How to Sleep After a Hysterectomy: Best Positions, Pillows and Tips for Better Rest

ByThe PartialHysterectomy.net Editor

Sleeping well after a hysterectomy is harder than most women expect. Your tummy is sore, turning over takes planning, you may wake up hot or needing the bathroom, and the pain medicine that helps during the day can leave your nights broken. The good news is that there is no single “correct” position you have to stick to. This guide explains which positions most women find comfortable, how to use pillows, how to get in and out of bed without straining, and what to do when pain, wind, night sweats or worry keep you awake.

Why sleep is harder after a hysterectomy

Poor sleep after surgery is very common, not just after a hysterectomy. A 2021 review of sleep problems around the time of surgery found that pain is the main cause, that strong painkillers such as opioids can themselves disturb sleep, and that noise, light and anxiety in hospital add to the problem. Sleep and pain also feed each other: a bad night makes pain feel worse, and pain makes the next night harder.[7]

Other common reasons for broken nights in the first weeks include:

  • Wound and internal soreness, especially when you roll over or try to sit up.
  • Trapped wind and bloating, and, after keyhole surgery, shoulder-tip pain from the gas used during the operation. This usually settles in two to three days.[6]
  • Hot flushes and night sweats if your ovaries were removed, because menopause starts suddenly after the operation.[1][8]
  • Tiredness that does not match your sleep. Your body uses a lot of energy to heal, so you may feel exhausted even after a full night.[2]
  • Low mood or worry, which the Royal College of Obstetricians and Gynaecologists (RCOG) notes can feel worse when you are tired.[2]

Knowing that this is normal can take some of the pressure off. Most women find their sleep improves as pain eases over the first couple of weeks, although energy levels often take six to eight weeks to return fully.[11] Our week-by-week recovery guide explains what to expect at each stage.

The best sleeping positions after a hysterectomy

None of the hospital leaflets we reviewed tells women to sleep in one particular position. The aim is simply to find a position that does not pull on your tummy or strain your back, and to support it with pillows. These are the options most women and physiotherapists find work best.

On your back, with a pillow under your knees

Lying on your back is often the easiest position in the first days, especially after an abdominal hysterectomy with a cut across the lower tummy. A pillow under your knees bends your hips slightly, which takes tension off the wound and the lower back.[3][5] Pelvic floor physiotherapist Michelle Kenway suggests using one pillow under your head that keeps your neck in line, rather than two large ones that push your chin towards your chest.[5]

Propped up on pillows

In hospital you will usually be encouraged to sit up in bed, supported by pillows behind your back or under your knees, because being upright helps air reach the bottom of your lungs after an anaesthetic.[3] Many women find a half-sitting position comfortable for the first few nights at home too, as it makes getting up easier.

Keep your back well supported and try not to slump, as slouching can tighten the tummy muscles around the wound.[3] Once you are home and moving more, Kenway advises against spending long periods sitting high up in bed unless your team has told you to.[5] If you have a recliner chair, it can be a comfortable place for a nap, but it is not a substitute for getting up and moving regularly. Our guide to how to sit after a hysterectomy has more on comfortable, upright sitting.

Smiling woman sitting upright in bed with white pillows around her
Sitting up in bed with pillows behind your back can make the first nights more comfortable. Keep your back supported rather than slumped.

On your side, with a pillow between your knees

Side lying is the most common sleeping position, and many women want to get back to it as soon as possible.[5] It may feel uncomfortable at first, but pillows help a lot.[3] Try:

  • a pillow between your knees, so your top leg does not drag your hips and pelvis out of line;
  • a pillow placed lengthways against your tummy, or hugged in front of you, to support your lower abdomen;
  • one pillow under your head that keeps your neck straight.[5]

There is no rule about which side to lie on. If you had keyhole surgery, the small cuts may make one side more comfortable than the other. Choose whichever hurts less.

On your stomach

We did not find any hospital guidance that sets a date for sleeping on your front. In practice, most women find it too uncomfortable for the first few weeks because it puts pressure directly on the tummy and wound. It is reasonable to go back to it once it no longer hurts, unless your surgeon has given you different advice. A thin pillow under your hips can make the change easier.

How to get in and out of bed without straining

Sitting straight up from lying flat uses your tummy muscles hard and can really hurt in the first weeks. NHS physiotherapists teach a “log roll” instead:[3][4]

  1. Bend both knees, keeping your feet flat on the bed.
  2. Roll onto your side in one movement, moving your shoulders and knees together.
  3. Let your legs gently drop over the edge of the bed.
  4. Push yourself up into sitting with your elbow and then your hand.
  5. Sit on the edge of the bed for a few seconds before you stand. It can be normal to feel a little dizzy the first few times.

