An ostomy is a surgically created opening, called a stoma, on the abdomen that diverts the flow of waste—either stool or urine—from the body when the digestive or urinary tract is damaged or diseased. The stoma is a small, pink, moist piece of intestine or urinary tract brought through the abdominal wall, where a pouching system is worn to collect the output. For people newly living with an ostomy, concerns about sleep are immediate, particularly regarding comfort and the possibility of damaging the stoma or causing a leak overnight. Adjusting to the presence of the external appliance requires learning new routines to ensure a secure, comfortable night of rest.
Is Sleeping Prone Safe for Your Stoma?
The immediate concern about sleeping directly on the abdomen is whether the pressure will harm the stoma, but sleeping prone is generally safe. The stoma is flexible mucosal tissue, and external pressure from the mattress will not crush or damage it. The primary risk associated with stomach sleeping is the increased likelihood of a pouch leak, not physical injury to the stoma. External compression can flatten the pouch, making it difficult for output to drain properly, especially as the bag fills during the night.
Pressure on a full pouch can weaken the adhesive seal against the skin, leading to a leak that disrupts sleep. People with a colostomy, whose output is often more solid and less frequent overnight, may find stomach sleeping easier than those with an ileostomy or urostomy, which typically have continuous output.
Adjusting Your Appliance for Overnight Comfort
Preparation of the ostomy appliance before bed is a significant factor in ensuring comfort and security throughout the night. The most important pre-sleep step is to fully empty the pouch just before lying down to minimize weight and internal pressure. A nearly empty pouch reduces stress on the adhesive wafer and lowers the risk of ballooning or leaking due to movement or body position.
To keep the appliance secure and flat against the abdomen, many people wear a supportive garment. This can be a specialized ostomy belt, a supportive wrap, or a snug-fitting undershirt that holds the pouch close to the body. For those who experience heavy output overnight, particularly with a urostomy or ileostomy, using a high-capacity night drainage system can be beneficial. These systems attach to the body-worn pouch and drain into a larger container next to the bed, significantly reducing the need to wake and empty the pouch.
Tips for Stomach and Side Sleeping
For those who prefer to sleep on their stomach, a positional adjustment can create the necessary space for the pouch. Placing a small, firm pillow or rolled-up towel under the hips or the side of the abdomen opposite the stoma helps create a slight “well” for the appliance. This technique reduces direct pressure on the stoma and pouch, allowing the appliance to fill without compromising the seal.
When side sleeping, lie on the side opposite the stoma to allow the pouch to rest freely on the mattress. If lying on the stoma side, ensure the appliance is not pinned underneath the body, which can obstruct the flow of output. Positioning the body in a slight three-quarter turn, leaning slightly toward the back, can also relieve pressure. To further minimize heavy output during peak sleep hours, consume your largest meal and most fluids at least two hours prior to going to sleep.