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How to Sleep After Botox Treatment – Is it Safe? (7 Tips)

Dr Ahmed Zayed
  • This article has been written and researched by Dr. Ahmed Zayed – a qualified and practicing plastic surgeon (M.D, MBBS) – to ensure maximum factual accuracy.

Cosmetic botox treatment is an effective way to reduce the appearance of fine lines and wrinkles that appear in your face as you age.

But how do you sleep after botox treatment – is it safe to lie down?

It’s safe to lie down after botox treatment once 4-6 hours have passed since the injections were administered. To sleep after botox treatment: sleep on your back, avoid sleeping on your front or side, don’t take a hot shower before bed, and avoid pressure on the injection sites to prevent dose migration.

The rest of this article explains in more detail how to sleep correctly after botox treatment so that you don’t risk causing the botox dose to migrate away from the treatment area – which could ruin the final look of the botox and the way your face looks.

Always make sure that you consult with your botox provider or another suitably qualified medical professional before sleeping or engaging in normal activities after your botox treatment.

Want to sleep more comfortably after botox? Then try the Puffy Lux Hybrid mattress (click here for my full personal review) – it has better pressure relief and helps maintain good posture for a more restful night’s sleep.

How to Sleep After Botox Facial Treatment – 7 Tips

The biggest risk to sleeping, lying on, or applying heat or pressure to the injection sites after botox treatment is dose migration – where the botox is forced away from the intended treatment area and could potentially result in excess swelling, your skin not appearing smooth, or other areas becoming affected by the botox.

Dose migration is relatively rare after botox but you should follow the 7 tips below to minimize the chances of it happening and to sleep more effectively after your botox treatment:

1: Sleep On Your Back to Avoid Injection Site Pressure

Until 48 hours have passed since the injections, the best position to sleep in after botox treatment is on your back because this prevents your face from coming into contact with the pillow and thus avoids any risk of pressure being placed on the injection sites that could cause the botox to migrate away from the area that it’s intended to treat.

However, as long as you don’t sleep or place pressure on the injection sites and surrounding areas before 4-6 hours since the botox was injected, the risk of the neurotoxins entering the surrounding muscles and tissues is relatively low – so if you did end up sleeping on your stomach or side after botox then the chance of an adverse reaction is minimal.

But to avoid any complications, you should make your best effort to sleep on your back for the first two nights after getting botox injections in your face.

If you find it difficult to sleep on your back then see the second tip below.

2: Use Pillows to Avoid Side and Stomach Sleeping

If you’re a stomach or side sleeper, then you should place pillows around your body to ensure that you sleep on your back and don’t roll over for the two nights that follow your botox treatment.

You can use regular pillows to do this, or invest in a set of wedge pillows and place one at either side of your hips/body to stop you from turning over.

3: Sleep On Silk Bedding to Reduce Wrinkles and Friction

Sleeping on pillowcases and bed sheets made from mulberry silk instead of regular cotton bedding is ideal after botox treatment because real mulberry silk can be ‘anti-aging’ by helping to reduce the appearance of wrinkles through the inclusion of the sericin protein that can help your skin to retain moisture and look less dehydrated, whilst also reducing friction on your skin [1].

Therefore, if you’re an age-conscious sleeper, then buying a set of real mulberry silk bed sheets is a good investment on the whole – even if you’ve not just had botox treatment.

4: Avoid Rubbing in Face Creams for 24 Hours

It’s best to completely avoid applying the face creams that you normally use at bedtime for the 24 hours after your botox treatment because the rubbing that is required to properly integrate the cream with your skin may increase pressure on the injection sites that may lead to the botox being moved to unintended areas.

But if you absolutely cannot bring yourself to not apply face cream, then you should apply it without excessive rubbing or massaging around the injection sites.

5: Sleep On Clean Bedding to Avoid Irritation

It’s important that you wash your bed sheets and pillowcases in time so that you can sleep on clean bedding after your botox treatment because it will help to keep dirt and bacteria away from the injection sites and thus prevent skin irritation/swelling.

You should wash your bedding at least once per week to reduce the chance of dirt causing blocked pores, a dull complexion, acne, spots, allergic reactions, and keep your skin looking fresh.

6: Avoid Headbands and Wraps to Decrease Pressure

You should avoid sleeping in a headband or a wrap that comes into contact with your forehead or the injection sites because the pressure could cause the botox dose to move around.

