Sleeping at a 45-90 degree angle

[Ralph kaka]

Hi everyone! I am 2 days post op and a few questions. I am trying to sleep at a 45 to 90 degree angle but a few questions. 

1.) How important is this?

2.) What is the purpose of this?

3.) Does this impact graft survival rate? if so how?

4.) If I am sleeping with 2 pillows behind my back and a neck pillow, but I am at a 30-45 degree angle, will the swelling still drain? It is hard to know exactly what position I am at as I can't see myself. But the two pillows are behind my back and my neck has the travel pillow.

5.) Does any1 have any pics of how their sleeping angle looked?

Thanks so much!

[HappyMan2021]

its actually very important to sleep at a 45-90 degree angle for at least the first few days. You legitimately and realistically run the risk of dislodging grafts if you are sleeping and inadvertently rub your heard into your mattress, pillows, etc. 

Just buy a travel pillow and you should be set. 

The best piece of advice I can offer in this matter is you are going to be sleep deprived the 1st week no matter what you do. Just accept it. 

[Ralph kaka]

2 minutes ago, HappyMan2021 said:

its actually very important to sleep at a 45-90 degree angle for at least the first few days. You legitimately and realistically run the risk of dislodging grafts if you are sleeping and inadvertently rub your heard into your mattress, pillows, etc. 

Just buy a travel pillow and you should be set. 

The best piece of advice I can offer in this matter is you are going to be sleep deprived the 1st week no matter what you do. Just accept it. 

Thanks! But what exactly does that mean though to sleep at a 45-90 degree angle-is it that my neck and head are elevated by pillows and above my back level? Or do I literally need to be in a recliner the whole time and not use my bed? @HappyMan2021

[Ralph kaka]

Btw @HappyMan2021 my grafted area is zone 1 and 2. the bed or headboard cannot touch it due to my sleep set up (2 pillows behind my upper back/neck, and a travel pillow). So without the risk of my zone 1 and 2 getting hit and dislodging grafts, do I need to worry about anything if my angle is not exactly 45 degrees?

I was more so wondering if the angle was important for fluid to drain and perhaps if the fluid doesn't drain efficiently, due to not sleeping at the right angle, it dislodges your grafts.

Can you help me understand? I am confused haha.

[HappyMan2021]

1 minute ago, Ralph kaka said:

Thanks! But what exactly does that mean though to sleep at a 45-90 degree angle-is it that my neck and head are elevated by pillows and above my back level? Or do I literally need to be in a recliner the whole time and not use my bed? @HappyMan2021

You don't literally need to sleep at an angle between 45-90 degrees, its moreso that like by default of protecting your scalp while you sleep, that happens to be the angle you sleep at. The essential thing is to not bump or scratch your scalp while you sleep. 

For example, I normally sleep on my side with 2 pillows propping my head up. Post-op, I will sleep on my back, use 1-2 pillows + the neck pillow (I may remove one of my standard pillows depending on the height the neck pillow adds)

Also keep in mind there are people on the forums who honestly and seriously will tell you you need to do something crazy like sleep in a chair for 2 weeks and handcuff your hands together, etc. Don't listen to these people they do not know what they are talking about. All you need is a neck pillow. 

Furthermore, after 3 days you can sleep normally. Since you are already at Day 2, seems like you only have 1 more uncomfortable and restless night ahead of you. 

[HappyMan2021]

1 minute ago, Ralph kaka said:

Btw @HappyMan2021 my grafted area is zone 1 and 2. the bed or headboard cannot touch it due to my sleep set up (2 pillows behind my upper back/neck, and a travel pillow). So without the risk of my zone 1 and 2 getting hit and dislodging grafts, do I need to worry about anything if my angle is not exactly 45 degrees?

I was more so wondering if the angle was important for fluid to drain and perhaps if the fluid doesn't drain efficiently, due to not sleeping at the right angle, it dislodges your grafts.

Can you help me understand? I am confused haha.

no worries! the specific angle itself does not matter. 

[Ralph kaka]

Thank you so much @HappyMan2021. So many instructions for post op but this helps me be a little less neurotic about it. Much appreciated 🙏🏻

[Ralph kaka]

btw @HappyMan2021 some other post op questions that you may know the answer to.

1.) What is the purpose of the constant day sprays of saline-is it just to keep the scalp moist? Or something deeper?

