The Best Sleep Positions for Sleep Apnea (And What to Avoid)

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Obstructive sleep apnea is a common yet serious disorder characterized by repeated episodes of airway collapse during sleep. This can lead to loud snoring, shortness of breath, and pauses in breathing throughout the night.

Several factors can influence sleep apnea, including sleep position. The position you sleep in can affect how easily air enters your lungs, largely because of gravity. Certain positions can cause the soft tissues in your throat and neck to shift in a way that narrows or blocks the airway while you sleep.

Positional sleep apnea occurs when symptoms are more noticeable or severe in certain sleeping positions. For some people, simply changing their sleeping position may help reduce symptoms such as snoring and improve airflow during the night.

If you're looking to reduce snoring or improve your sleep, understanding how different sleeping positions affect breathing may help. Here’s a guide to the best and worst sleeping positions for sleep apnea.

The Worst Position: Supine (On Your Back)

Sleeping on your back (the supine position) is universally considered the worst position for patients with OSA.

When you lie flat on your back, your tongue and other soft tissues in your throat can move backward as your muscles relax during sleep. This can make your airways narrower and, in some patients, can contribute to it becoming blocked.

You may notice that your snoring is louder when you sleep on your back. Your sleep study may also show more breathing interruptions when you sleep in this position.

Key insight: Over half of all patients with mild to moderate OSA see a dramatic improvement in their symptoms simply by avoiding sleeping on their backs.

The Best Position: Lateral (On Your Side)

Side sleeping (the lateral position) is the gold standard for anyone suffering from sleep apnea or heavy snoring.

When you sleep on your side, your tongue and other soft tissues are less likely to fall backward and narrow the airway. This can reduce the chance of airway blockage and may also reduce snoring for some patients.

  • Left Side vs. Right Side: While both sides protect your airway, physicians often recommend sleeping on your left side. Because of the stomach's anatomy, left-side sleeping helps prevent gastric acid from splashing up into your esophagus. Since acid reflux and sleep apnea frequently occur together, left-side sleeping tackles two major nighttime disruptors at once.

The Compromise: Prone (On Your Stomach)

Sleeping on your stomach can also help some people keep their airway more open because your tongue and soft tissues are less likely to fall backward. However, stomach sleeping is not comfortable for everyone. Turning your head to one side all night can put pressure on your neck, and some patients may experience neck, shoulder, or back discomfort as a result.

If you naturally sleep comfortably on your stomach, you may not need to change your position solely because you have sleep apnea. However, side sleeping is often more comfortable for people trying to avoid sleeping on their backs.

How to Stop Sleeping on Your Back

If you are comfortable with sleeping on your back, changing your sleeping position can take some getting used to. You may start the night on your side but find yourself back on your back a few hours later without realizing it.

To enforce side sleeping, consider Positional Therapy. The aim is to make sleeping on your back less comfortable or to remind you to move onto your side.

  • The "Tennis Ball" Trick: A traditional method that involves sewing a tennis ball into the back of a tightly fitting T-shirt. If you try to roll onto your back, the ball's discomfort forces you to roll back onto your side without waking you completely.
  • Wedge Pillows: A firm, specialized wedge pillow can support your back, preventing you from rolling over during the night.
  • Electronic Sleep Belts: Wearable devices gently vibrate when they detect you have rolled onto your back, training you to shift positions subconsciously.

While positional therapy can be incredibly helpful, it is not a replacement for medical treatment if you have moderate or severe OSA. If you have been prescribed CPAP, continuing to use your machine while adopting a comfortable side sleeping position can help you get the most from your treatment.

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