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What Sleep Position Is Best for Sleep Apnea?

The best sleep position for sleep apnea is on your side to keep your airways open. Positional therapy can help you make the change if you’re a back sleeper.
Published
2022-11-09
Updated
16 MINS
Man sleeping on side, which is the best sleep position for sleep apnea

For most people, the best sleep position is the one they can fall asleep in most easily. But as we develop health conditions or get older, finding a sleep position that helps us both get enough sleep and alleviate any health symptoms is important. 

When you have sleep apnea, your airways close and can cut off your breathing 30 times or more an hour. This leads to low oxygen levels and serious sleep disruption.

So, anything you can do to keep your airways open is hugely beneficial, and one of those things could be sleeping in the right position. 

Below, we’ll dive into the best sleep position for sleep apnea and how you can change your natural sleeping position to help your condition. Plus, we share how the RISE app can help improve your sleep and energy levels, even when sleep apnea is disrupting your nights. 

What is Sleep Apnea?

Sleep apnea is a sleep disorder that causes you to stop breathing for 10 seconds or longer throughout the night. When your brain realizes this, it wakes you up to kick-start your breathing again, either resulting in you waking up gasping for breath or waking up just enough to start breathing again, but not enough to notice the disruption. 

There are three types of sleep apnea: 

  • Obstructive sleep apnea (OSA) — when the muscles in your throat relax, closing your airways and cutting off airflow.
  • Central sleep apnea (CSA) — when your brain doesn’t send the correct signals to your respiratory muscles.
  • Mixed or complex sleep apnea — a combination of both obstructive sleep apnea and central sleep apnea. 

Obstructive sleep apnea is more common, and it’s what most people mean when they say “sleep apnea.” This is what we’ll be referring to when we say sleep apnea from here on out.

The symptoms of sleep apnea include: 

You can learn more about how to know if you have sleep apnea here. 

What Sleep Position is Best for Sleep Apnea?

Side sleeping is considered the best position for sleep apnea for a few reasons. Here’s why. 

Back Sleeping Can Make Sleep Apnea Worse 

About 56% of patients have position-dependent sleep apnea, meaning their apnea index (the measure of how severe sleep apnea is) improves by 50% or more when they sleep in a position that isn’t on their back. 

Research shows the number of sleep apnea episodes can double when sleeping on your back (also known as the supine position) compared to sleeping on your side. 

For some, sleep apnea can even be completely eradicated by avoiding back sleeping, and for others, it can significantly improve their symptoms. 

Both the frequency of apneas (times when breathing stops) and the duration of these episodes can be decreased by sleeping in the correct position. 

Why is back sleeping so bad? When you sleep on your back, it’s easier for your tongue to fall back and cover your airways and for gravity to pull soft tissue into your airways, obstructing them. 

Side Sleeping Can Keep Airways Open and Reduce Sleep Apnea Symptoms 

When you sleep on your side, your airways are less likely to collapse and your tongue and soft tissue are less likely to get in the way and stop you from breathing during the night. 

Stretching out when side sleeping, rather than curling up in a tight fetal position, can help increase lung capacity while sleeping, too. 

One study found when sleep apnea patients wore a vest with hard foam on the back, making back sleeping uncomfortable, they switched to sleeping on their sides. 

Their respiratory-disturbance index (a measure of how many times breathing stops, is shallow, or is difficult enough to wake someone up) dropped from about 39 times an hour when back sleeping to about 8 times an hour when side sleeping.

The amount of time spent sleeping with low oxygen levels and the amount of time spent snoring also dropped. 

The study was small, so more research needs to be done, but nine out of 12 participants were cured of their sleep apnea and a further two participants saw huge improvements in their conditions. Only one participant, who was 76 years old, saw no improvements, but sleep can be much harder to get as we age. 

Side sleeping has also been shown to reduce the number of apneas in those with central sleep apnea, where the brain doesn’t send the correct signals to your respiratory muscles. 

As changing sleep position can reduce sleep apnea episodes in some patients, it can be useful for those who don’t respond to other sleep apnea treatments. 

Right-Side Sleeping May Improve Symptoms Further 

When it comes to side sleeping, opting for your right side may help reduce sleep apnea symptoms even further. 

One sleep study found sleeping on the right side decreased the frequency of sleep apnea events in patients with moderate-to-severe sleep apnea. There wasn’t a difference for those with mild sleep apnea, however. 

While those with heart failure are recommended to sleep on their right, this position may make heartburn symptoms worse for those with gastroesophageal reflux disease (GERD) or for pregnant women. 

More research needs to be done here, and some experts simply recommend sleeping on either side, so you should find the side that’s most comfortable for you.

Side Sleeping Can Be Used with Other Sleep Apnea Treatments 

Those with mild sleep apnea may find a change in position is all they need to improve their condition, but others may still need treatments to manage their breathing at night. 

