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Swapping around can be more comfortable for a couple reasons... actual full flats will have a couple of degrees incline due to the nose-up attitude of the aircraft in flight. Some people don't like their feet being above their head. Turning around can solve that. Others like to have plenty of room for their feet, so changing direction gives you that. (The CX F seats are more comfortable in reverse!)
However, I'd be surprised if the crew didn't instruct the passenger to turn around as (a) the seat belt in that position is likely to be around the knee area and not the waist, which makes it less effective (and as pointed out, the head could come in to direct contact with the foot well), and (b) the proximity of the oxygen mask... which will be by the feet in this sleeping position and not in handy reach (plus the passenger may be disorientated).
Funnily enough, out of desperation, I thought of doing exactly the same on a CX A350 flight this week. Seat guru rated row 19 as bad seats so I got them to change to the front row seat which was one of the worst decision ever as both the toilets and galley were at the front and the curtain kept opening every 5 mins on a 2am flight disrupting my sleep.
There was a guy who regularly posted on the BA FT forum who had a continual battle watch FA'S regards his desire to sleep on the old BA First seats head to tail.
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