I once told a doctor that I place my hands and arms over my head when I get into bed for the night. He explained that wasn’t a good idea. According to his thoughts, raising the arms above the head changes the body alignment in such a way as to impede respiration because the airway would be narrowed, which would decrease breathing and increase the amount of carbon dioxide. On the one hand, it seemed a reasonable warning. But think about it and unpack the advice into smaller pieces.
First, reduced respiration is rarely a major health concern. Many of us commonly engage in activities that reduce airflow – blowing up a balloon or swimming underwater, for example. Unless a person is forced to maintain a restricted airflow they will automatically adjust the position and activities to increase respiration, thereby increasing oxygen intake and allowing more CO2 to be exhaled – balance is achieved.
Many sleeping, even babies, occasionally hold their breaths. Even if they are capable of holding it to the point of passing out, normal breathing spontaneously resumes again as soon as consciousness is lost. The automatic systems in everyone do a great job protecting us from unintentionally forgetting to breathe.
Consider the harm that could occur if respiration is reduced to the point where CO2 levels actually increase too much (hypercarbia). Some reported symptoms associated related to higher than normal CO2 levels (caused by reduced respiration) are fatigue, becoming tired easily, confusion, shortness of breath, sluggishness, and sleepiness. Aren’t those symptoms actual goals of a person who has difficulty sleeping?
Here’s a simple experiment to perform to establish the effects of going to sleep with hands and arms above the head. Go to bed, pull up the covers, and place your hands under your head. Sleep happens and the experimenter eventually wakes up, but usually not in the same hands-up position that was started. Presumably, the sleeping body shifted when there was a demand for more O2 and a reduction in excess levels of CO2. No harm and nobody died.
The doctor at the opening of this tale was undoubtedly relating information he learned and believed while becoming a doctor, and didn’t think too strenuously about it. The tidbit was stored in his memory banks as a fact and something worth sharing with his patients. There’s little to no evidence that modest increases in carbon dioxide will do any harm, especially when it’s the result of going to sleep with one’s arms under the head, or in a hands-up position. There is no need to fear that sleeping in this fashion can cause asphyxiation. Sleepiness? Maybe. Not asphyxiation.
It’s possible, then, that intentionally raising arms above the head when getting into bed for the night will help induce sleep. In a world where solutions to sleeplessness often include addictive drugs, might altering position in bed be a safer alternative?
Larry Frieders is a pharmacist in Aurora who had a book published, The Undruggist: Book One, A Tale of Modern Apothecary and Wellness. He can be reached at thecompounder.com/ask-larry or www.facebook.com/thecompounder.