2.) Do the day sprays enhance graft survivability?

3.) I find it a bit hard to hit all 3000 grafts with the spray and have to over spray to get them all-if I don't get them all perfectly each time what are the consequences?

4.) My understanding was that the grafts are already implanted deeply into the scalp and can be dislodged now only by head trauma. Would the pressure from my spray bottle be strong enough to dislodge grafts? It is on mist setting, but I feel a little bit of pressure when it hits my grafted area.

5.) What is the biggest factor in graft rate survival, is it how often we do our day sprays, sleep at the perfect angle, take our prednisone, etc., or is it mostly the skill of the surgeon/technicians and then the after care is like the final 10-25% of the result?

Thank you so much for any help. I am doing the post op as perfect as I can but I don't understand the reasoning behind some of it and when I don't do something correct, like in question 3 like I mentioned, I worry I am dislodging my grafts and ruining them. Is that even possible without head trauma lol?

[HappyMan2021]

1) Yes to keep moist

2) No clue if it affects graft surviviability, but 100% it helps with your scalp recovery and will help with all the scabbing

3) I dont think there are any consequences really. The only real thing that can f up your surgery is dislodging grafts or getting a really bad sunburn. Everything else you are told to do is to help aide in the recovery, but wont make or break your surgerry

4) No the pressure will not be enough

5) 99% of a surgery success happens in the operating room. If your HT fails blame the doctor and tech team, not yourself lol. The only things that are your responsibility are to avoid dislodging grafts and avoid sunburns. 

[Jerome]

u really have to train yourself to sleep like that.especially if something in your body hurts where u have to move to get comfortable.

[Rawkerboi]

5 hours ago, HappyMan2021 said:

You don't literally need to sleep at an angle between 45-90 degrees, its moreso that like by default of protecting your scalp while you sleep, that happens to be the angle you sleep at. The essential thing is to not bump or scratch your scalp while you sleep. 

For example, I normally sleep on my side with 2 pillows propping my head up. Post-op, I will sleep on my back, use 1-2 pillows + the neck pillow (I may remove one of my standard pillows depending on the height the neck pillow adds)

Also keep in mind there are people on the forums who honestly and seriously will tell you you need to do something crazy like sleep in a chair for 2 weeks and handcuff your hands together, etc. Don't listen to these people they do not know what they are talking about. All you need is a neck pillow. 

Furthermore, after 3 days you can sleep normally. Since you are already at Day 2, seems like you only have 1 more uncomfortable and restless night ahead of you. 

People do crazy things like you mentioned, but their goal is to protect their newly hair transplanted grafts.

Some people do tend to scratch their head while they are in deep sleep so such crazy methods do help them.

It depends person to person but my advice is do your best to protect your grafts for at least seven days after your surgery

[Sunset Dune]

All you really need is a travel pillow and it will help support your head in the correct angle position. Some people like myself tend to make sudden jerks within deep sleep and I sometimes move my hands and touch my head so I considered tying my hands with a rope but decided against it later 

[Gatsby]

I slept with thousands of grafts in my scalp as well as in my donor scars twice. I was literally hanging my head off the edge of a bed so that the grafts would not come into contact with anything during my sleep. You just have to accept that sleep will be pretty crappy for the first 7-10 days. In the bigger scheme of things it's a small price to pay. All the best!

[TheGreatPretender]

4 hours ago, Gatsby said:

I slept with thousands of grafts in my scalp as well as in my donor scars twice. I was literally hanging my head off the edge of a bed so that the grafts would not come into contact with anything during my sleep. You just have to accept that sleep will be pretty crappy for the first 7-10 days. In the bigger scheme of things it's a small price to pay. All the best!

I am one of those dudes that uses to move a lot during sleep. That concerns me a little because I have tried to train myself to avoid moving while sleeping but it's near impossible. Maybe I will need some cuffs during those initial days. 

