Sleeping in the best position for sleep apnea would not only reduce your sleep apnea severity but might also help you with some other issues, such as digestion, neck and back pain, and sore muscles.
If you disturb your spouse at night with your loud snoring or feel fatigued during the day even after at least 7 hours of sleep, chances are you suffer from obstructive sleep apnea (OSA).
OSA is a health condition where the back part of your tongue becomes so relaxed when you are asleep that it drops down and block your upper airway.
As a result of OSA, you might:
- Snore loudly.
- Suffer from night sweats.[1]
- Experience a fall in blood oxygen saturation.[2]
- Gasp or choke while sleeping.
- Wake up for a moment. You might not even realize that you woke up.
Switching to the best sleeping position for sleep apnea can immediately ease your OSA symptoms to help you feel more energized, stronger, and more focused during the day.
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How to Know Whether You Suffer from Sleep Apnea
In order to know for sure whether you suffer from sleep apnea, you need to be diagnosed in a sleep lab.
So if you are experiencing some sleep apnea symptoms, it will be a great idea to ask your health care to refer you to a sleep lab.
Common symptoms or signs of sleep apnea are:
- Loud snoring and/or gasps. You can search the app store for a free sleep recorder app that will record you whenever you make noises while sleeping.
- Mouth breathing during the night (dry mouth/bad breath in the morning).
- Frequent awakenings during sleep.
- Feeling fatigued during the day even though you sleep enough at night.
- Headaches.
Even a “mild” sleep apnea can cause you to stop breathing 15 times an hour, which means you wake up for a short moment every 4 minutes probably without even noticing.
Positioning your body in the best sleeping position for sleep apnea might eliminate, or at least ease, some of the symptoms of OSA.
So let’s see what is the best sleeping position for sleep apnea…
The Best Sleeping Position for Sleep Apnea
Your sleeping position might have a huge impact on your sleep quality, digestion during the night, and how you feel when you wake up.
When you lie down, gravity is working against the muscle of your airways.
This results in when those muscles become relaxed during the deep sleep state, the back part of your tongue might collapse backward and block your upper airways.
However, turning your body to the side when you sleep can minimize gravity’s effect on the muscles of your airway.
Researchers found that 56% of patients suffering from obstructive sleep apnea had at least 50% more apneas (gasps/chokes) per hour when they slept on their back.[3]
Side sleeping is also recommended for those who suffer from deviated septum.
Another advantage of side sleeping is optimized waste removal from the brain during sleep.[4]
It also a recommended sleep position in case you suffer from trapezius pain.
To not harm your spine, your back, and your neck muscles, there are some adjustments you should make while sleeping on your side…
Critical Adjustments for Healthy Side Sleeping
1. Place a pillow under your waist
When you sleep on your side, gravity might make your spine curve downward.
It means that during the night, your vertebras are in an unnatural alignment with each other, which creates stress in the spine.
Using a pillow in the right size to fill the gap between your waist and the mattress can prevent your spine from curving.
How big should the pillow be? It depends on 3 factors:
- The softer your mattress is the more you sink down, which means there is a smaller gap to fill so you need a smaller pillow.
- The wider your hips and shoulders are, and the narrower your waist is, the gap to fill is bigger, which means you need a bigger pillow.
- The softer your pillow is the bigger it should be.
Your best bet is to do some trial and error.
Ask someone to film you from the back while you are sleeping shirtless on your side, or use the timer in your smartphone’s camera to film yourself.
Your spine should be straight without any curve.
If your spine is curving downward, use a bigger pillow. If your spine is curving upward, then use a smaller (or softer) pillow.
2. Place a pillow between your legs
In order to prevent rotation in the hip and to stabilize the spine, you should put a pillow between your legs.
The pillow should cover the lower part of your legs completely – from the knees to the ankles.
During the hot summer, I put a pillow with a cooling gel between my legs.
Otherwise, it makes my legs warmer, which makes it harder for me to fall asleep.
A pillow with a cooling gel keeps my legs cold for about 20 minutes, which is enough time for me to fall asleep.
If you want to place the leg on top in front of the leg below (also known as the tiger knee position), you should place the pillow below the knee you move forward.
You will probably even need 2 pillows in order to keep the leg you move forward parallel to the mattress.
