How to Sleep After Hair Transplant: All the Essential Recommendations

Indeed, professionals estimate that approximately 80% of failures or complications after a hair transplant can be linked to an unsuitable sleeping position. Sleeping on your tummy or experiencing repeated friction to the micro-incisions that are still healing significantly increases the risk of graft loss (Garg & Garg, 2021).

Furthermore, spending several hours with your head flat can promote the appearance of frontal oedema—temporary swelling of the forehead due to fluid accumulation under the skin. To reduce this rather uncomfortable phenomenon, it’s recommended to slightly elevate your head using one or two additional pillows or a specific cushion to limit fluid stagnation in the frontal area (Gholamali et al., 2010).

Fortunately, adopting the correct posture (sleeping on your back with your head tilted) is both a straightforward and effective measure. By maintaining this position during the first post-operative week, you maximise the chances of implant survival. To optimise your recovery and ensure your new grafts regrow harmoniously and sustainably, it is absolutely essential to follow all your surgeon’s advice.

Adopting Ideal Positions to Protect Your Grafts

After your hair transplant in Turkey, one instruction is frequently emphasised: sleep on your back with your head slightly elevated. Indeed, during the first 7 to 10 days following the transplant, the follicles are not yet firmly anchored in the scalp: the slightest excessive pressure can compromise their proper integration. Specialists recommend a 45° angle between your torso and your head, so that your neck and spine remain aligned. This inclination also promotes good blood circulation, which is essential for the healing of micro-incisions (Zito & Raggio, 2024).

By reducing direct pressure on the grafted areas, the elevated back position thus limits the risks of friction or inadvertent contact when you move during your sleep. This simple precaution could significantly reduce post-operative complications, particularly frontal oedema (Gholamali et al., 2010).

Maintaining this position all night may seem rather constraining, but specific accessories make the task more comfortable. An orthopaedic cervical pillow is ideal: it follows the natural curve of the neck and stabilises the head. A U-shaped pillow (like those popular for long-haul flights) can also prevent untimely rotations. For those who struggle to remain lying in this posture, a medical reclining chair is another practical alternative: it maintains the upper body at a 45° angle without you having to make any effort. This type of medical equipment can be hired for a week from a specialised company in your local area or through the NHS if recommended by your GP.

Finally, be sure to use cotton sheets and pillowcases, changed daily to reduce the risk of infection. Cotton is gentle and allows the scalp to breathe, contributing to overall well-being. By adopting these few tips, you provide your grafts with the best conditions to implant permanently and begin their regrowth phase.

Positions to Absolutely Avoid

After a hair transplant, certain sleeping positions are particularly discouraged, as they exert direct pressure on the grafts or increase exposure to infections.

Sleeping on Your Tummy

Sleeping on your tummy is by far the riskiest posture. By pressing your head against the pillow, you apply direct pressure to the grafted areas, which can cause expulsion of the freshly positioned implants. Added to this is a reduction in air circulation around the scalp, which can increase perspiration and therefore bacterial proliferation. The result: an increased risk of infection and inflammatory complications (Garg & Garg, 2021).

Sleeping on Your Side

If you sleep on your side, you may not exert as much pressure as in the prone position, but constant friction against the pillow can be enough to weaken your follicles. Moreover, the weight of the head can slightly deform the implantation channels, compromising their healing and subsequent hair growth. Finally, some patients report the formation of small localised haematomas on the implanted area, aggravated by poor pressure distribution (Zito & Raggio, 2024).

In summary, these positions represent a genuine danger to your grafts. Even if they may seem more natural or comfortable in the short term, it is crucial to avoid them during the first week post-transplant, to ensure the best possible healing.

Practical Solutions for Comfortable Sleep

Managing Night-time Itching

Feeling a bit itchy up there? Quite normal: experiencing itchiness in the days following the procedure is common. The cause: healing and scalp sensitivity. To relieve this, you can use a saline spray (often provided by your surgeon) which gently hydrates and cleans the micro-incisions. Applying cold compresses (without direct contact with the grafts) just before bedtime can also calm irritations. In case of severe discomfort, a dermatologist or your surgeon can prescribe suitable antihistamines (Garg & Garg, 2021).

Pain Management

Some patients may experience mild pain or tension in the scalp. An analgesic protocol based on mild painkillers or anti-inflammatories (prescribed by the doctor) is often sufficient to spend a peaceful night. Relaxation techniques (deep breathing, guided meditation) also help reduce stress and facilitate falling asleep. The NHS website offers excellent resources for relaxation techniques that can be particularly helpful. If the pain persists or worsens, don’t hesitate to contact your surgeon for more thorough monitoring (Zito & Raggio, 2024).