[Gatsby]

You can arrange the bed so you’re sitting up with a pillow or two under each arm, a pillow or two behind you and wear a neck pillow so that your head doesn’t rub the pillow behind you. It’s like a throne seated position sleeping upright. Again, compared to having hair for the rest of your life, it’s nothing when you look at it in that perspective. 👍

Edited April 30, 2023 by Gatsby

[Rahal Hair Transplant]

@Ralph kaka,

While it’s not 100% necessary, sleeping in an elevated position for the first couple days after hair transplant surgery can aid the healing process in a couple of ways. Firstly, it forces you to lay on your back, which means that you won’t have a tendency to roll over, and inadvertently lay on or cause friction to, or cause friction to  the newly transplanted grafts. Secondly, elevation helps to reduce additional blood flow to the scalp, which will prevent, or at least minimize the oozing of any blood from the wounds.

If you don’t sleep elevated, it’s not like it’s going to prevent your hair transplant from growing or healing properly, it’s just a best practice in how to facilitate the healing process in the best way possible.

Best wishes, 

Rahal Hair Transplant

[shadowcast]

You don't have to spray the grafts, it just helps with the scabbing.

You can sleep without any angle, I did this because I literally cannot fall asleep unless I am physically comfortable. Slept on my side/on my cheek through crown, mid scalp, hair line, and temple surgery. No issues. Probably made the swelling take a little longer to go down, but who cares? You're not going out in public during that time anyway. Only thing I'd highly recommend is to wear rubber gloves once you get to the stage where your donor starts to itch. I found myself taking swipes at my itchy areas in my sleep.

Edited April 30, 2023 by shadowcast

[Ralph kaka]

Thank you so much @shadowcast. Really appreciate it. 2 questions for you:

1.) I am staying at home for 7 days in a temperature controlled environment, ranging from 68-72 degree F depending on how I feel. Today I sweat a little for like half an hour before I turned the AC on. Then I did my day spray. Could sweat like this hurt the grafts?

2.) Also, what are the risks with flying? My flight is on day 8 post op-could it somehow dry out the grafts and lose them? Should I perhaps stay where I am longer?

Ty!

[shadowcast]

34 minutes ago, Ralph kaka said:

Thank you so much @shadowcast. Really appreciate it. 2 questions for you:

1.) I am staying at home for 7 days in a temperature controlled environment, ranging from 68-72 degree F depending on how I feel. Today I sweat a little for like half an hour before I turned the AC on. Then I did my day spray. Could sweat like this hurt the grafts?

2.) Also, what are the risks with flying? My flight is on day 8 post op-could it somehow dry out the grafts and lose them? Should I perhaps stay where I am longer?

Ty!

1. The grafts are in your body, ambient temperature doesn't matter. Sweat will not hurt the grafts. Just don't touch the grafts with your hands (infection risk) and don't lose any grafts from rubbing or bumping your head. That's all you have to do.

2. I flew home on an 8 hour flight the day after my surgery, didn't spray my head once during the flight. Everything grew perfectly. At 8 days you should be fully healed and scabs will likely already have come off, there is nothing you can do at that point to ruin the surgery.

Edited April 30, 2023 by shadowcast

[HappyMan2021]

33 minutes ago, Ralph kaka said:

My flight is on day 8 post op-could it somehow dry out the grafts and lose them? Should I perhaps stay where I am longer?

the grafts are essentially secure after 3 days. between 3-10 days, you would have to SEVERELY injure yourself to dislodge the grafts. 

This isn't much help to you in hindsight, but you really didnt need to stay wherever you are for 8 days. 

[gillenator]

IMHO, 3 days post-op is enough time as I concur the grafts are secure enough by then.

[Ralph kaka]

Y’all are the best. TY so much for the helpful information 🙏🏻 @gillenator @HappyMan2021 @shadowcast

 

i will pay all this forward and help out people once I have gone through this process fully. But your answers have made this so much easier.

[Fue3361]

Take this with a grain of salt, but this is my understanding:

There are 2 advantages to sleeping upright.  One is that it drastically helps to reduce swelling in the face and head, as it lets gravity do its thing, and two, it makes it much less likely that you'll turn in your sleep and rub the grafts against the bed.

It's very important the first few days that you sleep on your back.  Sleeping upright can be the best way to insure this happens.

I don't think the actual angle itself does very much specifically for graft survival though.  

[Ralph kaka]

Hey @Gatsby @gillenator @HappyMan2021 and all, I was looking through my post op instructions and it said to sleep at a 45-90 degree angle for 28 days post op. That seems excessive, any idea why they would request that?

[Gatsby]

I think it’s just to be on the super Uber cautious side. Once the grafts are healed they’re healed. All the best. 👍