3. Prevent internal rotation in the shoulder.
Shoulder’s internal rotation is the rounded forward motion of the shoulder.
This motion has many uses, like scratching your back for example.
However, if your shoulders are internal rotated during your daily activities, it makes you look goofy and might cause issues in the shoulder joint.
Dr. Kelly Starrett, a physical therapist and the founder of MobilityWOD.com says in his book, Becoming a Supple Leopard, that in a good posture, the shoulders should be aligned with the ears and your thumbs should be pointed forward (and not inward) while your hands are on each side of your body.
We perform an internal rotation in the shoulder without even noticing it while we are typing, using our smartphones, and sleeping.
In order to prevent internal rotation in the shoulder joint while sleeping on your side, you can try one of the next solutions:
i. Sleep in the log position
When you sleep in the log position, your arms are to the sides of your body, unlike in the fetal and yearner positions where your hands are in front of your body.
In that position, your shoulder is in alignment with your ears so no further adjustments are required.
You don’t have to fully straighten your legs in the log position. You can have a little bend in the hip, knee, and ankle joints.
Another important advantage of the log position over the fetal position is that sleeping in the log position makes breathing easier.
In the fetal position, your body is curled forward which might limit your breathing.[5]
ii. Hug a pillow
Yes, you will need many pillows in order to sleep on your side with a straight spine.
Spooning with a pillow can prevent your shoulder from collapsing into your chest.
Make sure the pillow is big and firm enough to prevent your shoulder from rotating forward.
4. Use the right head pillow
In order to avoid damaging your neck, you must use a pillow with the right dimensions.
If the pillow is too big or too firm, it will push your head upward.
If the pillow is too small or too soft, your head will sink down.
Ask someone to film you sleeping on your side or use the timer in your smartphone’s camera to film yourself and make sure your neck is aligned with your torso.
A cool feature of the pillow with a cooling gel is that you can add or remove the fill in order to reach the soft level that fits you.
5. Prevent breast sag
This one is for the ladies.
When you sleep on your side, gravity pulls your breast downward.
Some believe that it might cause the breast to sag over time.
I couldn’t find any research that proves this belief, but to be cautious, you can place a special pillow between your boobs to support it.
You can search ‘Side sleeping boob support pillow’ if you are interested in a pillow made especially to prevent your breast from sagging.
How to Make Yourself Sleep on Your Side
Positioning yourself into a sleep position at night is hard because… You are sleeping.
If you usually switch to back sleeping during your sleep, you can glue a tennis ball to your back, which will prevent you from lying on your back.
Alternatively, you can use the Stop Snoring T-Shirt.
In case you switch to sleeping on your stomach during the night, glue a ball to your stomach.
Instead of a tennis ball, you can put some pillows behind you to prevent you from turning backward.
But at this point, you are probably already out of pillows.
Left side sleeping VS Right side sleeping. Which one is the best?
Both sleeping on your left side right side has some health benefits and side effects.
Consider those to decide which one of those sleep positions will help more to support your health goals.
Benefits of sleeping on your left side:
- Helps to prevent heartburn and acid reflux (GERD).[6][7]
- For pregnant women, it might help to reduce the risk of experiencing a late stillbirth.[8]
- It aids digestion. Gravity helps waste to move to your colon.
Disadvantages of sleeping on your left side:
- Those who suffer from congestive heart failure and sleep on their left side might experience discomfort and greater degrees of cardiomegaly than those who sleep on their right side.[9]
- Sleeping on your left side can increase the probability of having nightmares.[10]
The benefits of sleeping on your left side are actually the disadvantages of sleeping on your right side and vice versa.
For example, since sleeping on your left side helps to prevent acid reflux, sleeping on your right side might increase the severity of acid reflux.[11]
So I would say that unless you have health issues related to the heart and/or some pain on the left side of your body (left shoulder pain for example) it would be better to sleep on your left side.
Especially if you use to eat before bedtime or you are pregnant.
What to Do If You Can’t Sleep on Your Side
Side sleeping has many advantages and it’s my preferred sleeping position, however, it also has some disadvantages.
Some of the disadvantages of side sleeping are:
- In the morning, there might be some temporary pillowcase lines on the side of your face. And as the years go by, they might become permanent wrinkles.
- In case your shoulder hurts or you suffer from arthritis, side sleeping becomes painful.
