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Bed rest
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This article is about a medical treatment. For the type of pillow, see pillow. For the horror thriller film, see Bed Rest
(film).

Bed rest, also referred to as the rest-cure, is a medical treatment in which a person lies in bed for most of
the time to try to cure an illness.[1] Bed rest refers to voluntarily lying in bed as a treatment and not being
confined to bed because of a health impairment which physically prevents leaving bed. The practice is still
used although a 1999 systematic review found no benefits for any of the 17 conditions studied and no
proven benefit for any conditions at all, beyond that imposed by symptoms.[2]

In the United States, nearly 20% of pregnant

Bed rest
women have some degree of restricted activity
prescribed[3] despite the growing data showing it
to be dangerous, causing some experts to call its
use "unethical".[2][4][5]

Contents

Medical uses
Pregnancy

Back pain

Other The Invalid (c. 1870), painting by Louis Lang in the

Brooklyn Museum
Adverse effects

Technique Other names cessation, expiration,

halt, shutdown,
History
stoppage surcease, and
See also termination

References [edit on Wikidata]

Further reading

Medical uses

Extended bed rest has been proven to be a potentially harmful treatment needing more careful
evaluation.[2]

Pregnancy

Women who are pregnant and are experiencing early labor, vaginal bleeding, and cervix complications have
been prescribed bed rest. This practice in 2013 was strongly discouraged due to no evidence of benefit and
evidence of potential harm.[6]

Evidence is unclear if it affects the risk of preterm birth and due to potential side effects the practice is not
routinely recommended.[7] It is also not recommended for routine use in pregnant women with high blood
pressure[8] or to prevent miscarriage.[9]

Women pregnant with twins or higher-order multiples are at higher risk for pregnancy complications.
Routine bed rest in twin pregnancies (bed rest in the absence of complications) does not improve
outcomes.[10] Bed rest is therefore not recommended routinely in those with a multiple pregnancy.[10]

Use in combination with assisted reproductive technology such as embryo transfer is also not
recommended.[11]

Back pain

For people with back pain bed rest has previously been recommended.[12] Bed rest, however, is less
beneficial than staying active.[13] As a treatment for low back pain, bed rest should not be used for more
than 48 hours.[14]

Other
As of 2016 it is unclear if bed rest is useful for people in wheelchairs who have pressure ulcers.[15]

Bed rest may be sufficient treatment for mild cases of Sydenham chorea.[16]

In those with deep vein thrombosis early movement rather than bed rest appears helpful.[17]

Adverse effects

Further information: Lying (position) § Long-term risks

Prolonged bed rest has long been known to have deleterious physiological effects, such as muscle atrophy
and other forms of deconditioning such as arterial constriction.[18] Besides lack of physical exercise it was
shown that another important factor is that the hydrostatic pressure (caused by gravity) acts anomalously,
resulting in altered distribution of body fluids. In other words, when getting up, this can cause an orthostatic
hypertension, potentially inducing a vasovagal response.

Additionally, prolonged bed rest can lead to the formation of skin pressure ulcers.[19] Even physical exercise
in bed fails to address certain adverse effects.[20]

Phlebothrombosis is marked by the formation of a clot in a vein without prior inflammation of the wall of the
vein. It is associated with prolonged bed rest, surgery, pregnancy, and other conditions in which blood flow
becomes sluggish or the blood coagulates more readily than normal. The affected area, usually the leg, may
become swollen and tender. The danger is that the clot may become dislodged and travel to the lungs (a
pulmonary embolism).[21]

Technique

Complete bed rest refers to discouraging the person in treatment

from sitting up for any reason, including daily activities like drinking
water.[22]

Placing the head of a bed lower than the foot is sometimes used as a
means of simulating the physiology of spaceflight.[23]

History

As a treatment, bed rest is mentioned in the earliest medical

writings. The rest cure, or bed rest cure, was a 19th-century
treatment for many mental disorders, particularly hysteria. "Taking to This man in 1945 England has been
prescribed complete bed rest and
bed" and becoming an "invalid" for an indefinite period was a
accepts assistance so as not to sit up to
culturally accepted response to some of the adversities of life. drink.