Sleeping on your side can be one treatment option among many, and it may even mean you can use treatments like a continuous positive airway pressure (CPAP) machine — a mask worn at night that pushes air into the airways to keep them open — less often.

You may also be able to use a lower level of air pressure on your CPAP machine when sleeping on your side, compared to sleeping on your back, as you can breathe easier. 

CPAP therapy is the common first-line treatment for sleep apnea. However, the machines can be uncomfortable and loud, so many people struggle to use them long-term. Finding a sleep position that makes sleeping with a CPAP machine easier can help you stick to this treatment option.  

You should also speak to your healthcare provider about the best mask for you as there are different CPAP masks available to suit different sleep positions. 

Full-face masks can be harder to sleep with if you sleep on your side, but special pillows are available to make them more comfortable. Depending on your condition, you may be able to use a nasal mask that just fits over your nose and is more suited to side sleepers. 

Side Sleeping and Lifting the Head Position Can Reduce Snoring 

Those with sleep apnea often snore loudly, waking their partner up and disturbing their own sleep. But the right sleeping position could help this, too. 

A 2015 study looked at people with mild-to-moderate sleep apnea who used a head-positioning pillow designed to make side sleeping more comfortable and lift the head and neck when sleeping on the back. When sleeping with the pillow, both the severity and frequency of their snoring were reduced significantly.  

However, other research shows snoring doesn’t decrease for sleep apnea patients who switch to sleeping on their side, so it all depends on your condition. 

You can learn how to sleep when someone is snoring here. 

Side Sleeping Can Reduce Other Sleep Disturbances 

When you’ve got sleep apnea, you’re already experiencing serious sleep disturbances throughout the night, so the last thing you want are digestive issues or back pain waking you up and adding to this sleep loss. Luckily, side sleeping has been shown to improve these things, too. 

Side sleeping can help: 

While there are promising studies showing how side sleeping can help some sleep apnea patients, more research needs to be done. 

How to Change Your Natural Sleep Position?

If your favorite sleeping position is on your back, it can be hard to suddenly start sleeping on your side. You may find it hard to fall asleep this way, or you may find yourself rolling onto your back in your sleep.

You can try: 

  • Experimenting with body pillows to make side sleeping more comfortable
  • Buying a mattress that keeps your spine aligned when sleeping on your side
  • Using a thicker pillow to keep your spine aligned
  • Asking your partner to gently nudge or roll you over if they find you sleeping on your back during the night
  • Positional therapy 

Positional therapy includes methods that stop people sleeping in the worst position, which in the case of sleep apnea is on your back. 

These methods include: 

  • Special pillows that encourage side sleeping
  • Vests or belts that make back sleeping uncomfortable 
  • Devices you wear around your chest that vibrate when you roll onto your back
  • Sleeping with foam wedges on either side of you that stop you from rolling onto your back

One study saw participants wear a device around their chests that vibrated when they rolled onto their backs. The results showed wearing the device for a week reduced back sleeping and reduced apnea-hypopnea index (AHI), a measure of how many times breathing stops or gets shallow. 

What to Do If I Can’t Sleep on My Side?

If you find you really can’t sleep on your side, you don’t want to lose too much sleep on this. After all, you’re already losing enough with sleep apnea. 

But first, don’t give up. Side sleeping may be hugely beneficial to the sleep disorder, so it’s worth taking the time to experiment with different pillows and positional therapy devices to see if any can help you become a side sleeper. 

While side sleeping is best, consider sleeping on your front if you can’t train yourself to side sleep. Gravity will pull your tongue and soft tissue away from your airways, opening them up more than back sleeping will. 

Neck pain is a common complaint among stomach sleepers, though, so use a thin pillow to keep your spine aligned and reduce strain on your neck. 

While back sleeping is the worst sleeping position for sleep apnea, you can make it better by elevating your head and neck to stop gravity from collapsing your airways. You can lift your head up with a wedge-shaped foam pillow or an adjustable base bed. 

How Can I Improve My Sleep with Sleep Apnea?

Sleep apnea is a serious sleep disorder that can be life-threatening if left untreated. So, if you think you have it, speak to a doctor to get checked out. While sleeping on your side may help to reduce symptoms, you may need further treatments to fully manage the condition.

Sleep apnea treatments include: 

  • Wearing a CPAP machine  
  • Losing weight
  • Exercise 
  • Oral appliances 
  • Quitting smoking
  • Avoiding alcohol close to bedtime 

You can learn more about treatments and how to get rid of sleep apnea here. 

Beyond sleep apnea treatments, here’s what to do to get more sleep and boost your energy levels.

Keep Sleep Debt Low 

RISE app screenshot showing how much sleep debt you have
The RISE app can work out how much sleep debt you have.