- You might need up to 5 pillows in order to perform all the required adjustments to sleep with your spine straight.
- Some people find it hard to fall asleep while sleeping on their side.
If at least one of the problems mentioned above applies to you and your healthcare can’t help you to solve it, you will have to sleep on your stomach or on your back.
Stomach sleeping makes gravity pull your tongue forward, which helps prevent airway obstruction.
Therefore, sleeping on your stomach is great to reduce the severity of sleep apnea.
However, in my opinion, stomach sleeping is not the best sleeping position for sleep apnea because it also has many side effects.
Some of the disadvantages of sleeping on your stomach are:
- You have to turn your head to the side, which creates a twist in the cervical spine.
- Most people turn their heads to the same side always, which means there is a lot of stress on the same side of the neck throughout the whole night.
- The lower back tends to curve too much, which might lead to lower back pain.
- You might bury your face in the pillow so it covers parts of your mouth, which might worsen breathing problems, such as sleep apnea.
- The system of waste removal from the brain is the least optimized when you sleep on your stomach.[4]
- Some say it can cause digestion problems, but I couldn’t find any research that backs it up.
- It might create pressure on some nerves.
How to minimize the side effects of sleeping on your stomach
Actions you can take in order to minimize the side effects of stomach sleeping are:
- Use a very thin pillow in order to avoid curling the cervical spine.
- Turn your head from side to side whenever possible to avoid neck stiffness or put your forehead on a flat pillow so you don’t need to turn your head to any side.
- Avoid placing your hand below your head or below the pillow to avoid numbness and/or shoulder pain.
- Place a pillow under your pelvis in order to prevent an excessive extension in the spine.
- Don’t put one of your legs to the side with a banded knee. Keep your both legs flat and equals.
In order or avoid the side effects of sleeping on your stomach, you might prefer to sleep on your beck…
Advantages of Back Sleeping
The advantages of sleeping on your back are:
- Your spine is in a neutral position.
- You can use a wedge pillow to elevate yourself in order to reduce the severity of acid reflux, heartburn, and snoring.
- You don’t have pillow lines on your face in the morning.
However, sleeping on your back comes with a price…
The disadvantages of back sleeping
Some of the disadvantages of back sleeping are:
- The gravity causes your jaw and tongue to fall back and obstruct the airway. It might increase the severity of sleep apnea.[12]
- You have less control over your breathing volume when you sleep. It can cause you to inhale too much oxygen, which may result in blockage of the nasal breathing airway.
- Back sleeping might be harmful to women in their late pregnancy and for their fetus.
You can minimize the side effects of back sleeping by doing some simple adjustments…
Back Sleeping Best Practices
1. Use the right size pillow
A common mistake is using too many pillows or too big of a pillow when sleeping on the back.
It creates a flexion in the neck, which in time might create issues in the cervical spine and make it harder for the blood to reach the brain because of gravity as well.
You can also use too small of a pillow, which will make your head fall backward.
When using the right-sized pillow, the middle of the shoulder should be aligned with the middle of the ear.
For this purpose, a cervical neck roll pillow might be the best option, especially for those with a relatively small torso, because it perfectly fills the space between the neck and the mattress.
Make sure that the roll pillow you buy is made of memory foam so if it’s a little bit too big, your neck weight will compress it to the right size.
Alternatively, you can roll a towel and see if it fits and feels comfortable.
Whether you use a roll pillow or a regular pillow, take into account that the softer your mattress is the more you sink down, therefore the smaller your pillow should be in order to align your shoulders with your ears.
2. Place a pillow below your knees
There should not be a gap between your lower back and the mattress.
Lie flat on your back and try to enter your fingers between your lower back and the mattress.
If you find a space between your lower back and the mattress, it means you should bend your knees a little.
Bend your knees just enough to make your lower back touch the mattress.
In order to keep your knees bent while you sleep, you can put a pillow under the knees, or even better, you can use a special under knee pillow.
This is an ergonomic pillow, which is designed to offload the spine.
3. Elevate yourself
Elevating yourself a few inches by using a wedge pillow or an adjustable bed can help you to prevent or at least decrease the severity of acid reflux and heartburn.
Another advantage is that it reduces sinus build-up and snoring, which helps you to breathe better at night.
