Inclined Bed Therapy

How tree sap circulation inspired inclined bed therapy

Fletcher explains his circulation theory: evaporation concentrates sap at the top of trees, and gravity pulls the denser fluid downward, creating a return flow without a pump. He demonstrated this with tubing raised 24 meters up a cliff, defying the 10-meter limit predicted by physics.

"if you evaporate 98% of the water from the leaf, you must concentrate whatever's left behind by 98%. Now, because the leaves produce sugars from photosynthesis, converting carbon dioxide into energy, then that loss of moisture gives us a concentrated sap at the top of the tree."

Measurable heart rate and respiration improvements on inclined bed

Fletcher reports that sleeping on an incline reduces heart rate by 10-12 beats per minute and respiration rate by 4-5 breaths per minute compared to flat sleeping, while actually increasing circulation. He shares a hospital anecdote where tilting his son's recovery bed produced these exact predicted changes.

"The heart rate decreases by 10 to 12 beats per minute on an incline compared to sleeping flat. Respiration rate decreases by 4 to 5 breaths per minute on an incline. So the heart rate is 10 to 12 beats per minute, respiration 4 to 5 breaths per minute less on an incline, yet your circulation increases."

Varicose veins reversed by tilting the bed

Fletcher explains how flat sleeping pressurizes veins, causing varicose veins and edema. Tilting the bed reduces venous pressure, allowing veins to flatten and tissue fluid to return to circulation. His wife's varicose vein went flat in four weeks.

"So if you increase the pressure by sleeping on a flat bed, you cause the veins to bulge and this leads to varicose veins, but also causes the water inside the veins to seep through the vein walls and that leads to edema because the pressure on the inside of the vein is greater than the pressure on the outside of the vein."

Host's firsthand experience with inclined bed therapy

The host shares his personal results after six months of sleeping on an inclined bed. He reports dramatically improved sleep quality within a week, eliminated testicular varicose veins confirmed by medical check, reduced morning grogginess, and improved mood noticed by people around him.

"that has dramatically improved from, and I'm not joking, from a week in, dramatic improvement there. You mentioned varicose veins and varicose veins can be quite common in the testicular area. I'm someone who suffered from that for, I mean, it hasn't been a big deal, but I've suffered from it on and off for the bones of 15 years."

Ancient beds were inclined and the setup costs almost nothing

Fletcher describes historical evidence including inclined beds from Egyptian tombs, Constantinople hospitals, and tuberculosis sanitariums. He explains the setup is nearly free: house bricks, books, PVC pipe, or bed risers from eBay for about ten pounds. No special bed purchase is needed.

"If we look at the beds that they pulled out of the ancient Egyptian tombs, some of them buried for 4,000, 5,000 years, they're inclined."

Sleeping on an inclined bed for glymphatic flow

Asprey describes his inclined bed setup and the theory that slight head elevation improves cerebrospinal fluid flow during sleep. The guest discusses the gravitational effects on acid reflux and glymphatic drainage during sleep.

"So, what are the pros and cons of sleeping on a flat bed versus a slightly inclined bed?"

Inclined sleeping reduces snoring and improves deep sleep

A 2022 study found that sleeping at a 12-degree incline reduced snoring by 7%, decreased nighttime awakenings by 4%, and increased deep sleep by 5% across roughly a thousand nights of data.

"So this was a paper that was published in 2022 and the title of it was "Sleeping in an Inclined Position to Reduce Snoring and Improve Sleep." It was a relatively small study, but what was nice about it was that it was the same participants, where they did four weeks flat and then four weeks at a 12 degree incline."

Head elevation significantly reduces sleep apnea severity

Multiple studies show 7.5-degree head-of-bed elevation reduces the apnea-hypopnea index from 15.7 to 10.7, improves oxygen saturation from 83.5% to 87%, and enhances sleep efficiency. A 30-degree study also showed statistically significant reductions in apneas, hypopneas, and snoring.

"the AHI, which you may recall is the apnea hypopnea index, and it simply tells us about how many times per hour someone stops breathing or almost stops breathing with desaturation, and it went from 15.7 down to 10.7. That was statistically significant."

Head elevation reduces GERD symptoms with no quality-of-life trade-off

A randomized crossover study found that elevating the head of the bed by 20 cm (8 inches) produced statistically significant GERD symptom reduction. A systematic review of 37 articles recommends 8-11 inches of elevation. Importantly, quality of life was not reduced by sleeping inclined.

"if you regularly experience heartburn while trying to sleep, place wood or cement blocks under the feet at the head of your bed. Raise the head by six to nine inches. If you can't elevate your bed, you can insert a wedge between your mattress and the box spring to elevate your body from the waist up."

Elevated sleeping lowers eye pressure in glaucoma patients

Studies show that sleeping in a 30-degree head-up position reduces intraocular pressure by 20% or more in 35% of glaucoma patients. A second study with 24 patients confirmed the finding and recommended patients consider sleeping with 30 degrees of head elevation.

"there was a statistically significant difference between sitting up and laying down, and specifically, there was a reduction in the intraocular pressure of 20% or more in 35% of the patients, 6 out of 17."

Safety warning for infant inclined sleepers

While inclined sleeping is low-risk for adults, inclined sleeper products for infants have been linked to fatalities and product recalls. Babies should always sleep flat on their back on a firm surface with no loose bedding.

"Inclined sleepers and soft nursing pillows and other baby products can actually cause death in some of these neonates."