Should You Sleep with an Air Cast/Boot On or Off?

It’s big, it’s awkward, and it’s cumbersome. Living life after an injury and needing to wear an air cast or boot just to get around can be increasingly frustrating. Typically a boot is recommended directly after an injury or surgery on your foot or ankle. While it’s designed to give you more comfort and aid in daily activities, it makes some tasks slightly more challenging.

You know that you should be wearing it when you’re on the go (slowly), but what about when you go to bed? If you are trying to find some guidance on whether you should sleep with an air cast on or off, the short answer is that you should definitely sleep with it on.

Individual doctors or surgeons will give specific instructions on sleeping with a boot on, while some will provide no instruction at all. In the end, it’s often a personal decision, but let’s look at some of the reasons why boot wearers are choosing to keep theirs on at night.

Why You Should Sleep with An Aircast/Boot ON

The truth is, you will find many differing opinions or personal accounts of whether or not sleeping with an air cast is a good idea. The main reason that you will see for those who decide not to sleep with it on is purely out of comfort. This is an entirely valid reason; after all, who wants to lose sleep thanks to a massive device that is attached to their leg?

On the other hand, the reasons for going to sleep with the boot on are equally as compelling. Here’s why that air cast is actually your friend.

1. It serves as a reminder in your sleep – For some of us, it doesn’t take much to trigger our unconscious mind to remember specific things when we’re asleep. You’ll know that you’re one of those people if you’ve ever woken up before your alarm on an important day, or managed to stay on your side of the bed without rolling over onto a sleeping partner or child.

Something in your brain has the ability to retain needed information that your body will adhere to or respond to. By leaving your boot on, you’re giving your mind that subtle (or maybe not-so-subtle) reminder that you are still in the recovery stage of an injury, and that you can’t toss and turn on a whim.

2. It prevents you from doing more damage – If the above reason doesn’t apply to you and you are one of those people whose brain does not respond to subconscious reminders, that’s even more of a reason for why you should definitely sleep with your air cast on. Keeping it on can help to prevent further injury for those who roll in their sleep, sleepwalk, or otherwise manage to move around without waking up.

In the early days of wearing your boot, your foot will be in a very delicate state. The sensitivity could mean that it won’t take much to reinjure or cause more damage while you are trying to heal. Remember that each time you take it off, the weak bones, muscles, or tendons are more susceptible to reinjury.

For those who don’t sleep alone, you also might want to consider your partner, dog, or child who can inadvertently kick or roll onto you. Even if they don’t cause more harm to your foot, the pain alone should be enough to leave it on just in case.

3. It helps your ankle keep its shape – As we sleep, our entire body becomes more relaxed. When this happens, the muscles and tendons in your foot and ankle will not be in an active state, leaving your foot extended and in a more pointed position. This can be problematic because when you have your foot in the boot, it’s in a flexed position.

Because you will need to wear your boot each time you walk, you may be inclined to quickly put it back on as soon as you roll out of bed in the morning. By immediately putting your air cast back on without giving your muscles time to wake up and adjust, you can actually cause more damage to them.

If you do decide to sleep with your boot off anyway, be sure to massage your foot and ankle before putting it back on. Periodic ankle rolls when it’s off will also help to ensure that your boot is ready to be worn again.

How to Make an Aircast More Comfortable

In theory, knowing that you should sleep with a boot on is something you can tolerate, however putting it to the test can be frustrating. Here are a few tips that may help increase the comfort level while you’re trying to get some rest.

  • Loosen the front straps – Many people have found that giving the foot some room to move and breathe helps with the discomfort
  • Give your leg some space – Often, it’s the confining nature of the boot that makes people want to sleep without it. If you are worried about feeling claustrophobic or too hot, leave the booted foot outside of the sheets and blankets. Allowing a little bit of space and air to adjust will help you feel less restricted.
  • Take pain medication – It’s always advisable to continue taking the pain medication that has been prescribed after your surgery. Sometimes the boot may feel more uncomfortable if you are also feeling the pain of the injury. By staying on top of your pain management, you can alleviate one of the causes of disrupted sleep.
  • Try elevation – After an injury or surgery, swelling is a necessary step for the body to begin healing. If you feel the throbbing pain of your foot being swollen inside the boot, elevation will help with the blood flow. Try placing a few pillows under your leg to raise the foot above your heart.
  • DO take it off when resting – For the most part, you should be wearing your boot any time you are mobile or plan to be moving around. But understandably, having a contraption attached to your leg all day, every day (outside of showers), can begin to feel like you’re being suffocated. Take some of the stress out by taking the boot off when you are relaxing, such as watching tv or reading a book. Giving yourself a small break will hopefully help the mental distress of being confined to the boot all the time. While you’re resting without the boot is also a good time to ice the injury to help minimize swelling.

The reality is that an aircast or boot is going to cause you some discomfort. Finding ways to decrease the pain will help while you sleep with it and aid the healing process to continue without disruption.

Conclusion

Finding the patience to wear your boot through the pain is going to be a challenge, but for the sake of your injury, it’s a good idea to keep it on while you sleep. Once it’s over, if you manage to prolong the use of the boot, you will realize that it is much better to wear it uncomfortably for six weeks (or sometimes less time), rather than longer due to reinjury.

If you find that you aren’t receiving adequate instructions from your surgeon, seeking a second opinion may help you find more specific directions.