we live in the midwest. My sweatshirt was on as it is supposed to be. I am cold all the time so I usually have alot of clothes on to keep warm especially when we start the ice water flowing. As far as sleeping I sat up in bed with lots of pillows for support. Even after the sling came off. My PA let me take the sling away at 21/2 weeks. And we stopped the ice at 3 weeks. Then my daughter went home. Right now I am canning tomato juice and using my left arm to sieve the pulp so my muscles and joints are getting a workout and my left shoulder and it is getting sore. So I only do a batch every couple of days. If I can help with any other questions let me know. I was so surprised to wake up and never any pain. Hope all goes well with you and stay healthly.