To get back into bed, reverse the steps: sit on the edge, lower yourself onto your side using your arm, then lift your legs onto the bed together and roll onto your back.[3] Physiotherapists also advise never lifting both straight legs together while lying down and never sitting up with your legs straight out in front of you.[3] Holding a small pillow or rolled towel against your tummy as you move can make it more comfortable.

Getting your bedroom ready before surgery

A few changes made before your operation can save a lot of effort later. If you are still planning, our guide to preparing for a hysterectomy covers the rest of the house too.

  • Gather pillows. You may want four or five: for your head, behind your back, under your knees, between your knees and to hug. A long body pillow can replace several of them. There is no need to buy a special post-surgery pillow unless you find it helps.
  • Keep essentials within reach: water, your phone and charger, painkillers (if it is safe to keep them by the bed), tissues and a small towel for night sweats.
  • Clear the way to the toilet and use a night light, as you may feel unsteady when you first stand up at night.
  • Think about bed height. A very low bed or a soft mattress that you sink into can make getting up harder. If your bed is upstairs and stairs are difficult at first, some women sleep downstairs for the first few nights.
  • Keep the room cool, dark and quiet, with blinds, an eye mask or earplugs if needed.[9] A fan by the bed is useful if night sweats are likely.[8]

Practical tips for better sleep during recovery

Plan your pain relief around the night

Most women need regular pain medicine for the first week or two.[11][12] Take it exactly as prescribed. If pain keeps waking you, ask your pharmacist or care team whether you can time a dose so that it covers the first part of the night. Do not push through pain to “save” tablets: being in pain makes sleep, breathing and moving harder.

Be careful with opioids, alcohol and sleeping pills

Opioid painkillers can make you drowsy but often give poor-quality sleep.[7] They also cause constipation, and straining on the toilet at night is uncomfortable after surgery, so ask about a mild laxative if you have not opened your bowels after a couple of days.[12] The US Food and Drug Administration warns that combining opioids with sedatives such as benzodiazepines can cause slowed or difficult breathing, extreme sleepiness and even death, and that alcohol should not be mixed with these medicines.[10] Do not take sleeping tablets or over-the-counter sleep aids while you are on prescribed painkillers unless a doctor or pharmacist has said it is safe. If you use a CPAP machine for sleep apnoea, tell your surgical team before the operation.

Ease wind and shoulder-tip pain

Trapped wind is one of the most common causes of discomfort in the first days. Getting out of bed and walking around helps it move.[2] Shoulder-tip pain after keyhole surgery usually lasts 48 to 72 hours, and University College London Hospitals suggests peppermint tea may help.[6]

If bloating is your main problem, see our guide to swelly belly after a hysterectomy.

Keep your days active and your naps short

The RCOG says you may need a nap during the day for the first few days, but also that rest does not mean doing nothing, and that staying in bed can make you feel low. Try to get up at your usual time, wash and get dressed.[2] Short walks around the house during the day help your circulation and bowels and make you more ready to sleep at night. As the weeks pass, if your nights are still poor, cut back on daytime naps and keep to a regular bedtime and waking time.[9]

Look after your circulation in bed

The risk of blood clots is higher than usual after surgery. Avoid lying with your legs crossed for long periods.[2] When you wake, or while you rest, bend and stretch your ankles and circle them for about 30 seconds, and gently bend and straighten each knee in turn.[3] If you were given compression stockings or blood-thinning injections, use them for as long as you were told to.

Wind down before bed

General sleep advice still applies during recovery: relax for an hour before bed, avoid caffeine and big meals late in the evening, and keep phones and screens away just before you try to sleep.[9] If you cannot sleep, a few slow, deep breaths can help you relax, and you were probably taught breathing exercises in hospital that are worth continuing.[3]

Night sweats and hot flushes after removal of the ovaries

If your ovaries were removed during the operation, menopause begins suddenly rather than gradually, and symptoms can be strong.[1][8] Hot flushes, night sweats and poor sleep are common. A partial hysterectomy that keeps the ovaries does not cause this sudden change, which is one of the differences explained in our guide to what a partial hysterectomy is.

Simple measures include lighter bedding and nightwear in layers, a fan, keeping a glass of cold water by the bed, and avoiding triggers such as caffeine and spicy food.[8] If symptoms are disturbing your sleep, talk to your doctor about hormone replacement therapy (HRT). Many women who have their ovaries removed are offered it.[1][2][8] Our article on hysterectomy and hormones covers this in more depth.

Does the type of hysterectomy make a difference?