In addition to bed rest, patients were secluded from all family contact to reduce dependence on others. The
only person who bed rest patients were allowed to see was the nurse who massaged, bathed, and clothed
them. Not only were patients to be isolated in bed for an extended time, they were advised to avoid other
activities that may mentally exhaust them such as writing or drawing.[24]

In some extreme cases electrotherapy was prescribed. The food the patient was served usually consisted of
fatty dairy products to revitalize the body. This cure as well as its name were created by doctor Silas Weir
Mitchell, and it was almost always prescribed to women, many of whom were suffering from depression,
especially postpartum depression. It was not effective and caused many to go insane, suffer complications
of prostration, or die.

Before the advent of effective antihypertension medications, bed rest was a standard treatment for
markedly high blood pressure. It is still used in cases of carditis secondary to rheumatic fever. Its popularity
and perceived efficacy have varied greatly over the centuries.

In 1892, feminist writer Charlotte Perkins Gilman published "The Yellow Wallpaper", a horror short story
based on her experience when placed under the rest cure from Dr. Silas W. Mitchell himself. She wasn't
allowed to write in a journal, paint a picture, or release her imagination in any way, though she was
artistically inclined. If she ever felt ill, she was simply told to return to bed. Her specific instructions from Dr.
Mitchell were to "Live as domestic a life as possible. Have your child with you all the time... Lie down an
hour after each meal. Have but two hours' intellectual life a day. And never touch pen, brush or pencil as
long as you live."[25] Gilman abided by Mitchell's instructions for several months before practically losing
control of her sanity.

Eventually, Gilman divorced her husband and pursued a life as a writer and women's rights activist. She
later explained in her biography The Living of Charlotte Perkins Gilman that she could not be restrained to
the domestic lifestyle without losing her sanity, and that "it was not a choice between going and staying, but
between going, sane, and staying, insane."[26]

The narrator in "The Yellow Wallpaper" reflected her own authentic account. The narrator was advised by
her husband to perform the rest cure and avoid creative activities while struggling with fits of depression.
After becoming obsessed with the yellow wallpaper in her room, the narrator suffers a mental breakdown
and frees a "woman behind the wall," metaphorically resembling Gilman's own mental break and release
from female expectations. Gilman sent her short story to Dr. Mitchell, hoping that he might change his
treatment of women with mental health and help save people from her own experience.[27] The story
became a symbol of feminism in the 1970s at the time of its rediscovery.[28]

The author Virginia Woolf was prescribed the rest cure, which she parodied in her novel Mrs Dalloway
(1925) with the description "you invoke proportion; order rest in bed; rest in solitude; silence and rest; rest
without friends, without books, without messages; six months rest; until a man who went in weighing seven
stone six comes out weighing twelve".[29]

Some negative effects of bed rest were historically attributed to drugs taken in bed rest.[30]

See also

Bedridden

Postpartum confinement, the period after giving birth

Lying-in, the historic term for enforced rest after giving birth

Reduced muscle mass, strength and performance in space

References

1. ^ Collin (2008). Dictionary of Medical Terms. A&C Black – via Credo Reference.

2. ^ a b c Allen, C; Glasziou, P; Del Mar, C (9 October 1999). "Bed rest: a potentially harmful treatment needing more
careful evaluation". Lancet. 354 (9186): 1229–33. doi:10.1016/s0140-6736(98)10063-6 . PMID 10520630 .
S2CID 12196831 .

3. ^ Bed Rest During Pregnancy

4. ^ "Archived copy" . Archived from the original on 2013-10-04. Retrieved 2013-06-23.

5. ^ McCall, Christina A.; Grimes, David A.; Lyerly, Anne Drapkin (June 2013). " "Therapeutic" bed rest in pregnancy:
unethical and unsupported by data". Obstetrics and Gynecology. 121 (6): 1305–1308.
doi:10.1097/AOG.0b013e318293f12f . ISSN 1873-233X . PMID 23812466 .

6. ^ McCall, CA; Grimes, DA; Lyerly, AD (June 2013). " "Therapeutic" bed rest in pregnancy: unethical and
unsupported by data". Obstetrics and Gynecology. 121 (6): 1305–8. doi:10.1097/aog.0b013e318293f12f .
PMID 23812466 .

