MedicinePlanet: Airline Sleeper Seats, For Comfort and Safety

— -- Lengthy flights can present real challenges and raise serious health concerns for airline passengers with back or circulatory problems. Sitting for long hours in cramped or constricted positions can lead to loss of flexibility and back pain, or to “economy class syndrome” (ECS) — impaired circulation and blood clots in the lower extremities, with potentially severe complications (deep vein thrombosis and pulmonary embolism).

If you are among those who dread or avoid air travel for these reasons, consider upgrading your accommodations next time you fly. Most major airlines now offer “sleeper seats” in first class, and some have them in business or in a combination business/first class as well. These roomy, comfortable, adjustable seats convert into six- to six-and-a-half-foot beds, many of them fully horizontal, allowing the passenger more freedom of movement and lessening the risk of developing blood clots or of aggravating existing back problems. Of course, this increase in comfort and safety comes at an increased price, but if you travel extensively, for business or for pleasure, the greater cost on an extended flight could be money well spent.

Be Good To Your Back

Dr. Gregory Lutz, Physiatrist-in-Chief at the Hospital for Special Surgery in New York City, indicates that any kind of flying contributes to increased pressure in the discs between the bones of the spine. The combination of the prolonged pressure and the constant vibration endured during a lengthy flight (or car trip) increases the risk of disc strain, resulting in pain and discomfort. Lutz says that the best body position for flying is lying flat, as the horizontal posture relieves this pressure.

Lutz offered some tips regarding general back health and safety while flying, regardless of whether or not you already suffer from back issues. “People need to be educated about posture and body mechanics. The muscles around the spine must be strong. It’s imperative that people, especially those at high risk, stay in shape and exercise regularly. It’s a good idea to get up, move around, stretch, and change your position, every 30 to 40 minutes. Inactivity in a sitting, forward-flexed position can lead to back pain. Walking around the cabin, reclining, and elevating your feet can help ease and prevent this pain. You should also be careful when handling heavy luggage. It’s important to lift properly and get help if you need it.”

Airline passengers need the cooperation of the seat itself to be able to follow some of this advice. It must be able not only to recline dramatically — if not fully — but also to elevate and support the traveler’s legs. Robin Benick, also of the Hospital for Special Surgery, is an M.A.P.T. and senior physical therapist with a degree in ergonomics. She states that, “even a perfect position when maintained over a long period of time can lead to soft tissue damage.” This is a particular problem for those people traveling two to three times a month on flights of three hours or more. On these flights, roomier seats are crucial. “The ability to change your position while in flight is key.”

Economy Class Syndrome

Economy class syndrome (ECS) is a serious and potentially fatal condition, so called because it is typically associated with passengers experiencing limited mobility in cramped quarters for prolonged periods of time.

Blood has a tendency to pool in the calves and pelvis during long hours spent in a seated and relatively immobile position. ECS is the result of the formation of blood clots in the deep veins of the leg or pelvis (deep vein thrombosis or DVT.) These clots can break free and travel to the heart or lungs causing sudden and unexpected death in otherwise healthy people as well as in people already known to be at risk for clots. People at increased risk for this problem include pregnant women, obese travelers, cancer patients, smokers and women taking birth control pills.

ECS can actually afflict anyone with restricted leg movement or stagnant blood circulation in the legs. The ability to recline significantly, elevate and stretch the legs, and move around with ease while seated decreases the chances of developing ECS. Be sure to stroll about the cabin at regular intervals, and do some simple exercises while flying, such as rotating your ankles, clenching your toes, and contracting and relaxing calf muscles, in order to keep your blood circulating and inhibit pooling. In many cases, a single dose of enteric-coated aspirin may be sensible before traveling, but speak with your physician first to see if this option is right for you.

Sleeper Seats: A Necessary Luxury?

Sleeper seats are a relatively new development in commercial air travel, but they are catching on fast. The airlines’ fierce competition for passengers is currently centering on who can offer the most comfortable seating. There is now wide variation in the length, width, and adjustability of seats, with variations in the price of a ticket often correlating.

