Blood Pressure Lying Down

There is more than one way to measure your blood pressure. You can take it sitting down, standing up or lying down. While most people take it while sitting down, there may come a time when it requires a lying down or otherwise known as a supine position.

This may cause some confusion about how to measure it correctly. Just when you thought you had all the proper steps figured out, lying down may be a whole new adventure. This prompts some questions about the arm and blood pressure cuff positioning. What is the correct procedure to measure blood pressure lying down?

The procedure for measuring blood pressure while in the supine position (lying down):

  1. Relax for 5 minutes after lying down.
  2. BP cuff length should be 75%-100% of the arm circumference.
  3. BP cuff width should be 37%-50% of the arm circumference.
  4. Wrap cuff around bare skin.
  5. Don’t roll shirt sleeve up tightly.
  6. Support arm with a pillow
  7. Cuff should be at right atrium height.
  8. Legs should be uncrossed.

So now let’s take a look at the procedure and some of the mistakes some people make. In addition, I’ll discuss the reasons why you would measure it lying down and if the readings differ from the sitting down position.

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Blood Pressure Lying Down

Cuff and Arm Position

The procedure is very similar to measuring your blood pressure sitting down, except you’re lying down. The major mistake people make is resting their arm directly on the bed. The American Heart Association specifically states if the arm is resting on the bed, it will be below heart level 1.

The AHA also states when measurements are taken in a lying down position; the arm can be supported by a pillow so it can raise up to the same level as the right atrium. Just like in the sitting position, if the cuff is below heart level, your blood pressure reading will be unaccurate.

In a study published in the Journal of Human Hypertension, 25 people had their blood pressure measured while lying down. First, their measurements were performed with their right arms at the right atrium height. The second measurement was performed with the arm resting on the bed. The results showed both systolic and diastolic pressure were higher, 4.6 mmHg and 3.9 mmHg respectively, when the arm was resting on the bed 2.

This backs up other research findings when the BP cuff is below heart level, while sitting. The readings are higher than when at the correct heart level. You can read about it here in my blog post, Effect of Arm Position On Blood Pressure.

Other Mistakes

The relaxation time prior to measuring is very important. I’ve seen people make the mistake of lying down within five minutes. Even though their total relaxation time was five or more minutes, lying down while relaxing interrupts the process. It’s unnecessary body movement that causes an increase in the heart rate and muscle tension. Always start your five minutes after lying down.

This may seem silly because you’re lying down, but make sure your back is supported. I’ve seen people slightly lift their back off the mattress to reach for an object, like a remote or cell phone. This movement will tense your stomach muscles and can definitely affect your measurement. Keep your back supported while relaxing and measuring.

While resting or during measurement, keep your legs uncrossed. In addition, don’t rest your arm or hand up or behind your head.

Additional Tips For Measuring Blood Pressure Lying Down

  • Don’t eat or drink caffeine 30 minutes prior to your blood pressure measurement. Caffeine and coffee can cause a temporary spike. I wrote a whole blog post on how coffee affects your BP, short and long-term. You may be surprised about the long-term effect, you can read about it right here, Does Coffee Raise Blood Pressure.
  • Don’t measure your blood pressure with a full bladder. It can raise your systolic pressure by 10 to 15 mmHg 3.
  • Always measure your blood pressure prior to taking any medication. In addition, most medical experts recommend measuring in the morning after relaxing and before eating.
  • Don’t smoke 30 minutes prior to measuring your blood pressure.
  • Avoid any exercise within 30 minutes because it can affect your readings 4.
  • Don’t take any cold or warm showers before measuring your pressure.
  • Use the correct size BP cuff.
  • Make sure the cuff is positioned properly on the arm. This can be as critical as using an incorrect cuff size. Read more about how to do it correctly in my blog post, Blood Pressure Cuff Placement.
  • Don’t text, talk on the phone or watch television while relaxing or measuring your pressure.
  • Take two to three measurements and keep a log of your results. Most newer home monitors store the information on the machine or a phone app. In addition, you can send the results to your physician through the app. If you’re looking to upgrade your home monitor, you can check out the one I use here in my blog post, Home Blood Pressure Monitors.

