients following particular hip precautions, sleeping on the non-operated side can increase the risk of the legs crossing and therefore advises against it during the specified precautionary period.
If you have been given hip precautions, follow them carefully.
How can a pillow help when sleeping after hip surgery?
A pillow can be useful for positioning and comfort.
Depending on the instructions you have been given, you may find it helpful to place a pillow:
- Between your legs when sleeping on your side
- Between your knees to help keep your legs separated
- Alongside your operated leg for additional support
- Behind your back if this helps you remain in a comfortable position
The exact arrangement should reflect your surgical team’s advice.
If you have been told not to cross your legs, a pillow between your legs may help you maintain that position while sleeping.
Do not use pillows to force your hip into a particular position. Your hip should remain comfortable and within the movement restrictions you have been given.
How do I get into bed after hip replacement?
Getting into bed can feel more difficult immediately after surgery, particularly if your mobility is limited.
Your physiotherapist or occupational therapist should show you how to get in and out of bed safely before you leave hospital.
A general approach may involve:
- Stand close to the bed with your walking aid.
- Keep the operated leg in the position advised by your healthcare team.
- Sit down carefully on the edge of the bed.
- Move your body backwards onto the mattress.
- Lift your legs onto the bed without twisting the operated hip.
- Adjust your position once you are safely lying down.
The NHS advises avoiding certain movements during early hip recovery, including crossing your legs and bending the hip beyond 90 degrees.
However, your own physiotherapist should demonstrate the safest technique for you.
How do I get out of bed after hip replacement?
Getting out of bed requires the same care.
Before standing:
- Move towards the edge of the bed as instructed
- Keep your operated leg in the recommended position
- Avoid twisting
- Place both feet securely before standing
- Use your arms and walking aid as you have been shown
- Take your time
Do not try to stand quickly if you feel dizzy or unsteady.
If you are using a walking frame or crutches, keep them within easy reach rather than trying to walk without support before you are ready.
How high should my bed be after hip replacement?
A bed that is too low can make getting in and out more difficult.
If you have been given hip precautions, your occupational therapist may advise you about the appropriate bed height.
The Royal National Orthopaedic Hospital recommends considering bed height after hip replacement and notes that an additional mattress may be used to raise the bed if necessary.
Avoid making changes without considering whether they could create a trip or fall risk.
The aim is to make getting into and out of bed easier while maintaining the movement restrictions given to you.
What if I cannot get comfortable at night?
It is normal for your usual sleeping routine to change after surgery.
You could try:
Keep your bedroom comfortable
Make sure you have enough space around the bed to use your walking aid safely.
Keep essential items such as water, your phone and any medication you have been instructed to take within easy reach.
Use your prescribed pain relief correctly
Pain can make it harder to sleep. Take medicines exactly as prescribed by your healthcare team.
Do not take additional medication simply because you are struggling to sleep without checking whether it is appropriate for you.
Change position carefully
If your clinical team has given you permission to change sleeping positions, move slowly and avoid sudden twisting movements.
Take short periods of rest during the day
You may feel more tired than usual following surgery. The NHS notes that tiredness and changes to normal activity are part of recovery, which can take several months.
Try to balance rest with the walking and exercises recommended by your physiotherapist.
Avoid spending the entire day in bed
Your rehabilitation plan is important. Gentle movement and your prescribed exercises can support your recovery.
The NHS recommends regular walking and following the exercises recommended by your physiotherapist during recovery from hip replacement.
Should I sleep in a recliner after hip replacement?
Some people find a recliner more comfortable during the early stages of recovery, particularly if getting into a bed is difficult.
However, you should make sure you can get in and out of the chair safely.
The NHS advises sitting in a reclining position during hip replacement recovery while also recommending avoiding prolonged periods of sitting still.
A recliner should not replace the advice you have received about your hip precautions.
If you are considering sleeping in a recliner regularly, ask your physiotherapist or occupational therapist whether it is suitable for you.