British Airways is extremely proud of its high-tech and extraordinarily ergonomic and adjustable fully horizontal bed seats, and is also the first (and so far only) airline to offer fully horizontal sleeper seats in a separate business class — a slightly smaller version of its deluxe first-class offering.

The ne plus ultra of in-flight luxury seems to be Singapore Airlines capacious first-class seats, the roomiest in the world, which can metamorphose into the biggest airborne beds in the world. Some of these marvels of flying furniture incorporate features of an office and a living room as well.

The British Airways ‘Club World’ Model

British Airways officials commented on the design of their new “Club World” business class seating, which are the first full sleeper seats in business class, in addition to those in first class. In designing their seats, they started by asking two very important questions: “What makes an excellent seat, and what makes an excellent bed?” They answered their questions by applying not only the basic principles of sitting and sleeping but also those of eating, digesting, and working on a laptop. When all components are executed properly, the result is a passenger that feels more comfortable and well rested when exiting the plane.

The redesigned seats are lower to the aircraft floor, much like an armchair, and can adopt any position between fully upright, and completely flat. In the flat position, the goal was “no lumps or bumps, enabling the passenger to fall into a deep sleep,” British Airways Design Manager, Neal Stone, said. “Giving people back their time, maximizing it, and enhancing it while flying with British Airways was extremely important to us. We’re very proud of the seats. We firmly believe they are a great product and we’re getting a wonderful response from customers.”

In their quest for comfort, British Airways added an extensive electronic 4-way lumbar support system, with a large range of support options, that allows the traveler to independently adjust the supports depending on his or her lumbar needs, be it lower back, upper back, or both.

The headrest and footstool are also adjustable. “As you recline, the position in which you want your head and feet changes dramatically,” explained, Stone. “We tried to think of all passenger shapes and sizes, then tried to account for a vast majority of their needs.” The headrest has multiple tilt options as well as “ears” that can be angled in, towards the head, for additional support. The footstool, when engaged, becomes the end of the six-foot flat bed, or can be used with any of the seat’s reclining positions. Its height can be modified and the entire unit pivots, so travelers can utilize it to increase their comfort level as their body proportions dictate.

The ability to make such vast adjustments to one’s seat will come as a great relief to those passengers who have difficulty sitting for an extended period of time as a result of chronic back problems. Lutz went on to say that if British Airways is attempting to prevent additional pain for these people, “they’re on the right track.”

While these seats are without question a great leap forward, a six-foot bed for a 6'3" passenger will always be slightly small. Feet and legs will tend to dangle off the edges of the seat, creating edge pressure on the backs of the legs. Edge pressure increases the risk of impeded circulation; thus, even a sleeper seat can create problems if it is not long enough. If you are a very tall person, bend your knees so that your entire body is supported on the bed during the entire flight.

Are Sleeper Seats For You?

Are they affordable? To give an idea of fares, a British Airways business class ticket from New York to London will set you back about $6800, and from San Francisco about $8600. If these kinds of fares are out of the question for your next trip, then choose as much comfort and leg room as you can afford.

Continental Airlines, for example, offers an extra-wide seat in its combination business/first class. It doesn’t get flat, but it does recline 55 degrees. Delta Airlines is reconfiguring aircraft on certain of its flights and creating a “business/elite” (first-and-business combined) class, with fewer seats in roomier cabins and electronically-controlled sleeper seats that recline a little further than Continental’s, and also fully support passengers’ legs and thighs.

United is installing their version on most of its Pacific routes, and various styles of sleeper seats are available on Air France, Quantas, Cathay Pacific, Air New Zealand, Japan Airlines, Virgin Atlantic, All Nippon Airlines, Korean Airlines and Lufthansa, to name a few, and on American Airlines’ new Boeing 777s. Certain airlines on different flights are now offering upgraded, ergonomic seats in coach as well.

Our advice is to shop carefully when looking to book a flight. Ask your travel agent or search the Web to find the roomiest, most comfortable and supportive seat you can afford. On a long flight, your health and well being could depend on it.