7: Don’t Take a Hot Shower Before Bed

Don’t take a hot shower before bed on the day that you’ve had botox injections (or get in a sauna, hot tub, or engage in heavy exercise) because increasing your body temperature can boost blood flow that can increase the risk of the dose moving away from the injection site and ruining the final appearance of the botox treatment.

Guide to Sleeping After Botox Treatment

Below is a guide that answers many of the common questions related to sleeping and botox treatments:

Botox Has Many Medical and Cosmetic Uses

Botox is a protein made from Botulinum toxin, which derives from a bacterium called Clostridium botulinum.

Also called the ‘miracle poison’, Botulinum toxin is ‘one of the most poisonous substances known’ [2].

When healthcare professionals use it correctly, Botox can have many positive benefits.

Even though we tend to associate Botox with a cosmetic approach to reduce fine lines and wrinkles on the face, this substance has an array of medical uses.

Some medical uses of Botox include:

  • Preventing migraines in patients whose migraine episodes last at least four hours or 15 or more days per month.
  • Treating upper limb spasticity in patients older than two years.
  • Treating blepharospasms (eyelid spasm) due to dystonia (a movement disorder wherein muscles contract uncontrollably).
  • Management of strabismus (crossed eyes) in patients older than 12 years.
  • Treatment of hyperhidrosis (severe underarm sweating).
  • Reducing symptoms of the overactive bladder due to a neurological condition in cases when other treatment approaches don’t help.

Botox Can Be Used to Combat the Signs of Aging

When it comes to dermatology, botox is injected into the face to combat the effects of aging.

Cosmetic botox treatment can help to combat the following complaints [3]:

  • Frown lines.
  • Crow’s feet at the side of the eyes.
  • Horizontal forehead creases.
  • Wrinkles around the mouth.
  • Nasolabial folds (indention lines on either side of the mouth extending from the edge of the nose to the mouth’s outer corners).
  • Neck and chest/cleavage wrinkles.

The video below specifically discusses how botox can be used in your face to combat the effects of aging:

Risks of Botox

Botox is Relatively Safe

Botox treatments are relatively safe and most patients have a positive experience when the treatment is applied by a qualified and experienced practitioner – between 1989 and 2003, only 36 cases of adverse reactions were reported to the FDA [4].

Botox Can Have Some Mild Side Effects

Even though Botox is relatively safe, some of the following mild side effects may occur from botox treatment [5]:

  • Swelling, bruising, and pain at the injection site.
  • Dry eyes or excessive tearing.
  • Headache.
  • Flu-like symptoms.
  • Drooling and/or crooked smile.
  • Cockeyed eyebrows and/or drooping.
  • Tiredness.
  • Dry mouth.
  • Dizziness.
  • Skin rashes.

Serious Side Effects From Botox Are Possible But Rare

Serious side effects from botox treatment are rare but may happen if the injection spreads to other parts of the body – resulting in vision problems, muscle weakness, breathing problems, poor bladder control, and difficulty speaking and/or swallowing.

Lying Down After Botox Can Cause Dose Migration

If you lie down within 4-6 hours after having had botox treatment in your face, then there’s a (relatively low) chance that the dose may migrate (move away) from the injection site due to the pressure being placed on it – this may increase the swelling and negatively impact how the botox treatment looks once finalized.

Don’t Panic if You Lie Down After Botox

If you lie down before 4-6 hours have passed since your botox treatment, then you shouldn’t panic because swelling and dose migration is not guaranteed to happen immediately (or at all) – simply sit up to remove the pressure from the injection sites and contact your botox treatment provider if you’re concerned.

Botox Treatment Can Make You Sleepy

Some people may experience sleepiness after botox treatment but this is not a guarantee for everyone because these reports are anecdotal – there are currently no scientific studies investigating the link between sleepiness and botox treatment.

Botox Treatment May Temporarily Disrupt Your Sleep

The botox itself is unlikely to directly have a negative impact on your sleep but the botox treatment as a whole may briefly disrupt your sleep in the first 24-48 hours after treatment by causing pain at the injection sites, headache, migraine, or even flu-like symptoms.

Botox Can Be Used to Treat Sleep Disorders

Botox can be used to treat nocturnal bruxism (teeth grinding at night), cerebral palsy in children with sleep disorders, and snoring.

More details below:

Teeth Grinding

Nocturnal bruxism is the medical term for teeth grinding during sleep.

Studies confirm that Botox is an effective treatment option for nocturnal bruxism and even helped reduce pain in subjects.

