Have you ever tried to fall asleep with a really bad cold? When you try to lie flat, you can’t stop coughing. When you lie on your side, one section of your sinuses clogs right up. If you cope with a chronic breathing issue like chronic obstructive pulmonary disease (COPD) or sleep apnea, you can’t just wait it out and get better sleep once it passes. So what is the best sleeping position for breathing problems?
Note: The content on Sleepopolis is meant to be informative in nature, but it shouldn’t be taken as medical advice, and it shouldn’t take the place of medical advice and supervision from a trained professional. If you feel you may be suffering from any sleep disorder or medical condition, please see your healthcare provider immediately.
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Best Sleeping Positions for Breathing Problems
Difficulty sleeping can be caused by breathing issues like sleep apnea or COPD, says Dr. Theophanis Pavlou, Pulmonologist and sleep medicine specialist at Holy Name Medical Center in Teaneck, NJ. He explains that your best sleeping position for breathing problems depends a lot on your health condition. If you have breathing problems, different sleeping positions can have a big effect on your sleep.
Sleeping On Your Back
For many conditions like sleep apnea, sleeping on your back can make your breathing worse. “If you have sleep apnea,” says Dr. Daniel Rifkin, sleep medicine physician in Buffalo, NY, “you might want to try to avoid sleeping on your back as more than half of patients worsen in that position.”
Rifkin explains the throat, or airway, is basically a tube of muscle. The tongue makes up the heaviest part of that tube, and when the throat relaxes during sleep, your tongue can push down on your airway and close it off.
If you can’t fathom sleeping anywhere but on your back, you do have some options.
- Elevate your head: You can use various pillows to prop your shoulders, neck, and head a bit higher off the bed to take pressure off your airway. You can also put a pillow under your knees to keep your back comfortable in this position.
- Turn your head: One 2017 study found people who slept on their back but turned their heads to one side or the other experienced less sleep apnea than those who kept their heads centered.
If you elevate your head at night, be sure to experiment with different pillow configurations. You’ll know you found the right one when you don’t wake up with a crick in your neck or back!
Sleeping On Your Left Side
When you sleep on your left side, gravity works for you instead of against you. Your airway and tongue relax during sleep, and if gravity pulls your tongue toward your cheek instead of the back of your throat, you will breathe and sleep much easier.
For conditions like sleep apnea, says Pavlou, this position is preferred. Left-sided sleeping is also the best position for sleep in the third trimester of pregnancy. Don’t forget to put a pillow between your knees for ultimate comfort.
Sleeping On Your Right Side
Who knew sleeping on your right side could be any different from sleeping on your left side? Rifkin explains that research has shown sleeping on your right side can help keep your body keep oxygen levels high, especially in people with heart failure.
“However, the studies have been small and in select samples, so more research is needed,” he says. Rifkin also warns that sleeping on your right side can worsen heartburn. No thanks!
Sleeping On Your Stomach
During the COVID-19 pandemic, healthcare providers discovered that placing patients on their stomachs (prone) during recovery helped them to breathe easier. Experts suggest that the prone position takes the weight of the heart and large blood vessels off of the lungs so they can expand to max capacity. Sleeping on your stomach can cause neck and back pain, so be sure to keep an eye out for this complication.
Your tongue is the biggest culprit for causing breathing problems at night, especially if you have a breathing condition. Elevating your upper body just 7.5 percent can keep your tongue from falling back into your throat. Pavlou points out this method can work for those coping with heart disease as well.
Breathing Conditions That May Impact Your Sleep
You’ve heard a lot about different conditions and which sleep positions work best. But why do some positions work better for some health issues? Let’s look at some common breathing conditions that affect sleep.
When you have COPD, air gets trapped in your lungs and your body has a hard time getting enough oxygen. When someone with COPD sleeps, their oxygen levels can fall even further, triggering the brain to “do something, already!”
Your brain wakes you up, urging you to take some deep breaths. This can happen on a loop all night, making for restless tossing and turning. Sleeping with your head elevated or on your side can take some pressure off your lungs and allow more oxygen to flow in, letting you sleep more soundly.
Asthma causes your lung passages to swell and tighten, making it difficult to catch a breath. The best position for sleeping with asthma has been a subject of some controversy over the years. One older 2012 study found that patients had less asthma symptoms when they slept on their left side.
A more recent case study from 2016 found sleeping on your back can work best. If you have asthma that wakes you up at night, you may need to try a few positions out to find what works for you.