7. ^ Sosa, CG; Althabe, F; Belizán, JM; Bergel, E (30 March 2015). "Bed rest in singleton pregnancies for preventing
preterm birth" . The Cochrane Database of Systematic Reviews. 2015 (3): CD003581.
doi:10.1002/14651858.CD003581.pub3 . hdl:11336/51713 . PMC 7144825 . PMID 25821121 .

8. ^ Meher, Shireen; Abalos, Edgardo; Carroli, Guillermo; Meher, Shireen (2005). "Bed rest with or without
hospitalisation for hypertension during pregnancy" . Cochrane Database of Systematic Reviews. 2010 (4):
CD003514. doi:10.1002/14651858.CD003514.pub2 . PMC 8715743 . PMID 16235323 .

9. ^ Aleman, Alicia; Althabe, Fernando; Belizán, José M; Bergel, Eduardo; Althabe, Fernando (2005). "Bed rest
during pregnancy for preventing miscarriage" . Cochrane Database of Systematic Reviews. 2010 (2):
CD003576. doi:10.1002/14651858.CD003576.pub2 . PMC 8721648 . PMID 15846669 .

10. ^ a b Crowther, Caroline A; Han, Shanshan; Crowther, Caroline A (2010). "Hospitalisation and bed rest for multiple
pregnancy" . Cochrane Database of Systematic Reviews. 2010 (7): CD000110.
doi:10.1002/14651858.CD000110.pub2 . PMC 7051031 . PMID 20614420 .

11. ^ Küçük, M (April 2013). "Bed rest after embryo transfer: Is it harmful?". European Journal of Obstetrics,
Gynecology, and Reproductive Biology. 167 (2): 123–6. doi:10.1016/j.ejogrb.2012.11.017 . PMID 23274041 .

12. ^ Weiner, Richard (2002). Pain management: a practical guide for clinicians . Boca Raton: CRC Press. p. 741.
ISBN 978-0-8493-0926-7.

13. ^ Hagen, KB; Jamtvedt, G; Hilde, G; Winnem, MF (1 March 2005). "The updated cochrane review of bed rest for
low back pain and sciatica". Spine. 30 (5): 542–6. doi:10.1097/01.brs.0000154625.02586.95 .
PMID 15738787 . S2CID 33969187 .

14. ^ North American Spine Society (February 2013), "Five Things Physicians and Patients Should Question" ,
Choosing Wisely: an initiative of the ABIM Foundation, North American Spine Society, retrieved 25 March 2013

15. ^ Moore, ZE; van Etten, MT; Dumville, JC (17 October 2016). "Bed rest for pressure ulcer healing in wheelchair
users" . The Cochrane Database of Systematic Reviews. 2016 (10): CD011999.
doi:10.1002/14651858.CD011999.pub2 . PMC 6457936 . PMID 27748506 .

16. ^ "Sydenham Chorea Information Page | National Institute of Neurological Disorders and Stroke" .
ninds.nih.gov. Retrieved 30 January 2017.

17. ^ Izcovich, A; Popoff, F; Rada, G (28 June 2016). "Early mobilization versus bed rest for deep vein thrombosis" .
Medwave. 16 (Suppl2): e6478. doi:10.5867/medwave.2016.6478 . PMID 27391009 .

18. ^ Bleeker MW, De Groot PC, Rongen GA, et al. (October 2005). "Vascular adaptation to deconditioning and the
effect of an exercise countermeasure: results of the Berlin Bed Rest study". Journal of Applied Physiology. 99
(4): 1293–300. doi:10.1152/japplphysiol.00118.2005 . PMID 15932956 .

19. ^ "Ulcer." The Columbia Encyclopedia, Columbia University, and Paul Lagasse, Columbia University Press, 2016.
Credo Reference .

20. ^ Woods, Susan L. (2005). Cardiac nursing . Hagerstwon: Lippincott Williams & Wilkins. p. 921. ISBN 978-0-
7817-4718-9.

21. ^ Sell, Rebecca; Rothenberg, Mikel; Chapman, Charles F. (November 1, 2012). Dictionary of Medical Terms
(6th ed.). New York: Barron's Educational Series. ISBN 978-0-7641-4758-6. Archived from the original on 10
May 2017. Retrieved 5 September 2016.