Sleep debt is the measure of how much sleep you owe your body compared to your sleep need, which is the genetically determined amount of sleep you need. In the RISE app, we measure sleep debt over the past 14 nights. 

For example, if your sleep need is 8 hours 30 minutes, but you’ve only been getting seven hours of sleep recently, you’ll have built up a lot of sleep debt. You’ll also build up sleep debt as your sleep is disrupted by sleep apnea episodes throughout the night. 

When your sleep debt is high, everything from your productivity to your energy levels to general wellness is impacted. Research even shows sleep deprivation can increase the number of sleep apnea episodes you have at night, as well as make your snoring worse. But you can work to pay this sleep debt back. 

This first step is finding out your sleep need. The RISE app uses a year’s worth of phone use data and proprietary sleep-science-based models to work out your sleep need down to the minute. You may find your sleep need is much higher than you think, so you need to start giving yourself plenty of time to hit this amount of sleep each night. 

You can also use RISE’s sleep tracking to see how often you’re waking up during the night, and whether switching sleep positions is helping to reduce this. 

The app then works out how much sleep debt you’re carrying. We recommend keeping sleep debt to less than five hours to feel your best.

To pay it back you can: 

RISE users on iOS 1.202 and above can click here to view their sleep need.

RISE users on iOS 1.202 and above can click here to view their sleep debt.

Improve Your Sleep Hygiene 

RISE app screenshot showing when to get and avoid bright light
The RISE app can help you do 20+ sleep hygiene habits daily.

Sleep hygiene is the name for the healthy sleep habits you can do to fall asleep faster and wake up less often during the night. With great sleep hygiene, you can ensure nothing else, beyond sleep apnea, gets in the way of a good night’s sleep and the sleep you do get with the condition is the best it can be. 

Sleep hygiene is important for everyone, but especially for those whose sleep is already compromised, and it can be hugely useful if you’re trying to get used to a new sleep position. 

Here’s what you can do:

  • Get bright light first thing: This resets your body clock, waking you up in the morning helping you feel sleepy at the right time later that evening.
  • Avoid light in the evening: Light suppresses the sleep hormone melatonin, keeping you awake. About 90 minutes before bed, put on blue-light blocking glasses and dim the lights to stop this from happening. 
  • Avoid coffee, large meals, exercise, and alcohol close to bedtime: These common sleep disruptors can keep you up or wake you up during the night. 
  • Keep your bedroom cool, dark, and quiet: Aim for 65 to 68 degrees Fahrenheit, use blackout curtains, and wear an eye mask and earplugs to stop noise and light waking you up. 

The RISE app can guide you through 20+ sleep hygiene habits and tell you the ideal time to do each one depending on your own body clock to make them more effective. 

RISE users on iOS 1.202 and above can click here to set up their 20+ in-app habit notifications. 

Find the Best Sleep Position for You 

There’s plenty of research pointing to sleeping on your side as the best position for sleep apnea, but everyone’s different. You may find sleeping on your back is the only way you can sleep with a CPAP mask, for example, or sleeping on your front is the only other comfortable alternative to back sleeping for you. 

Before you give up on side sleeping, though, experiment with different pillows, positional therapy devices, and CPAP masks to see if you can make the position work for you.   

Besides sleep position, give yourself enough time to meet your sleep need and improve your sleep hygiene to make sure nothing else gets in the way of a good night’s sleep. 

The RISE app can work out your individual sleep need and sleep debt, and coach you through 20+ sleep hygiene behaviors each day for better sleep and better days, even when managing sleep apnea. 

Your snoring and sleep apnea questions answered:

Summary FAQs

What is a good position to sleep in if you have sleep apnea?

Sleeping on your side is a good position to sleep in if you have sleep apnea. Side sleeping keeps your airways open, helping to reduce the number of sleep apnea episodes each night. Sleeping on your right may be even more beneficial than on your left, although more research needs to be done on this.

What is the worst position to sleep in with sleep apnea?

The worst position to sleep in with sleep apnea is on your back. This is because gravity causes your tongue to fall back and soft tissue to block your airways, stopping you from breathing. Try sleeping on your side, which keeps airways open and has been shown to reduce sleep apnea episodes.

Does sleeping with your head elevated help sleep apnea?

Yes, sleeping with your head elevated can help sleep apnea as it stops gravity from causing your tongue and soft tissue to fall back and block your airways. You can elevate your head with a wedge-shaped pillow or an adjustable base bed.

Does sleeping face down help sleep apnea?

Sleeping on your side is the best position for sleep apnea, but stomach sleeping may be better than sleeping on your back. This is because it stops gravity from closing your airways while you sleep. If you sleep face down, use a thin pillow to avoid neck strain.

How do you keep your airways open while sleeping?

Sleeping on your side can help to keep your airways open while sleeping. Sleeping with your head elevated can help if you sleep on your back. Treatments like a CPAP machine and oral appliances can also keep airways open.

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