What sleeping positions should I avoid after hip surgery?
The positions you need to avoid depend on whether you have been given specific hip precautions.
Some patients are advised to avoid:
- Crossing their legs
- Bringing the knee towards the chest beyond the recommended range
- Bending the hip beyond 90 degrees
- Twisting the operated leg
- Sleeping in a position that allows the operated leg to cross the body’s midline
The NHS advises patients recovering from hip replacement not to cross their legs or bend the hip beyond 90 degrees during the early recovery period.
However, not every patient will receive exactly the same restrictions. Your surgeon should tell you which precautions apply to you.
What if I turn over while asleep?
You may naturally move during sleep.
If you have been given specific precautions, using pillows as recommended can help you maintain a safer sleeping position. However, you should not panic if you wake up having moved.
If you experience sudden severe pain, a new inability to put weight through the leg, a significant change in the position or appearance of the leg, or another concerning symptom, seek medical advice promptly.
If you are worried about something that happened while you were asleep, contact your surgical team for advice.
When should I contact my healthcare team?
Some discomfort is expected during recovery, but certain symptoms should not simply be attributed to sleeping in the wrong position.
Contact your healthcare team if you develop:
- Increasing or severe pain
- Increasing redness or warmth around the wound
- Worsening swelling
- Fluid or discharge from the wound
- Fever or feeling generally unwell
- New difficulty walking or putting weight through the leg
- A sudden change in the position or movement of your hip
Seek urgent medical attention if you develop symptoms that could indicate a serious complication, such as sudden chest pain, difficulty breathing or significant swelling and pain in the leg.
If you are unsure whether a symptom is part of normal recovery, it is better to ask your healthcare team rather than trying to diagnose the problem yourself.
Does private treatment change your recovery?
Choosing private or NHS treatment does not mean that the basic principles of recovery are automatically different. Your recovery will depend on factors such as your operation, general health, rehabilitation and how your body responds to surgery.
If you are considering private treatment, our guide to Private vs NHS Hip Replacement explains some of the practical differences between the two routes, including appointment flexibility, treatment pathways and aftercare.
If you are also considering knee replacement, you can read about Private vs NHS Knee Replacement to understand some of the differences between private and NHS treatment.
Where can I have private hip replacement surgery?
Transform Medical provides access to private orthopaedic care through a network of locations across the UK. The available hospital and consultant will depend on your treatment needs and the location you choose.
You can explore our Transform Medical locations to find information about hospitals and services in different areas.
Current location information includes centres serving areas such as Manchester, London, St Helens, Huddersfield, Darlington, Bath, Newcastle, Droitwich Spa, Basingstoke, Birmingham, Winchester and Rochdale.
For example, Transform Manchester provides private orthopaedic care for patients with hip and knee conditions, while Transform Medical London provides consultation and access to the wider Transform hospital network.
You can use the locations page to explore the services available in your area.
Download the recovery brochure
Knowing what to expect after hip replacement can make it easier to prepare for the practical aspects of recovery, including mobility, sleeping and returning to everyday activities.
Download our recovery brochure for further information about preparing for hip or knee replacement and the recovery process.
We provide a brochure request facility for patients looking for information about hip and knee surgery.
Your recovery will be individual, so use the brochure alongside the advice provided by your own consultant, physiotherapist and clinical team.
Final thoughts
Knowing how to sleep after hip replacement can make the early stages of recovery feel more manageable, but there is no single sleeping position or timeframe that is right for everyone.
Sleeping on your back may be comfortable initially, while some patients can return to side sleeping once their clinical team considers it appropriate. A pillow between the legs may provide additional support for some people.
Most importantly, follow the specific instructions given to you after your operation. If you have hip precautions, these should take priority over general advice.
Sleep may be disrupted for a while after surgery, but this often improves as pain, swelling and mobility improve. Give yourself time to recover and ask your healthcare team if you are unsure about any aspect of your sleeping position or recovery.