In one study, only two adverse events were recorded, meaning Botox is also a safe approach to the management of this common problem [6].

Botox helps manage this problem by decreasing the intensity of the masseter muscle, one of the muscles of mastication (chewing) [7].

Although Botox is an effective treatment option for nocturnal bruxism [8], you should still consult your doctor about this approach rather than opting for the procedure on your own.

Cerebral Palsy

Treatment with Botox could also help address sleep problems in children with cerebral palsy.

This is particularly important if we bear in mind that about 35% of children with cerebral palsy have a sleep disorder [8] – although more research on this subject is necessary.

Snoring

Botox injections could also help address habitual snoring.

Evidence shows Botox treatment is noninvasive, easy to perform, fully reversible, and deserves further investigation for this sleep problem [9].

Loud and habitual snoring is a common symptom of sleep apnea.

You Can Take Sleeping Tablets After Botox Treatment

Unless your botox provider states otherwise, it should be safe to take sleeping medication after botox treatment – provided that you don’t fall asleep on the injection sites within 4-6 hours of the botox doses being administered.

The Best Time to Have Botox Treatment is in the Morning

The best time to have botox treatment is in the morning between 9 am and 10 am because this will give you a greater period between the injection time and when you lie down to sleep – thus minimizing the possibility of dose migration occurring due to pressure being placed on the injection areas.

Avoid a Hot Shower Before Bed After Botox

You should avoid having a hot shower before bed on the day that you have botox treatment because exposing the injection sites to hot water within 24 hours of being administered can increase the blood flow and thus the risk of the dose migrating away from the intended area.

Results From Botox Injections Take 4-7 Days to Show

It takes between 4 and 7 days on average for the botox injections to produce the final intended result.

Therefore, you should take this into account when having botox before a special event.

Conclusion: Avoid Pressure and Heat

You should avoid heat and pressure on the botox injection sites for up to 48 hours after botox treatment – with the first 4-6 hours being the most critical – to prevent dose migration and ruining the desired effects.

Ideally, you should avoid lying down four to six hours after the treatment to keep pressure away from the injection sites.

You should still avoid sleeping on the stomach or your side after botox during the 48 hours after the injections.

Surround yourself with pillows so that you’ll remain sleeping on your back.

Ensure your bedding and pillowcases are clean.

Pillowcases should be made of silk if possible as they don’t cause lines, creases, and abrasions on your skin that may aggravate the injection sites.

Avoid headbands, wraps, hot showers, and the vigorous application of face creams in the 24 hours after treatment to reduce the risk of the dose moving away from the injection site.

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Sources and References

[1] Wikipedia – Sericin. Accessed 4/2/21.

[2] PubMed – Botulinum Toxin. Accessed 4/2/21.

[3] PubMed – Botulinum Toxin (Botox) A for Reducing the Appearance of Facial Wrinkles: A Literature Review of Clinical Use and Pharmacological Aspect. Accessed 4/2/21.

[4] PubMed – Botulinum Toxin Type A Injections: Adverse Events Reported to the US Food and Drug Administration in Therapeutic and Cosmetic Cases. Accessed 4/2/21.

[5] PubMed – The Possible Adverse Effects of Intramuscular Botulinum Toxin Injections and Their Management. Accessed 4/2/21.

[6] PubMed – The Evaluation of the Clinical Effects of Botulinum Toxin on Nocturnal Bruxism. Accessed 4/2/21.

[7] PubMed – Botulinum Toxin Therapy for Managing Sleep Bruxism: A Randomized and Placebo-Controlled Trial. Accessed 4/2/21.

[8] PubMed – Effect of Botulinum Toxin Injection on Nocturnal Bruxism: A Randomized Controlled Trial. Accessed 4/2/21.

[9] PubMed – Effects of Botulinum Toxin Serotype A on Sleep Problems in Children With Cerebral Palsy and on Mothers’ Sleep Quality and Depression. Accessed 4/2/21.

[10] PubMed – Treatment of Habitual Snoring with Botulinum Toxin: A Pilot Study. Accessed 4/2/21.

Medical Disclaimer

Although this article was written by a qualified plastic surgeon, none of the information should be acted upon without first consulting with a qualified medical professional that understands your unique situation.

Image Attribution and Licencing

Main image: ‘Sleeping’ by Juanmonino (Getty Images Signature) used with permission under the terms of Canva’s One Design Use License Agreement.

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