80: Sleep like a pro- find the best sleeping position for you!

Your best sleeping position depends on your preferences and health conditions.  Whether you’re on your front, back, or side, each position has its advantages and disadvantages. 

Back sleeping (also called the supine position):  

• Pros: Back sleeping can align your head, neck, and spine, potentially reducing the risk of developing wrinkles or neck and back pain. In fact, sleeping on your back is the best position for proper spine alignment.  If you are able to sleep on your back, it may alleviate pain in your shoulders, hips, or knees.  Nasal breathing may be easier in the supine position.
• Cons: Some people may experience snoring or worsened sleep apnea symptoms when sleeping on their backs.
• Tips:  put pillows underneath your knees and lower legs if you have any lower back discomfort when sleeping supine.  A small neck pillow can support the curve of your neck.  Sleeping with your torso at an incline may be better for some people. 
• CPAP users:  your pressure setting should be high enough to support your airway in the supine position so you aren’t having break-through obstructions or snoring if you roll onto your back.  All mask types are compatible with the supine position.  Tubing at the top of the head or a tube hanger may be helpful.  There is an increased likelihood of mouth breathing in the supine position, which should be avoided if your mask does not cover your mouth.  

Left side sleeping (also called left lateral position):

• Pros:  side sleeping may improve snoring and lessen sleep apnea.  You could have better digestion and less acid reflux on your left side.  This position allows the stomach to sit below the esophagus, so gravity helps keep stomach acid down.  Some people with back or neck pain prefer a lateral position with pillow support.
• Cons:  pain or stiffness in your spine or major joints (shoulders, hips, or knees) may be worsened in a lateral position and cause sleep disruption.  Some people with heart conditions avoid sleeping on their left side.  Side sleeping is associated with face wrinkles because of skin tension.  
• Tips:  A pillow between your knees and a pillow to hug may increase your comfort with side sleeping (a body pillow can do both).  Make sure the pillow under your head is keeping your neck in a neutral position.  
• CPAP users:  strap marks are more likely with side sleeping.  A lateral position is also more likely to cause disruption to the mask seal, particularly with nasal pillows or nasal cradle masks.  

Right side sleeping (also called right lateral position):

• Pros:  side sleeping may improve snoring and lessen sleep apnea.  People with heart failure naturally choose to sleep on their right side; echocardiograms of people with heart failure show that left-side sleeping impacts the way the heart functions, potentially causing discomfort.  Some people with back or neck pain prefer a lateral position with pillow support.
• Cons:  pain or stiffness in your spine or major joints (shoulders, hips, or knees) may be worsened in a lateral position and cause sleep disruption.  Right-side sleeping can make acid reflux symptoms worse.  Side sleeping is associated with face wrinkles because of skin tension.  
• Tips:  A pillow between your knees and a pillow to hug may increase your comfort with side sleeping (a body pillow can do both).  Make sure the pillow under your head is keeping your neck in a neutral position.  
• CPAP users:  strap marks are more likely with side sleeping.  A lateral position is also more likely to cause disruption to the mask seal, particularly with nasal pillows or nasal cradle masks. 

Stomach sleeping (also called prone position):

• Pros:  Stomach sleeping may reduce snoring and sleep apnea in some individuals.  However, this is my least favorite position!
• Cons:  stomach sleeping is likely to strain your neck and lower back (and even your shoulders), leading to discomfort and awakenings from sleep.  This position is not ideal for proper spinal alignment.
• Tips:  Even if you prefer sleeping on your stomach, consider giving a different position a try.  I recommend starting with side sleeping and good pillow support.  
• CPAP users:  Stomach sleeping is generally discouraged due to the potential for increased pressure on the mask (which may block exhalation holes or cause mask lines or skin lesions) and disruption to the air seal.

Sleeping sitting up?  This is often due to problems with breathing.  If you have sleep apnea, take steps to get treated so you can sleep safely and more comfortably!

The "best" position ultimately depends on what is comfortable and supportive for you and your sleep quality.  When you start using CPAP, you may notice that your sleeping position changes– it’s pretty common!  Everyone's needs are different, so it's best to try out different combinations of positions, pillows, and CPAP mask types to find out what suits you best.