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Is it ok to wear socks in bed at night?

In an effort to put myself 'out there', I keep an eye out for any articles being written about feet, and one came up from a reporter for Yahoo. I wrote a long answer which was quite factual, but probably didn't match the reporter's agenda... so here you go! These are the questions that were asked and then I've given my own commentary - the type without an agenda.

A man, woman and dog in a bed, all wearing fluffy socks.
A man, woman and dog in a bed, all wearing fluffy socks.

Do you recommend people sleep with socks on or without socks on?

For general health purposes, I would generally recommend that people sleep without socks on.

Are there any health benefits to sleeping with socks?

Sleeping with socks on may be beneficial if you have poor circulation or conditions such as Raynaud's phenomenon (where the small blood vessels go into spasm) and this can be painful and disturb sleep.

Are there any risks to sleeping with socks on?

Sleeping with socks on does prevent the feet from 'breathing' and may reduce the amount of friction that might help with removing dead skin. It may also mean that the feet sweat more and so could increase the likelihood of developing a fungal infection.

Are there any health benefits to sleeping barefoot (without socks)?

I do not know of any 'true' health benefits to sleeping barefoot.

Are there are risks to sleeping barefoot (without socks)?

For a person with healthy feet, no.

What about compression socks - should people sleep with them on? Are there any risks or advantages?

A graphic of a cartoon pair of legs with some varicose veins, with a couple of diagrams showing normal veins compared to varicose veins.
Varicose veins are a widening of the vein accompanied by a failure of the valves which prevent back flow of blood. The varicose veins swell up and fill with blood more than healthy veins do, because the walls are weaker.

Compression socks are designed to assist in encouraging blood flow back up the legs to the heart in patients with a faulty venous system (such as those with varicose veins).

The venous system relies on the pumping of muscles around veins to push blood back up the body (against gravity), to the heart.

As a result, compression socks are generally not necessary for people to sleep in as their venous return will be improved when laid down. - unless they have been advised to by their healthcare providers.

This can be evidenced by the fact that those who wear compression socks will often find that their feet and ankles swell if they stand up for longer periods during the day, but the feet and ankle swelling goes back down when they put their feet up or lay down.

What does a podiatrist have to say about wearing socks in bed at night?

I do not generally recommend that people sleep in socks if they are fit and healthy, but there are a number of reasons that it may be appropriate for a person to sleep in socks - or just for me to mind my own business if that's what they enjoy doing.

Firstly, if it is cold or you have poor circulation (or both!) then sleeping in socks may help you to be more comfortable while you sleep and also may mean that you are able to get a better night's sleep because of the increased comfort.

Wearing socks to bed may be part of a treatment plan

For patients who have a lot of dry or cracked skin on their feet, I will often recommend that they apply a urea-based foot cream (10-25%) to their feet before they go to bed and wear a pair of socks to stop cream getting on their bed. They can go a step further and wear two pairs of socks: 1 pair which are damp as this helps the cream to act longer, and 1 pair that are dry (so as to reduce the amount of water that may soak into the bed).

A pair of cracked heels with dirt which has got in the cracks.
A pair of cracked heels that would benefit from routine footcare to debride the cracks and then application of a wet-sock wrap.

Wearing socks may mean we don't shed dead skin

Our skin is constantly regenerating and is like a conveyor belt, with the newest skin growing and moving to the surface and the old skin dropping off. Buy walking around and brushing our feet against surfaces, this helps to knock the dead skin off, and one of the times that this happens is overnight. So by wearing socks, we may prevent some of the friction from happening.

Wearing socks may also reduce friction for sensitive skin

This loss of friction may be helpful - for patients who have fragile skin, or who might have recently had a procedure done and so need to keep dressings in place - by wearing socks, there is an extra layer of protection between the foot and the covers/bed and so it reduces the likelihood of a dressing being knocked off of the foot.

Why do socks cause fungal infections?

I mentioned above that wearing socks might increase the likelihood of developing fungal infections in the skin. This is because fungi like dark, warm and moist places. So by enclosing the feet in a pair of socks this could further increase the time that the conditions are optimal for developing a fungal infection.

Regularly changing socks (twice daily if being worn day and night) and using biological washing powders will reduce this risk.

I would like to take a moment more to point out that wearing socks when you are in shoes is essential and much more hygienic than going commando!

I think it remains worth pointing out that any health risks associated with sleeping with socks on or off need to be weighed against other health risks.

A fungal infection, for most people, is an irritation but unlikely to cause major health risks. So not wearing socks for that reason, but risking a dressing coming off and exposing an open wound or sacrificing sleep because your feet are cold and uncomfortable does not really outweigh the relatively minor inconvenience of a fungal infection.

So would I, as a podiatrist, recommend that you wear socks to bed?

I’m going to take my statement from earlier: it’s none of my business, and you should do what you’re comfortable with because it’s pretty unlikely the world will end whether or not you wear socks to bed.

Romantic implications of not wearing socks to bed

I think I would be a bit remiss in my attempts to be holistic if I didn’t state that none of the advice in this blog should be used to settle disputes about the romantic benefits of wearing socks (or not) to bed.

I therefore take no responsibility for any romantic implications of the advice in this blog… although, having been made to watch a few trashy TV shows in my time: gents, I hear that we’re meant to take our socks off..!

A man begging for forgiveness, possibly for wearing socks at an inappropriate time!

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