A Comfortable Environment for Optimal Sleep

To optimise your recovery, ensure you maintain a temperature between 18°C and 20°C in your bedroom. Air that is too dry or too humid can hinder skin respiration, so ensure moderate humidity. Avoid as much as possible fans directed at your head, as they can dry the skin and weaken the grafts.

Finally, remain attentive to any abnormal signs (unusual swelling, bleeding, intense pain). It’s better to contact your practitioner as soon as a worrying symptom appears, rather than letting the situation worsen. With these few practical solutions, you can preserve your grafts and go through the post-operative period in the best conditions.

Precise Schedule for Resuming Positions

First Week: Strict Back Position

During the first 7 days, it is strongly recommended to sleep exclusively on your back, with an inclination angle of about 45°. The objective is to maximally protect the freshly implanted grafts, which are still in the healing phase. You will probably notice the appearance of small scabs and redness; don’t panic, this is a normal sign of good healing. However, watch out for any unusual bleeding or swelling. Patience and adaptation will, during this crucial week, be the best allies for your new grafts. If you have difficulty sleeping, have a word with your doctor, who can prescribe a mild sleep aid for a few days (Zito & Raggio, 2024).

Second Week: Progressive Introduction of Side Sleeping

From the 8th day, if all post-operative signals are satisfactory, you can progressively introduce the lateral position. It is preferable to continue to slightly elevate your head and protect the grafted area with a suitable pillow (U-shaped cushion or cervical pillow). Sudden movements should still be avoided; turn gently to limit any friction on the grafts. Also continue to respect hygiene instructions (daily changing of pillowcases, etc.) (Garg & Garg, 2021).

Beyond 15 Days: Gradual Return to Normal Positions

After two weeks, most patients gradually return to their comfortable sleep. However, caution is advised: if the grafted areas are not yet completely healed, prolong the use of specific pillows and monitor the evolution of healing. As itching tends to diminish, it is often easier to maintain a good posture throughout the night. Thus, you maximise your chances of obtaining an optimal result in the long term (Zito & Raggio, 2024).

Sleep-related Complications to Monitor

While sleeping instructions may seem constraining, they are primarily aimed at protecting your grafts and scalp. In the days following the procedure, be attentive to immediate warning signs that should prompt you to quickly contact your surgeon.

• Abnormal bleeding: Small spots on the pillow may be normal, but significant or persistent bleeding requires medical evaluation.
• Intense pain: Mild pulling sensations are typical, but if the pain becomes sharp and throbbing, it’s better to consult without delay.
• Excessive swelling: Moderate oedema is common, especially around the forehead. However, massive swelling to the point of hindering vision or causing a feeling of oppression should be taken seriously: discuss it with your surgeon (Gholamali et al., 2010).
• Severe itching: This can reveal abnormal inflammation or a developing infection, which must be treated as quickly as possible.

In the medium term, an inadequate sleeping position can generate other problems:

• Poor orientation of grafts: Follicles can regrow askew, compromising the aesthetic result.
• Infections: Excessive friction on micro-incisions can irritate the skin and promote bacteria.
• Delayed healing: Any disruption to the healing process risks prolonging convalescence and compromising graft survival (Garg & Garg, 2021).

Stay alert to these signals; you will want to act quickly to minimise risks and optimise your recovery. Avoid anything that can compromise your good sleep: coffee and tea should be avoided in the evening, and do try to stay calm: beware of any source of stress. Right then, until your next check-up, sweet dreams!

If you’re still undecided about which technique to choose for your transplant, do have a look at the opinions and testimonials of our patients who have already undergone their procedure with our experts.

Sources

Garg, A. K., & Garg, S. (2021). Complications of Hair Transplant Procedures—Causes and Management. Indian Journal of Plastic Surgery, 54(4), 477-482. https://doi.org/10.1055/s-0041-1739255

Gholamali, A., Sepideh, P., & Emami, S. (2010). Hair Transplantation: Preventing Post-operative Oedema. Journal of Cutaneous and Aesthetic Surgery, 3(2), 87-89. https://doi.org/10.4103/0974-2077.69018

Zito, P. M., & Raggio, B. S. (2024). Hair Transplantation. StatPearls [Internet]. https://doi.org/10.1055/s-0041-1739255