Can Wearing Socks Help You Sleep Better? with Aparna Bhat, MD

John Horton:

Hey there, and welcome to another Health Essentials Podcast. I'm John Horton, your host.

When you go to bed at night, do you wear socks, or do you let your little piggies roam free under the covers? Surveys show that roughly 1 in 3 people cover up their feet at night, and the science says they may be onto something. To learn more, we have sleep medicine specialist Aparna Bhat to join us today. Dr. Bhat is one of the many experts at Cleveland Clinic who pop into our weekly podcast to offer tips on healthier living. Now, personally, I'm a naked foot sleeper, but I'm open to making a change. So let's hear the argument for wearing socks to bed.

Welcome back to the podcast, Dr. Bhat. We are thrilled to see you again.

Dr. Aparna Bhat:

Thank you so much for having me.

John Horton:

So I have to tell you, we cover a lot of pretty serious issues on the podcast, but today's topic is definitely a little on the lighter side. Sleeping with your socks on or off isn't exactly a lifesaving question, but it is heavily debated, and surprisingly divisive. So it's safe to say we have a lot to chat about.

Dr. Aparna Bhat:

You caught me by surprise with this one.

John Horton:

Well, I know you were a little like, "I don't know if there's enough here," but there's some interesting stuff. I guess, let's jump in with the real basic question to get going: Is sleeping with socks on good for you?

Dr. Aparna Bhat:

Yeah, you know what? I've always thought of this as being a personal choice, but I guess there is some evidence — and you gave me an opportunity to learn a little bit more. So we'll dive in together.

John Horton:

Yeah. So what is it? It seems like there's a certain theory, or some research shows, that if you sleep with socks on, it may help you fall asleep faster and sleep better. What would make this happen?

Dr. Aparna Bhat:

Yeah. And I think to understand that, it's important to take a step back and then look at the regulation of our core body temperature, because that is linked to sleep onset and sleep quality.

So just with everything in the body, there is a circadian rhythm, or a body clock rhythm, that is controlled by our brain, and it runs in parallel to the sleep-wake cycle. So throughout the day, temperature rises, and then it peaks sort of in the evening times. But then, as melatonin rises in the brain and is released in the brain at night, our body naturally works to lower the core body temperature, and this is done to prepare for sleep.

John Horton:

Yeah, you want your body to kind of chill out when you go to bed.

Dr. Aparna Bhat:

Yeah. So this temperature actually continues to drop, and drops down to its lowest value early morning, so around 3:00 or 4:00 a.m.

John Horton:

But if you wear socks, it seems like you're kind of warming. I mean, you're warming your feet. How does that help cool the rest of your body?

Dr. Aparna Bhat:

This deals with temperature regulation, or thermoregulation, and it's through distal vasodilation, which basically means that your hands and your feet warm up because of blood vessels that open to release more heat. And in doing so, it decreases the core body temperature and signals to the body that it's time to sleep.

John Horton:

Wow. So you make your feet warmer, your core gets a little cooler, and that kind of balances everything out.

Dr. Aparna Bhat:

Yeah. You're trying to dissipate the heat from your body.

John Horton:

That's just kind of wild. I mean, it's amazing how the circulation system kind of works and that all ties together.

Dr. Aparna Bhat:

Yeah. So wearing socks can be a matter of comfort, but wearing them can also be a passive body heating strategy as well.

John Horton:

It sounds like it can help you then fall asleep faster if you kind of have that, because you get that cooling sensation. Can having them on all night help you sleep better?

Dr. Aparna Bhat:

Yeah. So sleep quality can be affected by room temperature and body temperature as well. So you mentioned, "I thought this was all about keeping a cool temperature," and some of it is. It is important to have a cooler bedroom temperature, somewhere between 60 to 70 degrees. Too hot and it disrupts REM sleep, or dream sleep; too cold and our body kicks into action trying to raise the core body temperature up. And so sleeping with socks on can help with that process of keeping the core body temperature cool throughout the night as well.

John Horton:

Well, and we've all had those nights where you wake up because your feet are too cold. I mean, obviously, that's something where socks can maybe help address that, too.

Dr. Aparna Bhat:

Yeah. And it's especially important with patients who have vasoconstriction, or Raynaud syndrome, where you have abnormal tightening of the blood vessels in the fingers and the toes. And so instead of the vasodilation, meaning the opening up of those blood vessels, they have tightening. And so especially for patients who have colder hands and feet, wearing socks can be really helpful to promote the generation of heat and cool your body temperature.

John Horton:

I also read, when I started looking at this, too, that if you're in menopause, socks may help level out your body temperature, and maybe even be effective at limiting hot flashes and temperature spikes when you sleep.

