Compression Stockings Should Be Worn 8-12 Hours Per Day
Compression stockings should be worn for 8-12 hours per day during daytime hours to effectively manage symptoms and prevent complications of venous disorders. 1
Recommended Wearing Duration
The optimal wearing time for compression stockings depends on the clinical indication:
- For symptomatic post-thrombotic syndrome (PTS): 8-12 hours per day, during daytime hours, and at least 3 days per week 1
- For chronic venous insufficiency: Daily wear for an average of 11 hours per day 2
- For prevention of evening edema: Full-day wear is more effective than half-day wear, but even half-day wear provides significant benefits compared to no compression 3
Compression Levels and Selection
Different compression levels are recommended based on the condition:
- For symptomatic PTS: Start with 15-20 mmHg at the ankle/wrist level to enhance adherence 1
- For prevention of PTS: 30-40 mmHg knee-high graduated compression stockings 1
- For elderly patients (≥65 years): Consider lower pressure (18-21 mmHg) stockings for better comfort and compliance, especially in those with foot deformities, arthritis, or rheumatism 4
Application Guidelines
- Apply compression stockings in the morning when edema is minimal 5
- Remove stockings at night before sleeping
- For maximum effectiveness, put stockings on before getting out of bed when possible
- Ensure proper fit by having stockings professionally measured 5
Patient Adherence Considerations
Patient adherence is a significant challenge with compression therapy:
- Only 21% of patients report using compression stockings daily as prescribed 6
- Common reasons for non-adherence include:
- Difficulty applying stockings (2%)
- Discomfort or "cutting off" circulation (13%)
- Heat-related discomfort (8%)
- Perceived ineffectiveness (14%)
- Poor cosmetic appearance (2%) 6
Special Considerations
- For travel: Wear compression stockings during long-distance travel (>4 hours) to reduce risk of DVT 5
- For patients with arterial insufficiency: Check ankle-brachial index before prescribing compression stockings; avoid in severe peripheral arterial disease (ABI <0.5) 5
- For patients with heart failure: Monitor for signs of cardiac decompensation when initiating compression therapy 5
Clinical Pearl
While the American Heart Association suggests that a trial of compression stockings may be reasonable for PTS patients without contraindications 1, the evidence from the most recent guidelines indicates that wearing compression stockings for 8-12 hours daily provides the optimal balance between effectiveness and adherence 1.
Remember that patient education about proper application, wearing time, and mechanism of action significantly improves adherence to compression therapy 2.