Positional Therapy for Sleep Apnea: What It Is (And How To Try It)

Did you know that your sleeping position can affect your sleep apnea?

Certain sleeping positions can make the symptoms of obstructive sleep apnea worse, as well as cause snoring in people who don’t have sleep apnea.

For this reason, positional therapy for sleep apnea is an excellent solution for mild to moderate obstructive sleep apnea (OSA). 

In this guide, we’ll explain what positional therapy is, why it works, and how to try it safely. You’ll also discover practical device options and low-cost home methods that encourage side sleeping.

Positional therapy is a simple way to reduce nighttime breathing interruptions — by simply sleeping in a position that reduces snoring and helps keep your airways open. 

Sleep apnea occurs when your airway becomes blocked or restricted during sleep, resulting in repeated pauses in breathing. 

For many people, this happens far more often when sleeping on their backs. Gravity causes the tongue and soft tissues of the throat to collapse backward, making it harder for air to pass through.

Researchers estimate that up to half of people with obstructive sleep apnea have a position-dependent form (often called positional obstructive sleep apnea, or POSA) where symptoms are significantly worse in the supine position (on your back).

Positional therapy for sleep apnea encourages you to sleep on your side — or stomach — so that your airway stays open.

The idea is simple: if back-sleeping makes airway collapse more likely, then avoiding that sleeping position can help.

There are two main approaches:

• Behavioral methods, which involve training yourself to stay off your back using pillows or DIY hacks.

• Device-assisted methods, which include wearing positional therapy devices that detect or discourage back sleeping.

Typically, sleep apnea is treated with a Constant Positive Airway Pressure (CPAP) machine. But it’s not suitable for everyone, as the machine is costly and difficult to get used to. 

Positional therapy for sleep apnea can sometimes be used instead of a CPAP machine. It can also be used with a CPAP machine to boost effectiveness. 

People with more severe or non-positional sleep apnea may not find enough relief through positional sleep therapy alone. Instead, they might prefer to use positional therapy alongside a CPAP machine, or to stick to a CPAP machine alone.

There are several tricks and hacks you can use to ensure you sleep on your side and stay on your side throughout the night.

One of the easiest tools to try is a positional sleep apnea pillow. These pillows are designed to make back-sleeping uncomfortable or unlikely by supporting side-sleeping positions. Options include:

• Wedge pillows have an angled design that reduces the likelihood of rolling onto your back.

• Contour pillows are shaped to cradle the head and neck, encouraging side sleeping and airway alignment.

• Pregnancy pillows are large, supportive pillows that keep you comfortably on your side, which are useful even if you’re not pregnant.

If you want to know which of these options is the best for snoring, the answer (frustratingly) depends on your comfort preferences, but some pillows are better than others.

Make sure you invest in your sleep and health with a good quality pillow, like the Posiform Anti-Snoring Pillow.

Learn more about how anti-snoring pillows work.

Modern positional therapy devices for sleep apnea use wearable technology to detect when you’re on your back. Some use gentle vibrations or prompts to encourage repositioning without fully waking you. These can include positional sleep therapy belts, chest straps, or even small wearable sensors.

A classic low-cost DIY hack is the tennis ball technique — sewing or attaching a tennis ball to the back of an old shirt or pajama top, so lying on your back feels uncomfortable.

While it can work in a pinch and is rather inexpensive, it’s often not the most comfortable or sustainable option long-term.

Sometimes the solution is not a single device or technique, but rather a collection of strategies that all help you achieve consistent positional therapy. Small adjustments can go a long way:

• Strategic pillow placement. By using multiple pillows around your body to prevent rolling, you can create a comfort-based cradle of positional therapy.

• Bed tilt adjustments. Research has shown that slightly elevating your head can reduce snoring and airway collapse.

• Side-sleeping support. Experiment with anti-snoring pillows, body pillows, and pregnancy pillows to lock in a comfortable side position.

When it comes to trying new sleep hacks, ease into it. Changing too many things at once can often lead to bedtime anxiety, which can affect sleep quality. Pairing these strategies with a solid bedtime routine can be the key to unlocking better sleep. 

When you’re weighing your options for managing sleep apnea, it helps to know what positional therapy can realistically do — and where it might fall short. Like most treatments, it has clear upsides, but it isn’t a silver bullet for everyone.

For many people, positional therapy is a welcome alternative to machines or medical devices. It’s approachable, easy to try, and often very effective.

• Non-invasive and drug-free. There are no masks, hoses, or medications required in positional therapy, making it less daunting for those who are new to sleep therapies in general.

• Cost-effective. Positional therapy can be cheap (and in some cases, free). Given the cost of CPAP machines and surgery, this is a huge bonus. 

• Improved snoring relief. Positional therapy can provide relief from both snoring and apnea, which can be helpful if your partner struggles to cope with your snoring.

• Flexible. Positional therapy can be combined with other sleep apnea treatments and snoring solutions, like mandibular advancement devices (MADs).

These benefits make positional therapy worth a try. However, you also need to be aware of the limitations and disadvantages.

On the flip side, positional therapy isn’t always enough on its own. It tends to work best for a very specific group of people — those whose symptoms clearly get worse in the back-sleeping position.

• Consistency matters. Much like most treatment plans, results depend on your consistency. The more you avoid back-sleeping, the less lightly you are to instinctively shift onto your back during the night.

• Not a one-size-fits-all. If you have sleep apnea or snore in any sleeping position, this might not solve the problem. Positional therapy might also not help people with severe sleep apnea. 

• Comfort issues. Sleeping on your back can worsen snoring and sleep apnea — but some people might still prefer it, especially if they have back pain or find it unbearably uncomfortable to sleep on their side. 

Some people also find that the benefits wear off over time. The novelty of a new pillow or device can fade, making it harder to stick with it night after night.

If positional therapy isn’t working for you, it’s a good idea to check in with your doctor or a sleep specialist — they can help you track whether positional therapy is really making a measurable difference. 

To make things easy, here is a table comparing the benefits and limitations of positional therapy for sleep apnea. 

Positioning yourself for a good night’s rest isn’t always easy, but knowledge is power, and knowing how best to sleep to reduce snoring is a gift.

For many people, positional therapy for sleep apnea is a practical, low-tech solution. Encouraging side-sleeping and avoiding the supine position (aka back sleeping) may reduce breathing interruptions, improve snoring, and even enhance CPAP comfort when used together.

Here are some tips for trying positional sleep therapy:

• Experiment with different options. From DIY solutions to pillows and vibrating belts — in order to find what’s comfortable and sustainable for you.

• Pair it with healthy sleep habits. Good sleep hygiene and a healthy lifestyle can make a major difference.

• Talk to your doctor, especially if you suspect sleep apnea. The safest path is to get a sleep study and professional guidance.

If you think your sleep apnea might be positional, it’s worth experimenting with pillows or devices — but it’s a good idea to check with a sleep specialist to make sure it’s the right fit for your needs.

The content in this article is for educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a licensed healthcare provider with any questions you may have regarding a medical condition or treatment options. Please consult a qualified healthcare professional for personalized medical advice or concerns about snoring, sleep disorders, or related health issues.