PSP Association

Any advice on sleeping flat or at an angle please

Mum is just recovering from her first bad bout of pneumonia. In hospital we were told that she should sleep with the bed head at a slight angle but now she is home, dad insists she should be flat because she will be more comfortable. Mum has a hospital bed and when she is flat, seems to cough more which does eventually ease. When at an angle, she slips down the bed and almost 'crumples' up. This then causes her some distress. Can anyone suggest anything please?

11 Replies

I had an adjustable bed for my dad - he hated having his head raised because he slept on his side but with an adjustable bed I could raise the feet as well to relieve some pressure. The adjustable bed was wonderful - -we could even raise it up so he could sit up in bed to eat when we needed it. We also had one with massage -seemed to help break up the fluid in his chest as well and felt good. I'd say get one of them or use lots of pillows between the legs and/or by her bum to help with slipping. Her head doesn't have to be raised much but it will help aid her with aspiration.


Mum always preferred to lie flat on her side, when she was able to make that decision, and I always felt relieved when I saw evience of saliva on her pillow as I thought that, at least, would not aspirate silently.

Unconscious patients are always recovered flat on their sides to prevent aspiration, and I feel as a matter of common sense that this is the better way to lie. Gravity in an upright position will encourage any fluid to travel downwards, this will aid aspiration.

when my mother recently aspirated some food in hospital I wanted to lie her head down on her side and tap her back and apply suction to help her retrieve the aspirate. The staff wanted to sit her as upright as they could and thump her on the back. Mum was very ill for a few days, we nearly lost her, but she has made a full recovery though is now much weaker. This question is a very crucial one, and requires a definate and unconflicting response from an expert.


Hi Swifty,

Sorry to hear your Mum has been poorly. I would suggest you try "playing" with the angle of the bed. She doesn't need to "sitting up", an angle of 30 degrees (i.e as if she had 2 or 3 pllows) should be enough to stop her coughing but not so much that she slides down the bed. It is quite important that you try to find a position that minimises the coughing as the probable cause is that her own saliva is going into her lungs rather than her swallowing it as she would normally have done.

Contact your OT/Physio to see if they have any useful suggestions. Or speak to the PSP specialist nurse for you area (contact details available from I've always found them very helpful

Good luck

Kathy x


Hi Swifty - Lots of advice here -- I encourage you to read all you can on PSP -everything I have read has suggested that it is much better to have the patients sleep slightly elevated then flat.


Thank you dllera, barbren and Kathy for your advice. We have asked various nurses and professionals but had not been given a definitive answer. It's interesting that sleeping on the side seems to be a choice and we may well try this. Once again, thank you. x


We've found over time, trial and error that allowing my husband to lie with his head slightly raised is the best for him. We learned eventually to raise the bottom of the bed first and then the head. In that way he doesn't slip down the bed so much. But after a lifetime of sleeping on his stomah he must now sleeep on his back. He always says he is comfortable but can no longer adjust his position or 'get comfy' himself.

Take care SheilaN


Thank you SheilaN. It seems that everyone is doing pretty much the same thing so it must be working. I am so glad that this forum is here - just a shame that PSP is around though. x


I am having the same problem with my husband . He also has a profile /hosppital bed .which has been a huge help .

He is a short man and is even shorter since the Parkinsons . . I can now lower the bed which maked it easier for him to get on and off , the raise it when I need to tend him .

Our trouble is finding the best part of the bed to sit on with slipping further down the bed when raising the head . He can only manage to sleep on his back . Because he is then in a sitting position this puts more stress on his bottom and causing pressure sore . A tip for that ( I place a piece of slidey material under his bottom so that when he shuffles along the bed he doesnt rub his bottom . I then turn him and remove the piece of sheet ) I also do the same thing when he gets in and out of the car . If not going far you can leave iit in place so that it also helps when getting out of the car

To go back to where I started lol he usually ends up wth his feet touching the end oof the bed where he slips down .

Can you get beds where the head rises more gradually don't quite know how to explain what I mean ..

More of a rolling rise !! Any other tips gratefully received



How does the suction work ,please ?

Can it be done at home . My husband gurgles most of the night which worries me .

I am pretty hands on and want to help him as much as I possible can myself


Buy one pair of 5 inch risers and one pair of 3 inch risers. It gives a 2 inch lift. Support the center bed frame support with some books. Buy from this company because they sell best price and best quality.


Personally I used to get sick all the time. I have nasal flow restrictions. I lifted my bed 2 years ago and I haven't gotten sick since. I also eat really good and am in excellent shape. This was just a piece of my puzzle. it might help others as well. :)


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