And I thought sleeping at an angle was just for the sick

Turns out we used to do it all the time!

For most of human history, people commonly slept in a semi-upright position, often propped up on pillows or in short beds, as this posture aided breathing, provided protection from environmental hazards, and signaled social status. Additionally, segmented sleep patterns with wakeful intervals and communal, watchful rest characterized ancient sleep habits, contrasting sharply with today’s uninterrupted, flat sleep enabled by modern technology and safer living conditions.

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For most of human history, sleeping flat on one’s back was not the norm. Instead, people often slept propped up, reclined against pillows or bolsters, or even wedged into short beds that were too small for lying flat. Historical evidence from medieval European homes shows beds were short not because people were smaller but because they slept in a semi-upright position. This position was not just a quirk of a few centuries or cultures—it was widespread and persisted for centuries, especially in wealthy households where beds were designed specifically with elevated headrests and cushions.

There are several reasons why people historically chose to sleep sitting up. One practical reason is related to health: sleeping elevated helped with breathing and reduced the risk of fatal respiratory diseases common before modern medicine. Environmental factors also played a role, such as keeping off cold, damp floors and avoiding smoky areas near open hearths, since chimneys were a later invention. Social status and power further influenced sleeping positions; in European courts, reclining in a grand, pillow-stacked bed was a display of dignity and authority, while lying flat was associated with death or poverty.

Sleeping upright was not exclusive to Europe. Around the world, many cultures adopted similar semi-reclined positions for sleep, including enclosed box beds in rural France and wooden or stone headrests in ancient Egypt and parts of Africa and the Pacific. These varied sleeping arrangements often served multiple purposes: warmth, protection from drafts and animals, preserving hairstyles, cooling airflow, and maintaining alertness. Thus, the flat sprawl we assume as the universal sleeping posture is actually one of many cultural and historical possibilities.

Historical research also reveals that pre-industrial humans practiced segmented sleep—splitting their night into two distinct sleep periods with a calm wakeful interval in between. This pattern, lost with the advent of artificial lighting, was confirmed by scientific experiments showing that in conditions mimicking natural darkness, modern humans’ sleep cycles revert to this biphasic rhythm. Alongside sleeping position and timing, ancient humans prioritized safety due to constant night dangers, sleeping lightly, communally, and in positions that allowed rapid awakening to threats, unlike the deep, flat sleep common today.

Ultimately, the flat, uninterrupted eight-hour sleep in a secure, enclosed environment is a recent human development enabled by technological advances like strong locks, thick walls, and artificial light. For the vast majority of human existence, sleep was a watchful, upright, shared state dictated by survival needs. Modern sleeping habits may feel natural, but they represent a radical break from evolutionary history—made possible only by the invention that reshaped the very nature of darkness and safety in our lives.

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That is very interesting James.

When I came home from open heart surgery, I was told not to sleep on my side until the sternum had healed. It took about three months before it sufficiently healed that I could lay on my side. Attempts to lay on my side before then resulted in sharp pain from my sternum.

Sleeping on my back was not a simple solution. I’ve been on a CPAP for Sleep Apnea since 1995. My heart surgery was in 2004, so I was very dependent on the machine and CPAP and sleeping on my side. Attempting to sleep on my back resulted in my airway sealing off and being unable to breathe as I started to drop off to sleep.

My sleep doctor recommended sleeping on a wedge, propping the upper part of my body up from the waist up.

I collected every unused pillow from beds around the house and built a huge wedge on the bed. At bedtime I lay back on the wedge with my CPAP on, and I could not recall the last time I was that comfortable. My breathing was easy and without labor.

I used the wedge for several months, far past the time it took my sternum to heal. I can’t recall when I stopped using the wedge and I can’t remember why.

After reading James’s “history of sleeping on the incline” I am seriously thinking about finding a way to go back to the wedge. It really was comfortable.

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That’s rough. Glad you passed the point where that was necessary. You’ve really been through the wars, Eric! My friend had heart surgery on a valve (only in his 50s) but he was able to have the entire work done via his arm pit. When staying with him one summer he had his shirt off and I was surprised how small his scars were. Your surgery must have been much more difficult to recover from! :hugs:

I have “wedge-like” experience because there was a long period where if I was not sleeping at an angle I would have got vertigo and would have woken up or been unable to go to sleep.

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It is ironic that they can replace a heart valve with a much less invasive procedure than doing an arterial bypass. I had three bypasses. And they made an incision from below my throat to just above my diaphragm, and another scar on my left arm from my elbow to my wrist.

My mother-in-law had a valve replaced by using a catheter to go through the femoral artery in her leg. She ended up with a 1/2” scar on her inner thigh.

Technology improves daily, but it isn’t going to improve fast enough for me.