The Best and Worst Sleep Positions for People With Obstructive Sleep Apnea

Some sleep positions are more comfortable than others. But when you have obstructive sleep apnea (OSA), which interferes with the ability to breathe at night, it’s also important to consider how your sleep position affects the condition.

Certain sleep positions (e.g., lying on your back) can actually make OSA symptoms worse. But other positions (e.g., lying on your side) can improve symptoms, especially if you’re using a treatment such as a continuous positive airway pressure (CPAP) machine. Keep reading to learn more about the best sleep positions for people with OSA — plus, why you should steer clear of one position.

When you sleep, your tongue and surrounding throat muscles relax, which helps air flow to your lungs.

How does sleep position come into play? Lying on your back, for example, can cause your tongue and throat tissues to collapse further, making it even harder for air to flow to your lungs, says Stephen Carstensen, DDS, a dental sleep specialist who treats sleep-related breathing disorders in Bellevue, Washington. This is true even with a CPAP machine.

But other positions can help keep your airway open, making it easier for a CPAP machine to usher air into your lungs and help you get a good night’s rest.

“Gravity helps keep your tongue forward and your airway open,” says Dr. Carstensen.

The key is making sure your head is centered over your shoulders (similar to how it is when you’re awake), so your chin isn’t tucked down toward your chest. “When the head is down towards the chest, it pinches the airway, making it harder to breathe,” he says.

As a result, you might have to work harder to keep OSA under control. That could mean needing to use a higher pressure level on the CPAP machine or using additional treatments, such as a dental device, to keep your airway open enough to sleep without frequent disruptions, says Carstensen.

Here are a few tricks that can help you sleep on your side:

• Use the right pillow. If you tend to tuck your chin toward your chest while sleeping on your side, consider looking for a pillow that’ll help keep your head centered over your shoulders, such as a curved pillow designed for spinal alignment.
• Tuck a small pillow or blanket between your knees. This helps relieve some of the stress on your hips, which can reduce pain and discomfort caused by side sleeping.
• Try a tool to prevent sleeping on your back. If you tend to roll onto your back in the middle of the night, try placing a pillow behind your back to help you stay on your side. Another option: Use a wearable monitor that emits a gentle vibration when it senses you’ve rolled onto your back. This can encourage you to change positions without fully waking you up. Research suggests these devices can be helpful for OSA.

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  “If a person can tolerate the minor signaling by the device and the sensation of wearing it during sleep, it can be a perfect strategy,” says Carstensen.

• The best sleeping position for obstructive sleep apnea is most likely on your side, since it helps keep your airway open and allows for more airflow to your lungs.
• Sleeping on your back can cause your tongue to fall back in your throat, further obstructing your airway and making it harder to breathe.
• Stomach sleeping can work for some people, but it can also cause neck or back discomfort later in the day and make it harder to use a CPAP machine.