Recovery is usually quicker after vaginal or laparoscopic (keyhole) surgery than after an abdominal operation, which can take six to eight weeks.[1] Kenway notes that sleep problems may be worse in the first week after an abdominal hysterectomy than after a vaginal one.[5]

  • Abdominal hysterectomy: the cut across the lower tummy makes lying on your back with a pillow under your knees, or propped up, the most comfortable option for many women at first. Side lying with a pillow against the tummy usually becomes possible within days to weeks. See what each type of incision looks like.
  • Laparoscopic or robotic hysterectomy: the small cuts are usually less painful, but wind and shoulder-tip pain can make the first two or three nights uncomfortable.[6]
  • Vaginal hysterectomy: there is no tummy wound, so you may find side lying comfortable sooner. Soreness is lower down, and a pillow between the knees often helps. Our guide to vaginal hysterectomy has more detail.

If you wake with backache, it is usually linked to lying in one position for long periods or changes in posture while you protect your tummy. Our article on back pain after a hysterectomy explains what helps and when to get it checked.

When poor sleep needs attention

Some broken sleep is normal in the first weeks. Sleep problems after surgery can last longer in some people, and they are worth discussing with your doctor rather than putting up with.[7] Speak to your GP or care team if:

  • pain is waking you night after night and your pain medicine is not controlling it;[11]
  • night sweats or hot flushes are stopping you from sleeping;
  • you are still sleeping badly several weeks after surgery despite trying the tips above;
  • you feel low, anxious or tearful most of the time, or the feelings are not going away.[1]

Warning signs: when to get medical help

Call emergency services or go to the emergency department straight away if you have:

  • shortness of breath, chest pain or coughing up blood, which can be signs of a blood clot in the lungs;[2]
  • extreme drowsiness, slow or shallow breathing, or difficulty waking up, especially if you are taking opioids (someone else may need to call for you).[10]

Contact your surgeon, GP or the hospital the same day if you have:

  • a painful, red, swollen or hot leg, or difficulty putting weight on it;[2][11]
  • a fever above 38°C (100.5°F);[11]
  • a wound that is red, warm, bleeding or leaking thick yellow or green fluid;[11]
  • pain that is getting worse instead of better, or is not helped by your pain medicine;[11]
  • nausea or vomiting, being unable to eat or drink, or being unable to pass wind or open your bowels;[11]
  • pain or burning when you pass urine, or being unable to pass urine;[11]
  • vaginal bleeding that is heavier than light spotting, or passing blood clots;[1][11]
  • vaginal discharge that smells bad.[1][11]

Key points

  • There is no single correct sleeping position after a hysterectomy. Choose what is comfortable and support it with pillows.
  • On your back, a pillow under the knees eases the tummy and lower back. On your side, use a pillow between the knees and one against your tummy.
  • Use the log roll to get in and out of bed instead of sitting straight up.
  • Take pain relief as prescribed, and never mix opioids with alcohol or sleeping pills without medical advice.
  • Stay active during the day, keep naps short as you recover, and keep your legs moving in bed.
  • If your ovaries were removed, night sweats are common. Ask about HRT if they are disturbing your sleep.

Sources

  1. NHS. Hysterectomy: Recovery. nhs.uk
  2. Royal College of Obstetricians and Gynaecologists (RCOG). Abdominal hysterectomy: recovering well. Patient information leaflet, reviewed 2025. rcog.org.uk
  3. NHS Borders. Physiotherapy advice after abdominal gynaecological surgery. Right Decision Service. rightdecisions.scot.nhs.uk
  4. Northern Devon Healthcare NHS Trust. Physiotherapy advice following hysterectomy, repair and other gynaecological operations. royaldevon.nhs.uk (PDF)
  5. Kenway M (pelvic floor physiotherapist). Sleeping positions after hysterectomy. Pelvic Exercises. pelvicexercises.com.au
  6. University College London Hospitals NHS Foundation Trust. Laparoscopic hysterectomy. Patient information. uclh.nhs.uk
  7. Lin D, Huang X, Sun Y, Wei C, Wu A. Perioperative sleep disorder: a review. Frontiers in Medicine. 2021;8:640416. frontiersin.org
  8. Royal Free London NHS Foundation Trust. Surgical menopause. Patient information leaflet. royalfree.nhs.uk
  9. NHS. Insomnia. nhs.uk
  10. US Food and Drug Administration. FDA Drug Safety Communication: FDA warns about serious risks and death when combining opioid pain or cough medicines with benzodiazepines; requires its strongest warning. 2016. fda.gov
  11. MedlinePlus (US National Library of Medicine). Hysterectomy – laparoscopic – discharge. medlineplus.gov
  12. Kaiser Permanente. Abdominal hysterectomy: what to expect at home. kaiserpermanente.org

This article is for general information and is not a substitute for medical advice. Always follow the instructions of your surgeon and care team, and contact them or emergency services if you are worried about any symptom after your operation.

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