Dr. Aparna Bhat:

Yeah, that's exactly right. Yeah. It's the very same concept of allowing your body to dissipate heat or release heat from your extremities, your hands and feet. So modulating it by wearing socks can really minimize those hot flashes because your temperature isn't going up and down as much. And in doing that, you improve your sleep quality.

John Horton:

It is just so hard to believe that warming up your feet can have this effect on your entire body, that the system is kind of that delicate.

Dr. Aparna Bhat:

Yes, that's right.

John Horton:

So temperature is obviously a big thing, but what other potential benefits can you maybe see if you wear socks to bed at night?

Dr. Aparna Bhat:

Yeah. So for retaining moisture. So if you have cracked heels or dry feet, then wearing lotion and wearing some socks on can help retain that moisture, so for skin benefits. Then, for patients who might have diabetes or peripheral arterial disease, wearing socks can actually reduce the risk of ulceration as well.

John Horton:

Well, that makes a lot of sense. Little skin care, you got to pamper yourself a little bit at night.

There's another one that I read, and I'm going to try not to blush what I do and ask this question, but there was a study that showed that people who wore socks to bed at night had better sex. I guess cold feet can be a big turnoff. Is there any truth or legitimacy to that thought?

Dr. Aparna Bhat:

I've never heard that one, but it's an interesting thought, and I'm sure there are other factors that contribute to it, too.

John Horton:

All right. So maybe that comes down to that personal preference thing. If you're feeling a little better, maybe it'll help with those extracurriculars.

So if you decide to wear socks to bed after hearing all of this and maybe some of the benefits, are there certain socks that work better than others that you want to add to your shopping list?

Dr. Aparna Bhat:

Yeah. So it's important that they're comfortable and the material should be breathable, and they should be moisture-wicking as well. So you want to make sure that they're loose-fitting, so that you avoid that ulceration or irritation to the skin. So materials like cotton, merino wool, bamboo, viscose — those are all good materials to wear, and they're moisture-wicking, and they allow the heat to escape, too.

John Horton:

You had mentioned being a little more loose-fitting. So I know sometimes people will look to wear compression socks to bed because they think maybe it'll help with some cramping or things like that. Is that a good idea?

Dr. Aparna Bhat:

Yeah. Compression socks are typically advised for the daytime. And so the benefits of wearing compression socks are to help your blood flow back toward your heart and work against gravity. And typically, when we're lying down and sleeping, you don't really need compression socks to help with that aspect. And since they're tight, they can lead to blisters or skin irritation, ulceration, as well as restricted blood flow. So there may be some exceptions to this rule, so it's really important to ask your provider and figure out what's right for you.

John Horton:

Well, it sounds like, for the most part, then stick with those warm, comfy, fuzzy socks when you go to bed at night. Something that makes you feel good and comfy.

Dr. Aparna Bhat:

Correct.

John Horton:

Now, I don't want to ignore the barefoot crowd here. So let's address whether there's anything, I guess, inherently wrong with just letting the dogs roam free all night. I take it there's no harm in going sockless?

Dr. Aparna Bhat:

No, no, not at all. It's a personal choice. So definitely nothing wrong to leave them bare. And for some people, wearing socks can be helpful. It can help with promoting sleep onset. If you are having trouble sleeping, though, wearing socks may not solve all your problems. So it's definitely not for everyone.

John Horton:

Yeah. It sounds like the sort of thing you can always experiment with. If you're having trouble sleeping, put socks on. Or if you're not wearing them, put them on. And maybe if you're having trouble sleeping and you're wearing socks, take them off and maybe that'll help.

Dr. Aparna Bhat:

Yep, that's right.

John Horton:

All right. So with all the debate about this — and there really is a lot of debate when you look online — it sounds like there isn't just a true right or wrong answer when it comes to your sock preference at night.

Dr. Aparna Bhat:

Not at all. And like I said, this topic took me by surprise because I've always thought of it as a personal choice. So really, do whatever makes you feel comfortable.

John Horton:

It seems like that's the way to go. So when you go to bed tonight, do whatever you want, I guess. And hopefully, you have a good night's sleep and wake up and put a new pair of socks on and get about your day.

Dr. Aparna Bhat:

Yeah.

John Horton:

Well, Dr. Bhat, thanks again for coming in. I know this was a fun topic, a little different, but hey, you got to answer these big questions that are out there.

Dr. Aparna Bhat:

Yeah. Thank you so much for having me.

John Horton:

Are there potential benefits to sleeping with your socks on? Absolutely. But that doesn't mean you have to tuck your toes in at night. Comes down to personal preference, which is why my feet won't be covered up tonight.

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Speaker 3:

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