Are There Benefits of Wearing Compression Socks To Bed?

Compression socks have come a long way since their inception in 1950. Compression garments now come in different grades—medical or standard—and are available in an assortment of colours. Whether doctor-recommended or for athletic use, compression socks do have proven benefits for the wearer, it just depends on when you wear them.

From an athletic standpoint, these special sleeves or socks can be worn to increase blood flow in the arms, legs or knees while running. Though, in order for compression socks to provide physiological benefits, the sock must extend from the ball of your foot to mid-calf (covering the foot and ankle), said Ellen Derrick, MD, MPH, FACS, FSVS, a vascular surgeon and founder of BoxBar Vascular.

When worn during exercise, compression socks can improve the flow of oxygenated blood throughout the body, which can result in more muscular energy and stamina, Derrick said. This positive effect was also suggested in the results of a small-scale study on male basketball players, published in a 2020 issue of the Journal of Sport and Health Science, which concluded that markers of "muscle blood flow and muscle oxygenation are increased with sports compression garments".

Derrick said that in order to understand these benefits, it's important to know that veins and arteries are different. While arteries deliver oxygenated blood to the muscles, veins are responsible for returning that blood to the heart to be recirculated throughout the body. She likened the circulatory system to a lift, which is working harder when having to work against gravity to return blood from the foot up to the heart.

"If you wear the compression sock when exercising, you are going to reduce the work", Derrick said. "It is going to hasten—or give it a boost—up to the heart so you have a return of that blood to be reoxygenated in the lungs more swiftly and pumped back out to the muscles".

When worn for recovery after a workout, compression socks can help fatigued legs by getting blood to the foot faster. YS Robert Kim, MD, FACS, and a vascular surgeon at Northwest Vein & Aesthetic Center, said that compression socks support vein health, prevent swelling and improve circulation. A 2020 systematic review on compression socks and exercise performance noted that studies suggested compression socks lower muscle fatigue when worn after exercise.

Compression socks can either be medical grade (often recommended by a doctor) or standard. Compression socks are graded in mmHg, or millimetres of mercury. A unit of pressure, mmHg is the reading that a blood pressure cuff gives on its gauge. This number is used to measure the pressure in the blood vessels. And in compression socks, this is classified by the pressure applied at the level of the ankle.

According to Derrick, medical-grade compression socks rate as 20–40 mmHg whereas a standard pair—or what an athlete would probably be using—is 15–20 mmHg. Before buying over-the-counter compression socks, make sure you speak with a doctor. This is especially important if you have vascular disease or any type of diabetes, which can cause high blood pressure and foot complications.

Kim added that if someone has arterial insufficiency, or any condition that slows or completely stops blood flow through the arteries, compression socks can be detrimental to their health.

"People should check with their healthcare provider if they are concerned. The squeeze can actually decrease circulation to the foot", Kim said.

Since there is evidence that compression socks can aid in recovery, is there any benefit to wearing them when you sleep (which in itself is already a part of promoting health and performance)? The short answer from the experts: no. This is because when you sleep, your venous pressure is zero since you are lying down, Derrick said.

"When you lie down and sleep, your veins are doing the same work [as when you're upright] but there is no gravity. So adding a sock is not going to give you any advantage … wearing a compression sock doesn't impact the physiology in a meaningful way, the way wearing the sock when you exercise or straight after for recovery will impact the physiology".

You can wear compression socks to bed, but know that there is no current medical or physiological evidence to support any benefit. So far, the only way that compression socks might benefit sleep is that—when worn during the day—compression socks can decrease symptoms of sleep apnoea at night, according to a small-scale 2015 study in Sleep Medicine.

"There is no benefit to wearing compression stockings to bed—when the leg is flat in bed, gravity does not affect blood flow", Kim said. "That being said, it doesn't hurt to wear them to bed if you please. Just bear in mind that wearing them in bed doesn't mean you don't have to wear them during the daytime. The benefit of compression is apparent when you use it, not how many hours in the day you use them".

Words by Ashley Lauretta