Sleep apnea causes periods of paused breathing while you sleep. Sleep apnea can be:
- Obstructive: part of your body blocks your airway
- Central: signals from the brain get confused and your body doesn’t know when to breathe
Either way, you can minimize sleep apnea symptoms by keeping pressure off of your airway. Experts agree: if you have sleep apnea, choose any position but your back. One recent study showed better breathing when subjects slept on their left side (lateral position). Again, if sleeping off your back isn’t an option for you, elevate that head and chest.
Other Factors That May Affect Your Breathing And Sleep
Chronic health conditions aren’t alone in causing disrupted sleep. Plenty of other factors can thwart your breaths and stop your snoozing.
Allergies hit some worse than others. Your partner may have a sniffle or two, while you feel like you may have pneumonia… Stuffed up sinuses are no friend to sleep, and many people coping with allergies find themselves struggling to fall asleep or waking through the night trying to catch their breath. Until your allergies calm down, you can try sleeping with your head elevated, or on one side.
Your sinuses fill up like a bucket when you lie on your back, but if you move to the side, or prop your head up, they can drain more easily, opening up those airways and allowing you to stay asleep. If your allergies seem to want to stay, make sure you keep your sleeping area clear of allergens with a hypoallergenic mattress and pillow.
Heat and humidity do not equal good sleep. However, an overly-dry bedroom can lead to subpar slumber, too. The Environmental Protection Agency (EPA) suggests you keep your home between 30 and 50 percent humidity for optimal comfort and to discourage mold growth. A highly humid environment can also help certain allergens thrive.
However, a very dry environment can cause dry sinuses and even a bloody nose. Rifkin suggests using a humidifier at night for a dry room. “Using a humidifier with an air purifier is even better,” he says, “as you want to try to avoid drying-out or irritating the tissues in your nose, sinuses, and throat. When those areas get dry and irritated, they secrete thick mucus to try to protect the tissue.” If you’re worried about the humidity in your sleeping area, try using a humidifier and see if your sleep improves.
If you have ever tried to drift off in a room that is either too hot or too cold, you know how important air temperature is for sleep. Whether you’re pushing off your socks or adding another blanket, finding the right temperature can pose a difficult puzzle, especially if you share your room with a partner or child.
One study found that subjects slept the best in 68 degrees Farenheit (20℃). Cleveland Clinic recommends a range of temperatures, from 60 to 67 degrees Fahrenheit. The one thing everyone seems to agree on? A room temperature under 60 degrees F or over 70 degrees F doesn’t allow your best night’s sleep.
Anxiety loves to ruin sleep. If you’re worried about a specific problem or cope with anxiety in general, that nasty feeling can’t wait to get loud at bedtime. You can treat anxiety when trying to fall asleep the same way you treat it during the day. Here are some tips from the Anxiety and Depression Association of America:
- Exercise during the day
- Get enough sleep
- Play music
- Talk to a friend or professional
If you try all the things and still feel like your anxiety is keeping you from dreamland, you can reach out to your healthcare provider to talk about treatment options.
Other Ways To Improve Breathing And Sleep
While you’ve already read a lot of great sleep tips, you can do even more to ensure you get those zzz’s. “Daily exercise, avoiding eating late, keeping weight down, and avoiding alcohol — to name a few behaviors — can be helpful,” says Pavlou. Let’s look at a few other practical options:
- Warm shower or bath before bed: Nothing beats a steamy hot bath or shower right before you hit the sheets. If you worry you’ll have trouble falling asleep, take some extra minutes to pamper yourself.
- Wash bedding every week: This one can be hard to stick to — doesn’t everybody hate changing sheets? But cleaning out those allergens can really help your shuteye, especially if you have pets around.
- Keep pets out of the bedroom: “As much as you want your pets to sleep with you, just say no,” urges Rikfin. “The animal dander is one thing, but pets are very disruptive to human sleep as they cause greater sleep fragmentation.”
- Windows closed: Rikfin also suggests keeping your windows closed at night so you don’t accidentally let in any allergens like pollen.
“If you have other breathing issues, like asthma,” says Rikfin, “your sleep environment should be kept clean.” He explains that dust mites and other allergens can trigger worsening asthma, and could cause an asthma attack. Feel free to try your own ideas for improving sleep, too!
The Last Word From Sleepopolis
If you have a breathing condition and aren’t sleeping well, it can be frustrating. “However,” urges Pavlou, “don’t ignore symptoms or avoid discussing sleep disruption with your physician.” You deserve good sleep, so try out some new sleep positions and don’t be afraid to ask for help!
Abby McCoy is an RN of 16 years who has worked with adults and pediatric patients encompassing trauma, orthopedics, home care, transplant, and case management. She has practiced nursing all over the world from San Fransisco, CA to Tharaka, Kenya. Abby loves spending time with her husband, four kids, and their cat named Cat.