4. Close your mouth
It is proven that mouth breathing at night increases the severity of sleep apnea.[13][14]
If you can breathe easily through your nose during the day, but your mouth is getting open at night, I recommend you use tape to keep your mouth closed.
You know your mouth is getting opened at night if you wake up in the morning with a dry mouth and/or bad breath.
In case it is hard for you to breathe through the nose even during the day, I recommend you to read the book, The Oxygen Advantage, by Patrick McKeown.
It contains training programs that will turn you from a mouth breather to a nose breather and techniques to open the airway.
If nothing helps, it is recommended to consult your healthcare about more intrusive solutions such as surgery (if required).
Back Sleeping VS Stomach Sleeping
To sum it up, stomach sleeping is the best sleep position for reducing sleep apnea severity.
However, it comes at a great price…
It can damage your spine, shoulder joint, and some nerves. It also makes the pillow block a part of the airway.
In my opinion, you should try any method to reduce sleep apnea severity before you use stomach sleeping as a last resort.
When you do sleep on your stomach, do all the adjustments mentioned above in order to minimize the damage of belly sleeping.
If you sleep on your back, take into account that even though there are advantages, it is the worst sleeping position for sleep apnea.
When I don’t sleep on my side, I sleep on my back. So I use the techniques mentioned above to sleep on my back without having sleep apnea symptoms.
How to Reduce Sleep Apnea Severity
3 hacks you can do yourself to reduce sleep apnea severity are:
- Avoid alcohol at night. Alcohol makes your airway muscles become too relaxed when you sleep.
- Breathe through the nose at night.
- Lose Weight. Excessive fat in the neck area might close down the airway when you are lying down.
There are also more complicated but highly effective solutions for sleep apnea:
CPAP (Continuous Positive Airway Pressure) therapy
The most effective therapy against sleep apnea is probably the CPAP machine.
It’s a mask you put over your nose and mouth at night and it keeps your airways open by using pressurized air.
As a result, your airway doesn’t collapse at night so you can sleep more peacefully and wake up more energized in the morning.
The downsides of CPAP therapy are:
- The CPAP machine is very cumbersome and not convenient.
- You have to get a prescription for CPAP therapy from a doctor.
- It doesn’t work for everyone.
If you have tried less intrusive solutions but nothing helped, I think you should consult your health care about using CPAP therapy.
Oral appliance
In case you only have mild sleep apnea, a good solution would be a mouthguard suited for you by a dentist who specializes in appliances for sleep apnea.
Don’t confuse this type of custom-made mouthguard with the regular type mouthguard that boxers and wrestlers use that only covers the teeth.
A custom-made mouthguard for sleep apnea keeps your airways opened by placing your lower jaw forward (mandibular repositioning mouthpieces) or by holding your tongue (tongue retaining devices).
This is a more convenient and less cumbersome solution than sleeping with a CPAP mask so if you don’t have a really severe case of sleep apnea, give it a try.
Surgery
In some cases, sleep apnea might occur due to genetics.
For example, you might have an excess tissue in the soft palate and pharynx, which makes it harder to breath at night.
In that case, your healthcare might refer you to a surgical procedure called Uvulopalatopharyngoplasty (UPPP).
In that procedure, the excess tissue is removed to make breathing easier.
Take into account that in a study, the success rate of UPPP in a mild to moderate OSA (53% success rate) was lower than the success rate of dental-appliance (81% success rate).[15]
In addition, 8% of the UPPP group in the study complained about nasopharyngeal regurgitation of fluid and 10% complained about difficulty with swallowing.
Final Words…
Sleep apnea is sabotaging the health, relationships, and mood of more than 22 million Americans, which many of them are not even knowing that this is the cause of their issues.
The best sleeping position for sleep apnea and the other techniques mentioned in this post are more than likely to help you reduce the severity and even eliminate the symptoms of OSA.
As a result, you should feel higher energy levels and more focused during the day than you felt before executing those techniques.
If you still experience any OSA symptoms or you believe that your OSA is a severe case, you should consult your healthcare ASAP.
Untreated sleep apnea might cause:
- Hearth problems
- High blood pressure
- Migrants
- Stroke
- Atrial fibrillation (400% increased risk!)[16]
Sleep apnea is a serious condition (but manageable) and should not be ignored.
p.s.
Some of your friends and followers may probably be suffering from sleep apnea and might not even be aware of it. Would you like to help them?
