Getting a good night’s sleep can be challenging when you’re living with sleep apnea. Your doctor may recommend certain treatments and lifestyle changes to help. One at-home treatment approach your doctor may suggest involves adjusting your sleep position to help you breathe more easily.

Read on to understand how your sleep position influences your breathing and which positions are best for people with sleep apnea.

How Sleep Apnea Disrupts Rest

Sleep apnea is a condition where the body has trouble breathing while sleeping. Common symptoms include frequent waking and daytime tiredness. A sleeping partner may also point out that you’re holding your breath at night, snoring loudly, or breathing oddly (like unusual periods of shallow or deep breathing). This can make it hard to get a good night’s rest.

The most common type is obstructive sleep apnea (OSA), which happens when the airway narrows and obstructs airflow. People can also have central sleep apnea (CSA), where the brain doesn’t communicate well with the muscles that control breathing. Some individuals may have both types, which is called mixed or complex sleep apnea.

The Importance of Sleep Positions

People with OSA may benefit from positional changes that keep the airway open, support breathing, and improve sleep quality. Typically, physicians recommend avoiding the supine position (sleeping on your back). Back sleeping may cause your tongue and soft palate (the tissue at the back of your mouth) to move backward toward your throat. When this happens, it can put pressure on the airway and block airflow, leading to symptoms.

If you’re a loyal back sleeper, your doctor may recommend positional therapy to help you change your sleeping habits. This typically involves wearing a backpack to prevent rolling onto your back at night. More modern wearable devices can detect when you’re on your back and use gentle vibration to encourage you to change positions without waking you. These devices can also collect data while you sleep, like how often you snore or change positions, to see if treatment is working.

Doctors treating mild OSA may recommend positional changes (alongside other lifestyle changes) before other treatment approaches to see if symptoms improve. However, some people with mild OSA and those with moderate to severe symptoms may need additional treatment.

Even those with mild symptoms being managed with lifestyle changes and positional therapy alone should track symptoms and see their doctor regularly to make sure the condition hasn’t worsened over time.

3 Best Sleep Positions for Sleep Apnea

Below are the top positions for obstructive sleep apnea based on a growing collection of research.

Keep in mind that positional changes can help — but not cure — sleep apnea, and no single position will improve everyone’s symptoms equally. For example, some children with OSA may sleep better on their backs because different body tissues may be blocking their airway, which aren’t affected by gravity (unlike many adults with OSA). Always consult your care team to find out which treatment approach is best for you.

1. Side Sleeping

Sleeping on your side is the most recommended position for adults with OSA. Research suggests that side sleeping prevents airway narrowing and allows airflow.

The position could also complement other breathing treatments, including continuous positive airway pressure (CPAP). One study found that, on average, CPAP pressure settings didn’t need to be as strong for people who slept on their sides as for those who slept on their backs. But each person should follow their care team's instructions carefully.

2. Back Sleeping With Elevation

If you strongly prefer sleeping on your back, you can try elevating your head and trunk to reduce gravity’s effect on your throat and airway.

Research suggests elevating the head of an adjustable hospital bed by 30 degrees to help keep the airway open and potentially improve symptoms. While an elevated head doesn’t help as much as side sleeping, it can still improve nighttime breathing patterns and oxygen saturation (the amount of oxygen in the blood). A small study also found that turning your head to the side while lying on your back can help prevent breathing-related sleep disruptions.

3. Stomach Sleeping

Some experts may also recommend stomach sleeping to reduce snoring and help with mild symptoms. Although there’s little research exploring stomach sleeping and sleep apnea, one small study suggested that stomach sleeping could improve your nighttime breathing patterns and oxygen levels.

Stomach sleeping isn’t for everyone. For some people, it can cause back or neck pain. Others may not be able to comfortably wear their CPAP mask without air leakage, which can make the treatment less effective.

Sleep Adjustment Tips for Sleep Apnea

Adjusting your sleep habits isn’t always easy, even with positional therapy training devices. Here are a few tips to help you adjust:

• Optimize your CPAP gear — Some positional discomfort may be caused by your breathing device, like your CPAP mask. Ask your doctor how to adjust it or if you need to try a different mask.
• Position your pillow — You can make a new sleeping position feel better by using pillows. For example, elevated back sleepers can try placing a pillow under their knees to take pressure off the lower back.
• Swap out your pillow — If you have neck soreness in your new position, experiment with different pillows to find what works best for you. Elevated back sleepers may need several pillows (or a wedge-shaped one) to stay propped up at the right angle all night.
• Consider a new bed or topper — If you’re used to sleeping in your old position on a worn mattress, it may be time to upgrade or get a topper to encourage better, more comfortable sleep. This may include investing in an adjustable bed that can elevate your head.

Other Sleep Apnea Management Strategies

Positional therapy can be an effective way to treat your sleep apnea, but your doctor may recommend multiple approaches to help reduce symptoms in the long term.

CPAP machines are just one type of positive airway pressure (PAP) device to keep air flowing through your airway. Your doctor may also suggest other breathing devices, including:

• Bi-level PAP (BiPAP) device — A machine that uses higher pressures while breathing in and lower pressures with exhalation
• Auto PAP device — A CPAP or BiPAP machine that regulates its own pressures based on what it detects you need
• Adaptive servo-ventilation (ASV) — A type of therapy used for people with CSA who need consistent monitoring, pressure adjustments, and machine-delivered breath if needed

Your doctor may suggest using an oral appliance (mouthpiece) to keep your airway open. The most common option doctors recommend is a mandibular advancement device, which pulls your lower jaw and tongue forward to create more space for airflow through your windpipe.

Positional therapy and other treatments can make a difference in sleep apnea symptoms, but the best approach depends on what’s causing your breathing interruptions. If you think your sleep position may be making symptoms worse, talk with your doctor or sleep specialist about whether positional therapy could help and how to use it safely. With the right plan, many people find they sleep more comfortably and wake up feeling more rested.

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On MySleepApneaTeam, people share their experiences with sleep apnea, get advice, and find support from others who understand.

Which sleep position has worked for your sleep apnea? Do you have advice for others undergoing positional therapy? Let others know in the comments below.