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5 Sleep Mistakes After Hip Replacement (Surgeon Explains)

Bone Doctor

89,545 views

"When can I sleep on my side?" #hipreplacement

That question comes up before surgery more than almost any other, and the answer surprises people. After an anterior hip replacement, it is whenever it is comfortable. Not week six. Not after a checkpoint.

The anatomy explains it. Anterior means front, so the incision sits over the front of the hip, roughly where a front pocket would be. Nothing on the side, nothing behind. Roll over at two in the morning and you are not lying on your incision. Back, side, stomach, curled up: all fine. The one standing precaution is avoiding extremes of motion. #hipreplacementrecovery

What strikes me is how durable the retired protocols have proven. Patients still arrive carrying wedge pillows and flat-on-your-back rules nobody in the room prescribed. I do not mandate a pillow between the knees. It is a comfort tool, not a precaution.

The posterior approach deserves a note, because the name misleads. The hip is entered from behind, but the incision sits largely on the lateral hip, so that side can stay genuinely sore for a couple of weeks. Comfort remains the gauge, whatever the approach.

Three mistakes I see repeatedly:

Expecting sleep to be free because it is "just a hip." Healing tissue keeps the body revved, sometimes with a slight temperature rise. Sleeping poorly at two weeks is usually the process, not a complication. Most of my hip patients are comfortable by three to four weeks.

Using a narcotic as a sleeping pill. Opioids cut into deep, slow-wave sleep and push patients into lighter stages. A full night in bed that somehow does not count. Take pain medicine for pain.

Reaching for a prescription sleep aid. I do not prescribe them for postoperative sleep. Dependency develops quickly, and stacking a sleep aid on a narcotic is the combination that concerns me most.

Full discussion: https://corycalendinemd.com/blog/slee...

Which side did you end up sleeping on, and how long did it take you to get there?

Video chapters:
0:00 When can I sleep on my side?
0:27 Anterior approach: where your incision actually sits
1:24 Mistake 1: Following precautions that were never yours
2:12 Mistake 2: Forcing a position before your incision is ready
3:32 Mistake 3: Expecting sleep to be free because it is just a hip
5:08 Mistake 4: Using a narcotic as a sleeping pill
6:11 Mistake 5: Reaching for a prescription sleep aid
7:09 What to do instead
7:41 Recap: the five mistakes
8:19 Which side do you sleep on?

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𝗖𝗢𝗥𝗬 𝗖𝗔𝗟𝗘𝗡𝗗𝗜𝗡𝗘, 𝗠𝗗 | Orthopedic Surgeon · Franklin/Nashville, Tennessee

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About Dr. Cory Calendine, MD - 3000 Edward Curd Lane, Franklin, TN 37067
In the operating room, I get to perform more than 700 hip & knee replacement surgeries each year. From LIVE surgical demos to viral video highlights, together let's explore - react - discuss all things related to bone and joint health. #orthopedicsurgeon #jointreplacement

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Opinions expressed are solely my own and do not express the views or opinions of my employer. Information in this video is not intended or implied to be a substitute for professional medical advice, diagnosis and/or treatment. All content [images, digital graphics, text, and other information] contained in this video is for general information purposes only and does not replace or substitute for a consultation with a qualified physician or health professional.

20 Comments

@JewelryEnthusiast 3 weeks ago

62 years old. Had anterior hip replacement 8 days ago, still awaking every hour on the hour. Not in pain, just waking up. For years I have take n Trazadone before going to sleep but I was told I can not resume it yet. I tried Tylenol PM last night it didn't help. Good news is I slept in my bed for the first time last night and finally out of the lifting chair! Toady I am walking freely without my walker which in itself is amazing! Luckily I am retired and can take cat naps during the day to catch up on lost sleep. thanks for these awesome videos.

@cathyisgrigg1813 6 days ago

This is a great informative doctor that I would tell anyone having surgery to start watching before a surgery and continue watching the videos throughout

@violettaabramova46 1 month ago

I was so worried about sleeping positions post surgery 😅 but my recovery was dragging and I needed answers. I read Stop Feeding Disease by Mark Keller and realized inflammation from food was affecting my healing more than my sleeping position. After changing my eating I dropped 19lbs, my discomfort decreased and I could finally sleep peacefully. feels like recovery goes way beyond just following position rules))

@meme3239 3 weeks ago

At 70 having my hip replaced and the intense pain I feel is beyond horrible,sorry I waited so long.

@marcpost4034 8 hours ago

Rented an adjustable hospital bed after my THR. Being able to adjust head and leg angles during the course of the night made sleeping much easier and comfortable. Kept it for a month before returning it.

