The Effect of Supine Sleeping Position on Brain Detoxification: An Integrative Review of Traditional and Modern Medical Perspectives for Optimizing Neurological Care

Abstract

The brain uses the glymphatic system to clear harmful waste like amyloid-β, which is most active during sleep. Research shows that people with neurodegenerative diseases tend to sleep more in the supine position. The current study aimed to identify and synthesize evidence from traditional and modern medicine literature on the effect of supine sleep position on brain detoxification. This integrated review combines findings from two studies: a literature review on traditional Persian medicine from the 8^th to 19^th century and a rapid review of modern medical databases, including PubMed, Scopus, Web of Sciences, and Google Scholar, without time limits, covering various methodologies and including human and lab research. Eight Persian medical texts, including Alvaḥ al-Sehheh, Al-Qānūn fi’l-ṭebb, Khafi Alaei, Memory in Medical Knowledge and Pharmacy, Al-Aghraz al Tibbia val Mabahess al–Alaiia, Tebb Ghiasi (Ghiasieh), Mofarrehu al-Ghulub, and Elm Al-Abdan, offer consistent recommendations against prolonged supine sleeping positions. Five sources directly highlight the impaired brain detoxification associated with the supine position. Additionally, in review of modern medical databases 37 articles were identified, of which five were selected for detailed analysis after three rounds of evaluation. The findings from these articles indicated that sleeping in a supine position diminishes the function of the glymphatic system; whereas the lateral sleeping position enhances its function. This review sought to provide insight into the role of the supine sleeping position on brain detoxification. Combining traditional and modern medical knowledge may optimize evidence-based neurological nursing practice.