“Bed rotting” is a term often used on social media apps to describe spending time in bed—from a few hours to several days—as an act of self-care.
While bed rotting videos show the aesthetic side of bed rotting (beds adorned with cozy blankets and plush pillows), experts think that excessive bed rotting could lead to a sedentary lifestyle. This could lead to a myriad of health concerns, including cardiovascular disease and sleep disorders.
Patients engaged in bed rotting may also have a mental health issue that needs to be addressed.
Upon hearing the term “bed rotting,” you may think of a mattress that has seen better days. However, it has more to do with the individual in the bed. The term “bed rotting” alludes to a person staying in bed all day (or for multiple days)—by choice, according to Urban Dictionary. There’s a chance your patients—especially Gen Zers—are engaging in it or thinking of doing it after seeing others ‘bed rot’ on social media.
The trend has garnered mixed responses. One TikTok platform user and sleep scientist, Vanessa Hill, uploaded a video saying the trend is all about honoring anti-optimization and anti-productivity. Another TikTok user, @dryftsSleep, describes the trend as “soft living,” an intentional way to de-stress while in bed.
Bed rotting is an antidote against the stressors of the modern world, where people are forced to juggle a constant inundation of information and stimuli. However, some experts think excess bed rotting could signify a deeper issue or lead to physical or mental health concerns.
Spending time in bed: Harmful or helpful?
According to Shelby Harris, MD, director of sleep health at Sleepopolis, the trend represents a double-edged sword: “Bed rotting can be a healthy practice when done in moderation, as it allows people to take time for self-care and relaxation. It can also be beneficial for managing stress and promoting mental well-being,” she says.
But while spending a Sunday afternoon in bed every once in a while can be rejuvenating, it’s best if patients don’t seek out bed rotting as their go-to form of self-care. “Excessive bed rotting may have negative effects. Spending too much time in bed can disrupt mood, increase stress levels, and interfere with healthy sleep patterns,” Dr. Harris says.
Excessive bed rotting may also lead to more serious health issues. Patients who consistently sleep longer than eight hours daily may be at increased risk of mortality compared with those who sleep just an hour less each day. Research has also shown an association between long sleep hours and incident diabetes mellitus, cardiovascular disease, stroke, coronary heart disease, and obesity.
Of course, people who engage in bed rotting may just be spending time in bed while awake. If done often, it may contribute to a sedentary lifestyle, which increases “all-cause mortality and the risks for cardiovascular diseases, diabetes mellitus, hypertension, and cancers (breast, colon, colorectal, endometrial, and epithelial ovarian cancer),” according to the Korean Journal of Family Medicine. 
Spending time resting in bed—a place reserved for sleep at night—could also be problematic, especially for patients with sleep disorders, says Brandy Smith, a Licensed Psychologist with Thriveworks in Birmingham, AL. “When it comes to people with sleep issues, [there are recommendations] not to spend extra time in bed because it can impact their sleep experience…It would be advised to rest in another space.” In fact, the Division of Sleep Medicine at Harvard Medical School recommends reducing the time in bed awake to reduce sleep issues.
In fact, bed rotting itself may signify a sleep disorder in certain patients. According to the International Classification of Sleep Disorders, Clinophilia is the “tendency to remain in bed in a reclined position without increased sleep time.”
Social media glamorizes the self-care aspect of bed rotting with aesthetic videos of cozy bed linens and lit candles. Meanwhile, an individual might need more targeted help, like therapy. These self-care trends can also have unintended consequences, writes Kristen Lee, Ed.D., LICSW writes for Psychology Today. They can “distract us from being able to turn our attention to methods that are more likely to sustain us,” she says.
Dr. Harris agrees. “If someone uses [bed rotting] as an excuse for avoiding responsibilities or neglecting important aspects of their life, it could potentially promote unhealthy behaviors. Ultimately, it is up to [the individual] to use the concept of bed rotting in a responsible and balanced manner,” she says.
At worst, bed rotting may be an aspect of a patient’s mental illness. “Bed rotting can also be a sign of depression….anxiety, or stress,” says Gary Tucker, chief clinical officer, and licensed psychotherapist at D'Amore Mental Health in California, noting that some patients may seek out bed rotting if they find themselves struggling to get up, be productive, or engage in activities they enjoy.
Essentially, it all boils down to how often someone engages in bed rotting. “The term ‘bed rotting’ itself does not inherently promote bad behaviors. The interpretation and behavior associated with the term depend on how people engage with it,” Dr. Harris clarifies.
How can HCPs help patients engaging in bed rotting?
Dr. Smith says that if she were treating a patient who tends to spend excessive time in bed, she’d have an open and honest conversation with them around how the behavior looks for them.
“If I was discussing ‘bed rotting’ with a client, then I would make sure to talk through such points as how is this helping [them], how might it be holding [them] back, and what can better balance within rest and engagement look like for them, their life, and their energy level,” Dr. Smith says. “Those questions will foster critical thinking, exploration, and intentionality of what the person may need in the moment along with what broader changes they may need/want to make in their life.”
Finally, “If [patients] find themselves stuck in a bed rot rut, it is important [they] talk to a professional for help getting back on track,” Tucker adds. If it’s not your area of expertise, you may need to refer them to a mental health specialist.