Best Sleep Position for Sleep Apnea

Key Takeaways

• Your sleep position affects how you breathe, and if you have obstructive sleep apnea (OSA), that means your sleep position matters.
• The best sleep position for sleep apnea is either lying on your side or sleeping on your back with your head elevated and turned to one side.
• Sleep positions that could worsen your OSA symptoms or make CPAP treatment less effective include sleeping flat on your back and sleeping on your stomach.

Best Sleeping Positions for Sleep Apnea

OSA is a condition in which your upper airway gets blocked during sleep because your tongue falls backward. Therefore, the way you position your body and head during sleep could cause gravity to either work in your favor — or against you. 

Using that logic, it makes sense that side sleeping, or at least turning your head to one side, tend to be sleep positions that are most often recommended for people with OSA. Some sleep specialists even use positional therapy to treat mild OSA before moving to CPAP and other treatments. Here’s a closer look at each of the sleep positions and how they can impact OSA. 

Side Sleeping Position

Evidence suggests that for many people with sleep apnea, the side-sleeping position is best. People tend to experience fewer and less severe breathing events in this position because it helps prevent the narrowing or collapse of throat tissues.

Sleeping on the right side may help reduce respiratory events, especially for people with moderate to severe cases of sleep apnea. However, people who struggle with swallowing air during continuous positive airway pressure (CPAP) therapy may be less likely to do so on their left sides.

Back Sleeping With Head Elevated

If you have a strong preference for sleeping on your back or are unable to sleep in other positions, you may get some of the same benefits of side sleeping by simply turning your head to one side while lying on your back. You can also try slightly elevating the head of your bed, which appears to improve sleep apnea symptoms, as it can help prevent your tongue from blocking your airway.

For children with sleep apnea, the general guidance is less clear. Doctors may recommend that some children with OSA sleep on their backs, while some experts suggest avoiding that. It likely depends on the child’s age and other factors. Consult with your child’s pediatrician about the best sleep position for your child.

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Sleeping Positions to Avoid With Sleep Apnea

If you’re diagnosed with OSA, there are a couple of sleep positions that aren’t ideal. Stomach sleepers may have difficulty using a CPAP effectively, while people who sleep flat on their backs put themselves in a position in which the tongue can roll back more easily.

Stomach Sleeping Position

Stomach sleeping generally isn’t recommended for people with OSA, but not because it’s a bad position for breathing. In fact, small studies have found that sleeping on your stomach actually could help improve airflow. The problem is more so for people with OSA who are using CPAP therapy, since the prone position (stomach sleeping) can interfere with the mask, causing it to shift and create air leaks. 

Along those lines, stomach sleepers may not be able to sleep with certain mask types, such as full face masks. This can limit therapy options.

Sleeping Flat on Your Back

Experts generally recommend that people with sleep apnea avoid sleeping flat on their back with their heads facing up (referred to as the supine position). In this position, gravity can cause the tongue to fall and block the throat. Studies also show that OSA tends to be more severe when sleepers remain in the supine sleeping position for most of the night.

Other research suggests that collapsibility of the upper airways is strongly influenced by body position, with higher CPAP pressure needed for people who sleep flat on their backs. In other words, if you have OSA and need to sleep on your back, try to elevate your head and turn it to one side.

How to Change Your Sleeping Position

Training your body to sleep in a new position can be challenging, especially if you’re also adjusting to using a CPAP machine. However, there are several steps you can take to help you make a change. 

• Prioritize comfort: If you’re trying to sleep on your side, you may feel more comfortable if you hug a pillow and place a pillow between your knees. Also, be aware that your pillow and mattress preferences may change when you sleep in a new position. 
• Use a specialty pillow: Some pillows are designed to facilitate side or stomach sleeping. There are also CPAP pillows designed to improve comfort and limit leaks during CPAP machine use. 
• Prevent back sleeping: A number of products have been created to prevent sleepers from rolling onto their backs. These include vests, belts, and backpacks that place an obstruction, such as a fin or ball, on the back. You can also create your own sleep position trainer by sewing a tennis ball to the back of a pajama shirt.
• Try a device: Several products have been designed to discourage back sleeping through the use of vibrations. Worn around the chest or neck, these devices vibrate when a person rolls on their back. They’re intended to disrupt sleep less than other wearable products, though more research is needed to confirm their efficacy.

Other Sleep Tips for Improving Sleep Apnea

OSA, and how you sleep and breathe in general, can also be impacted by some of your lifestyle choices and sleep hygiene. In order to improve airflow and promote a restful night, here are some of the lifestyle changes you should consider:

• Limit alcohol: Alcohol consumption is associated with a higher risk of sleep apnea. If you’re diagnosed with OSA, you should try to avoid alcohol as much as possible, particularly close to bedtime.
• Stop smoking: The negative effects of smoking on the lungs has long been documented, but it also causes upper airway inflammation and affects sleep quality in general. Quitting smoking is recommended for anyone with OSA.
• Maintain a healthy weight: The research is clear that the prevalence of OSA is directly correlated to a higher BMI (body mass index). Studies also show that weight loss — even as little as 5% to 10% body weight — can reduce the severity of OSA.
• Upgrade your bedding: Sometimes, selecting a pillow and mattress that matches your sleeping position can result in a better night’s sleep.
• Try a different CPAP mask: If you’re on CPAP therapy, talk to your sleep specialist about mask options based on how you sleep. For example, there are masks for side sleepers, whereas a full face mask may be a better choice if you sleep on your back.