@waynematthew5093 8 days ago

I love how you explain stuff I would love to come see you for my hip

@vickie30 2 days ago

Im 2 weeks out from accident..broke my hip and arm..I am still in lots of pain..I knew I broke my body immediately..im hoping it gets better day by day

@darlenevm0821 1 day ago

Many thanks doctor for these videos. I had an anterior left hip replacement surgery last week. The first night was bad, but it has improved a lot. I sleep on the other side (right side) I haven’t tried yet. I have been sleeping face up. Love all your videos.

@DanielRocks_RocksWhatElse 1 month ago

Have hip replacement scheduled for November, videos like these are helpful, thanks..

@mariehodges6750 13 hours ago

I had full hip replacement on right hip, I’m arthritic in both hips so left one needs doing as well. I’ve found the healing process really challenging but manageable , lack of sleep started to come back on week 4 to 5 and some weight-bearing on right leg aided with crutches. I can now turn carefully with knees together to side sleep on my left not my operation side, but I do use a narrow pillow between my knees , but caution ,, listen to your body, if I wake up and it feels sore around my operated right hip , I turn back onto my back to continue sleeping,,,, don’t force it , I only use side sleeping to help me fall asleep. Hope this helps .

@priscillabalderas2916 1 month ago

This helped a lot thank you

@DavePuckett 1 month ago

Since you mentioned "Don't follow rules that were never yours" I keep hearing about this don't bend at the hip past 90 degrees. I have a portable comode so I know I'll initially sit correctly at 90 but during the course of wiping and standing up I do bend over a little to help give myself (my non operative leg) some leverage to stand up strong. I'm sure it's past 90 but I don't want to be scared to death to dislocate my hip either. My surgery is coming up in 4 days. Oh, and I am having the "Anterior" approach. I still workout at the gym 4 days a week and finish my workout with stationery bike 6 and a quarter miles in 28 mins. I just want to be in the best shape I can for surgery.

@hiesl3594 1 month ago

Very informative; thanks for sharing

@jamiea1939 3 weeks ago

I slept on my surgery side first night. Obviously, not all night but because incision was anterior it was comfortable enough to do that. One thing I found weird and this video helped was I can no longer sleep with a pillow between my legs like have I done for decades. It’s extremely painful now. But, sleeping is so much better than before.

@SMJacobus 1 month ago

First couple of nights I slept on my back, then was able to sleep on non surgical side. By day 10 - 12 started sleeping on both sides comfortably. Great info from this surgeon!

@krissieben1947 1 month ago

3 weeks post op, slept lateral on incision side (posterior approach)

@SusanMiller-o5o 6 days ago

I had my right hip replaced August 2024 with an anterior lateral approach. The manipulation of the muscles and mostly the nerves during surgery greatly pissed off the restless leg syndrome I have. I usually get relief for awhile from twitching by lying on the twitching limb. That was a problem with a new incision. I had to double the gabapentin, for the RLS not pain, so the twitching would stop and I could sleep. Was mostly on my back which was another problem. Lying on my left side only worked with pillows that were difficult to place. Finally was able to sleep on My stomach which was wonderful.

@marvinshenk 1 month ago

I need both hips replaced. Life is constant pain. I'm trying to get hip replacement surgery, but they make you quit smoking 3 months before the surgery. I am smoke free for 5 days. I still have to wait 3 or 4 months for the surgery though.

@laurawilliams5363 1 month ago

I feel on the 15 of July, I fx the neck of my L femur along w/ fractures upper and lower of the pelvis on the L side., The ortho surgeon did an excellent job, anterior approach to a total hip for me. I was d/c from hosp to rehab center early am on the 18th of July. I came home on the 11th of Aug, I had zero pain w/ the total hip, This is the 1st time I have ever fallen as an adult and hurt myself. I am 71, I only had to use a walker for 4-5 days and then I was walking around w/ no devices to help me. I was dx w/ SSc in 2017 and this injury has put me in a flare and it is crazy how much my joints and large muscles hurt during the day, and through the night. I went into palliative care this April as my GI system is shutting down. I slept very well until the flare started. I slept on my left side as well as my right side. I haven't needed a pillow between my knees. I went to school in my early 40's and became a licensed massage practitioner. I worked in the med field in direct pt care in the 70's & 80's, then I enjoyed being the prac admin for a very busy OB/GYN clinic. So I have done a lot of lymph massage along w/ effleurage for self care.

@mrredMavicair 4 weeks ago

Thank you so much for giving people you're experience and advice , I'm going to have mine done in October and have been worried about sleeping because I sleep on my side . Again thank you very much 🙏