taking blood pressure lying down

Reasons Why You May Take Blood Pressure Lying Down

Postural Hypotension: This occurs when blood pressure is abnormally low when a person stands up from a lying down or sitting position. The decrease may recover closer back to the person’s normal pressure or remain lower. It’s also known as orthostatic hypotension 5. To help diagnose and treat the condition, blood pressure will be measured while lying down and standing up. Orthostatic Hypotension can be caused by the following:

  • Old age
  • Prolonged bedrest
  • Certain medications
  • People who don’t experience a drop in BP when sleeping.
  • Supine hypertension

Orthostatic Hypertension: This is the opposite of postural hypotension. This condition is when a person’s blood pressure increases while standing up 6. This can occur for the following reasons:

  • Elderly people
  • Type 2 diabetes
  • Fluctuations in blood pressure and heart rate.
  • An increase in the heart rate and change in blood pressure when standing up.
  • When an artery in the back gets compressed.
  • Conditions that cause the autonomic nervous system not to work properly.

Supine Hypertension: A condition when someone’s pressure increases while lying down. This can occur while awake or sleeping. A common cause is autonomic failure which is a disease that affects the nervous system that regulates involuntary functions like BP 7.

The Patient is Hospitalized: In a hospital, it’s very possible your blood pressure will be measured while lying down. Depending on your medical condition, during and after surgery are reasons why you may be confined to the bed.

Confined to the bed at home: Your medical condition, injury or recovery may force you to remain in a lying down position while at home.

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Is Blood Pressure Higher Or Lower When Lying Down?

This topic seems to be controversial. You would think blood pressure would be lower when lying down. My body is more relaxed and less tensed if I’m lying down correctly. After all, we lay down while we sleep and not sit in a chair.

I scoured highly authoritative medical journals, studies and research papers to find an answer to this question. I found eight trusted sources and found different conclusions.

Four of them stated blood pressure lying down is higher compared to sitting. Three of them concluded blood pressure was lower while lying down. One of them found systolic was higher but diastolic was lower, when lying down.

Why the inconsistencies? I cannot say for sure, but some of the studies didn’t mention arm or cuff positioning. We know, positioning the cuff at heart level is crucial for measuring BP, lying down or sitting up. No one seems to disagree with that.

When I require a solid answer on blood pressure, I always lean on my most reliable resource. I checked what The American College of Cardiology and The American Heart Association had to say.

In the new blood pressure guidelines, they stated systolic blood pressure has been reported to be 3-10 mmHg higher in the supine (lying) than the seated position. In addition, they said diastolic blood pressure is 1-5 mmHg higher when measured supine vs seated 8.

Read Next

Fluctuating Blood Pressure and Inconsistent BP Readings


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Article Resources: Blood Pressure Explained follows strict guidelines to ensure our content is the highest journalistic standard. It's our mission to provide the reader with accurate, honest and unbiased guidance. Our content relies on medical associations, research institutions, government agencies and study resources. Learn more by reading our editorial policy.
  1. Journal Hypertension: Measurement of Blood Pressure in Humans: A Scientific Statement From the American Heart Association[]
  2. Journal of Human Hypertension: Both body and arm position significantly influence blood pressure measurement[]
  3. Journal of Hypertension: European Society of Hypertension recommendations for conventional, ambulatory and home blood pressure measurement[]
  4. National Center for Biotechnology: Postexercise Hypotension: Central Mechanisms[]
  5. Genetics Home Reference: Orthostatic Hypertension[]
  6. National Center for Biotechnology Information: Orthostatic hypertension: Recognizing and under appreciated clinical condition[]
  7. American Heart Association: Heating pads may lower blood pressure in people with high blood pressure when lying down[]
  8. Journal Hypertension: Measurement of Blood Pressure in Humans: A Scientific Statement From the American Heart Association[]

Kevin Garce

Kevin Garce is a Certified Health Coach who encourages people by informing them on blood pressure topics important to them. His years of research and knowledge inspire people to achieve their goals. Read more here About Me

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