Does Positional Therapy Work for Sleep Apnea?

Millions of people around the world suffer from obstructive sleep apnea (OSA), a condition that causes pauses in breathing during sleep. 

Many people have mild sleep apnea although even this can leave you tired and not fully functional due to the lack of proper sleep. Positional Therapy might help.

What is Positional Therapy?

Obstructive sleep apnea is caused by a blockage in the air passage which wakes you up at multiple intervals. This is most likely to occur when sleeping on the back -- because the tongue is inclined to slip backwards, creating a temporary barrier and restricting air flow.

Most people have developed the habit of sleeping in a particular position and this is difficult to change. The sleep position impacts airflow and obstructive sleep apnea symptoms -- and experts recommend the following positions to improve airflow:

  1. On the side
  2. On the stomach
  3. On the back once the head is elevated

Side Sleeping: Sleep experts unanimously agree that sleeping on your side is the most effective method of reducing, or possibly eliminating, sleep apnea as there is less likelihood of the air passage being obstructed. 

A medium to thick pillow to keep the neck and head elevated is necessary -- and there are a number of specifically designed pillows available to help you stay on your side. [link to positional pillow in webstore

A body pillow is also an excellent idea as this will help prevent sufferers rolling onto their backs during sleep.

Stomach: Sleeping on the stomach is unnatural for many and often uncomfortable. Although the air passage is kept clear of obstructions, it can result in neck strains or a stiff neck in the morning. Although special pillows are available for people who sleep on the stomach, a thin pillow is more than adequate.

Back: Not only does sleeping on the back exacerbate the effects of sleep apnea but it can also increase the level of snoring. On top of this, a considerable percentage of OSA sufferers also have a problem with gastroesophageal reflux disease (GERD) and a supine position (on the back) increases the likelihood of heartburn and acid reflux.

Regardless of which sleeping position is used, choosing the right pillow is of prime importance. A thin or medium pillow will create enough elevation when sleeping on the side or stomach while a thick, firm pillow is essential for those who prefer sleeping on their backs. 

Possible Solutions

Changing sleeping position will not cure OSA but it can certainly lessen its impact. Sleeping supine plays a significant role in sleep apnea as blockages of the air passage and throat are far more likely to occur when lying in this position.

If sleeping on the back is the “normal” position there are a number of methods available to discourage this habit ranging from simple to more complex:

Tennis Ball. It may sound weird but sewing something like a tennis ball onto or into a tee-shirt and wearing it to bed will discourage the wearer from lying on the back due to the discomfort caused.

Filled Backpack. Similar to the tennis ball method, sleeping with a backpack containing irregular shaped objects will have the same effect.

Bumper Belts. A level up from tennis balls and backpacks are specially designed bumper belts. These usually consist of a solid block attached to a Velcro belt worn around the waist. These can be expensive and some may even require a doctor's prescription.

Night Shift Device. Not inexpensive but effective, a Night Shift Device is a neck band that vibrates when the wearer shifts into a supine position. 

Adjustable Bed. Sleeping at an angle can be of benefit to some OSA sufferers and an adjustable bed can be of benefit although an expensive one. A less costly alternative is to stack blocks or books under the feet of the bed to achieve the desired angle.

Before investing in a Bumper Belt, Night Shift Device or adjustable bed, a less expensive but often effective way of combating OSA may be a wedge pillow. 

These are triangular in shape, composed of foam and sloped to an angle of 20 to 40 degrees. This will raise the head by six to eight inches and this can reduce the incidence of snoring and acid reflux when sleeping on the back. [link to wedge pillow in webstore] 

Is Positional Therapy Effective?

Positional Therapy is certainly effective in reducing snoring and the incidence of nighttime acid reflux and has also been shown to benefit apnea sufferers. 

Sleeping on the back plays a major role in the severity of OSA and learning to sleep in a new position can only be of benefit.

A recent study concluded that sleeping on the side (or even the stomach) had a positive effect on the control of sleep apnea and was even more effective than a CPAP device in many instances. Researchers found that although simple remedies were of some benefit the best outcomes were achieved using a Night Shift Device for a period of months until the body became conditioned to not sleep supine.

If OSA is a real issue, and acquiring a CPAP device seems inevitable, it is worthwhile discussing the possibility of trying Positional Therapy as it may be all that is required to control the condition if not virtually eliminate it altogether!