22. ^ "Bed rest during pregnancy: Get the facts" . Mayo Clinic. 2011. Retrieved 27 March 2014.

23. ^ Atsunori Kamiya; Satoshi Iwase; Daisaku Michikami; Qi Fu; Tadaaki Mano (1 March 2000). "Head-down bed rest
alters sympathetic and cardiovascular responses to mental stress". American Journal of Physiology. Regulatory,
Integrative and Comparative Physiology. 279 (2): R440–R447. doi:10.1152/ajpregu.2000.279.2.R440 .
PMID 10938230 . S2CID 26443012 . "To examine effects of microgravity on vasomotor sympathetic and
peripheral vasodilator responses to mental stress, we performed 10 min of mental arithmetic (MA) before and
after 14 days of 6° head-down bed rest (HDBR), a ground-based simulation of spaceflight."
Millet, C.; Custaud, MA; Maillet, A; Allevard, AM; Duvareille, M; Gauquelin-Koch, G; Gharib, C; Fortrat, JO
(March 2001). "Endocrine responses to 7 days of head-down bed rest and orthostatic tests in men and
women". Clinical Physiology. 21 (2): 172–183. doi:10.1046/j.1365-2281.2001.00315.x . PMID 11318825 .

Edgell, Heather (December 2007). "WISE-2005: adrenergic responses of women following 56-days, 6° head-
down bed rest with or without exercise countermeasures". Environmental, Exercise and Respiratory
Physiology.

Randa L. Shehab; Robert E. Schlegel (August–September 1998). "The NASA performance assessment
workstation: Cognitive performance during head-down bed rest". Acta Astronautica. 43 (3–6): 223–233.
Bibcode:1998AcAau..43..223S . doi:10.1016/s0094-5765(98)00156-8 . PMID 11541926 .

Wilson, Thad (4 January 2003). "Effects of 14 days of head-down tilt bed rest on cutaneous vasoconstrictor
responses in humans". Journal of Applied Physiology. 94 (6): 2113–2118.
doi:10.1152/japplphysiol.00067.2002 . PMID 12524372 . S2CID 6965213 .

Meck, Janice V.; Dreyer, Sherlene A.; Warren, L. Elisabeth (May 2009). "Long-Duration Head-Down Bed Rest:
Project Overview, Vital Signs, and Fluid Balance". Aviation, Space, and Environmental Medicine. 80
(Supplement 1): A1–A8. doi:10.3357/asem.br01.2009 . PMID 19476163 .

Shibasaki, Manabu (November 1, 2003). "Exercise throughout 6° head-down tilt bed rest preserves
thermoregulatory responses". Journal of Applied Physiology. 95 (5): 1817–1823.
doi:10.1152/japplphysiol.00188.2003 . PMID 12882999 .

24. ^ Geller, Jeffery L. (1994). Women of the Asylum: Voices from Behind the Walls 1840-1945. New York: Anchor
Books. pp. 161–168.

25. ^ Gilman, Charlotte Perkins. "The Yellow Wallpaper". The Norton Anthology of English Literature. New York: Gale,
1996. 230-37. Print.

26. ^ Geller, Jeffery L. (1994). Women of the Asylum: Voices from Behind the Walls 1840-1945. New York: Anchor
Books. pp. 161–167.

27. ^ Gilman, Charlotte. " "Why I Wrote "The Yellow Wallpaper" " . Charlotte Perkins Gilman.

28. ^ "Feminist Gothic in "The Yellow Wallpaper" " .

29. ^ Lee, Hermione (1996). Virginia Woolf (1. publ. in Great Britain ed.). London: Chatto & Windus. ISBN 978-0-
7011-6507-9.

30. ^ Dock, William (1944). "The evil sequelae of complete bed rest". Journal of the American Medical Association.
125 (16): 1083. doi:10.1001/jama.1944.02850340009004 . ISSN 0002-9955 .

Further reading

Stuempfle, K., and D. Drury. "The Physiological Consequences of Bed Rest ". Journal of Exercise
Physiology online (June 2007) 10(3):32-41.

Last edited on 24 November 2023, at 14:04

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