Sleeping Position and Snoring

man in different sleeping position

Your sleeping position matters

Sleeping on your back (supine) makes you more likely to snore or experience sleep apnea. Switching to sleeping on your side (laterally) is one of the most basic and effective ways to reduce snoring. This is because side sleeping reduces the compression of your airways.

The evidence for a sleeping position role in sleep-breathing problems is overwhelming. More than half of all obstructive sleep apnea cases are referred to as “position-induced” sleep apnea [1], where the severity of the condition is massively reduced when switching to side sleeping.

It has long been known that side sleeping prevents snoring. Soldiers in the American War of Independence and in the First World War were advised to wear their rucksacks filled with bulky things whilst they slept. This was to stop them rolling onto their backs and snoring, giving their position away to the enemy [2].

Why does sleeping on your back worsen snoring?

By sleeping on your back, your mouth has a tendency to fall open which causes changes to the shape of your upper airway. Additionally, the effect of gravity on your face, head and neck starts to compress your airway; this is particularly poignant if you are overweight due to the excess fat on the neck. Science has gone as far as measuring these airway dimensions meticulously: using MRI, radiography and infra-red analysis of the upper airway [3].

Findings from these studies show that by sleeping on your back, several changes put you at risk of snoring and obstructive sleep apnea [4]:

  • Your jaw recedes, compressing the upper airway
  • Your tongue falls back
  • There is more oval shape of the upper airway

All of these factors combine to compress the airway, disturb airflow and cause vibration – i.e. snoring. In the worst-case scenario, they cause complete blockage and sleep apnea.

What to do next

The good news is that simple causes have simple solutions; try sleeping on your side! Making this basic change, without the need for any invasive techniques, complicated devices or significant expenditure could have a huge impact on your snoring or sleep apnea.

If you find yourself sleeping on your back and snoring, it’s time for some “positional therapy”. This can include hacks you engineer at home, specially designed pillows or even vibrating training devices that tell your subconscious mind that it’s time to turn over.

Homemade hacks

Before you buy something to help you sleep on your side, give some of these tactics a go:

  • Tennis ball therapy. Tape or sew one to the back of your pajamas to make sleeping on your back difficult.
  • Inflatable pillow prop. Stuff a fully inflated camping pillow into an empty pillowcase. Lie on the empty portion of the pillowcase with your back resting on the inflated pillow.

Read SnoreLab’s full article on homemade hacks to improve your sleeping position

Specially designed pillows

Some pillows are build to keep you in more favourable positions to stop your snoring:

  • Wedge pillow. For the stubborn back sleeper who simply can’t sleep on their side; wedge pillows elevate your head which lessens the effect of weight on your airway. Check out SnoreLab’s recommended memory foam wedge pillow.
  • Neck realignment pillow. If you find side sleeping uncomfortable on your neck and back, try one of these. SnoreLab’s approved pillow has adjustable height and aligns your airway to reduce the chance of snoring.
  • Pillows to promote side sleeping. Some pillows make it difficult to sleep on your back either with ergonomically designed ridges or with arm holes to stop you turning in your sleep.

Read SnoreLab’s full article on specialist anti-snoring pillows

Vibrating training devices

These are devices that attach to your body and vibrate when they detect that you are sleeping on your back. This creates a subconscious prompt for you to roll onto your side. The evidence for their effectiveness is growing, showing positive results for mild obstructive sleep apnea comparable to using a mouthpiece [5].

Night Balance by Philips is a small and discreet device that fits into a belt worn around your chest. It has plenty of smart features:

  • Gradual increases in vibration to prevent waking you
  • Fall asleep period where the device remains inactive
  • Syncs with your computer so you can track your nocturnal movements
  • Pause mode for if you wake during the night
  • Automatic intensity adjustment

Have a think about your usual sleeping position and consider positional therapy to start to sleeping in quieter, healthier positions.

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  1. Madeline JL, et al. Efficacy for the New Generation of Devices for Positional Therapy for Patients with Positional Obstructive Sleep Apnea: A Systematic Review of the Literature and Meta-Analysis. Journal of Clinical Sleep Medicine 2017; 13(6): 813-824. 
  2. Ravesloot MJL, et al. The undervalued potential of positional therapy in position-dependent snoring and obstructive sleep apnea – a review of the literature. Sleep and Breathing 2013; 17(1): 39-49. 
  3. Chen H, et al. Three-dimensional imaging of the upper airway anatomy in obstructive sleep apnea: a systematic review. Sleep Medicine 2016; 21: 19-27.
  4. Saigusa H, et al. Three-dimensional morphological analyses of positional dependence in patients with obstructive sleep apnea syndrome. Anesthesiology 2009; 110(4): 885-890.
  5. De Ruiter MHT, et al. Durability of treatment effects of the Sleep Position Trainer versus oral appliance therapy in positional OSA: 12-month follow-up of a randomized controlled trial. Sleep and Breathing 2018; 22(2): 441-450.

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