Best (and Worst) Sleeping Positions for Sleep Apnea

September 7, 2023 | Casper Editorial Team

Fact checked by Jonathan Eilenberg, CPE

Sleep apnea, a widespread sleep disorder, is marked by interruptions in breathing and reduced airflow while one slumbers.1 These disturbances hinder individuals with sleep apnea from reaching the deep, rejuvenating sleep stages. The aftermath? A debilitating sleep shortage that affects overall health and day-to-day performance.

The role of one’s sleeping position is crucial when considering sleep apnea. While some positions enhance air circulation, others might further obstruct it. Identifying the right sleeping positions can be a game-changer, enhancing sleep quality at night and boosting daytime vitality.

Understanding Sleep Apnea

There are two main types of sleep apnea – obstructive sleep apnea (OSA) and central sleep apnea (CSA).2 OSA is the more common form, affecting around 22 million Americans.

  • Obstructive Sleep Apnea—Here, the airway shuts or becomes obstructed in sleep. This happens when the muscles and tissues in the throat become overly relaxed and impede the airway. Snoring often accompanies OSA because of tissue vibration. It’s notably prevalent among middle-aged adults, more commonly seen in men.3
  • Central Sleep Apnea—CSA is when the brain fails to instruct muscles to breathe during sleep. This variant is rarer and might indicate other grave health conditions like heart failure.2 Unlike OSA, body weight doesn’t play a role.

For OSA sufferers especially, sleeping position is paramount. If you’re a back sleeper, you can actually exacerbate the problem as gravity pulls down on the tongue and throat tissues, leading to airway obstruction.

Diagnosing Sleep Apnea

A polysomnogram, an overnight sleep study, is often used to diagnose sleep apnea. This analysis tracks brain activity, oxygen levels, heart rhythm, breathing patterns, and more.4 Alternatively, some might undergo an at-home sleep assessment using a device that measures factors like oxygen saturation and snoring.4

These evaluations provide doctors a window into your nocturnal breathing patterns. The frequency of breathing pauses and the drop in oxygen levels determine the sleep apnea’s severity. Mild to moderate OSA presents 5-30 interruptions hourly, while severe cases can exceed 30.5

The Best Sleeping Position for Sleep Apnea

Side Sleeping

For many, side sleeping is the best sleeping position for alleviating both OSA and CSA symptoms. It counters the gravitational force that might otherwise cause the tongue and tissues to collapse into the airway.6

Benefits of Right-Side Sleeping

Choosing the right side can be particularly effective against OSA. Since our stomach and liver are right-oriented, resting on this side aids in pulling the diaphragm downward, enhancing airway openness.7

Benefits of Left-Side Sleeping

Though right-side sleeping takes the trophy for OSA, the left side can be a boon for acid reflux and heartburn sufferers. The esophagus enters the stomach on the right, so left-side sleeping keeps acid down through gravity.8

Left side sleeping also improves circulation and blood flow for pregnant women.9 The aorta artery that transports blood to the fetus is located left of the spine.

Stomach Sleeping

Is it bad to sleep on your stomach? Sleeping face down in a prone position is controversial when it comes to sleep apnea. While some find it beneficial as it prevents the airway from being blocked,10 others argue it might intensify sleep apnea symptoms. It’s also reputed to strain the spine, potentially leading to neck and shoulder pain.11 

A study from 2014 discovered that sleeping in a prone position benefited individuals with OSA. Notably, 80% of participants with position-related OSA and 42% with non-positional OSA experienced a notable reduction in breathing interruptions every sleep hour.12

If you do choose to sleep on your stomach, turn your head to the side to allow room for breathing, and be sure to explore the best mattresses for stomach sleepers. You can use a thin pillow under the pelvis and abdomen to prevent hyperextending the neck.

The Worst Sleeping Position for Sleep Apnea

Back Sleeping

Sleeping on the back is often considered the worst sleep position for sleep apnea. In the supine position, gravity pulls the base of the tongue and throat muscles down into the airway. This narrows breathing passageways and commonly worsens obstructive sleep apnea symptoms.

Solutions for Back Sleepers

Using a very firm mattress can help keep airways open if you sleep best on your back. Avoid pillows to keep the head flat and prevent the tongue from falling into the throat. This allows for better air movement.

If using a pillow, consider a wedge pillow to elevate the head. Position the body at a 30 degree incline or higher to minimize the gravitational effects on the tongue and soft tissues. Alternatively, you can use an adjustable base to reach the perfect incline for your body’s needs.

Turn the head slightly to the side while back sleeping as well. Rotating the head left prevents structures from closing off the airway. A small pillow can help maintain the turned head position. Knowing how to sleep on your back properly is key.

What About Combination Sleeping?

Frequent position shifters can mix side and stomach sleeping to optimize breathing.

Start out on the right side to allow gravity to pull the diaphragm down and open airways. When moving to the stomach, rotate the head to the left to keep the airway clear. Use a thin pillow under the stomach if needed, and long periods on your back or left side.

Importance of Head Positioning

Proper head positioning is key to optimizing the airflow, regardless of the overall sleep position. Rotating the head so the mouth and throat are open, rather than pressed into the mattress or pillow, can significantly impact sleep apnea management.

Right-side sleepers should tilt their heads down to move the chin away from the chest. This prevents compression of the airway. Left-side sleepers can turn their heads up slightly to maintain an open airway.

Back sleepers should turn the head to either side to avoid direct pressure from the mattress closing the mouth and throat, allowing for better air movement.

Stomach sleepers should rotate the head to the left or right to allow room for breathing away from the mattress. Avoid keeping the head and neck in line with the back as this can constrict airflow.

Other Natural Ways to Manage Sleep Apnea

Maintaining a Healthy Weight

Since obesity is a leading risk factor for OSA,13 maintaining an optimal weight through diet and exercise can help reduce apnea episodes. Even losing 10-15 pounds can open up breathing passageways for better sleep.

Avoiding Alcohol and Smoking

Both alcohol and smoking can relax muscles and worsen OSA.14 It’s wise to steer clear of these, especially before hitting the sack.

The Role of CPAP Therapy

Continuous positive airway pressure (CPAP) devices provide pressurized air to the throat to keep airways open using an oral mask.4 While not natural, CPAP is an effective medical treatment for moderate to severe sleep apnea.

Improving Nasal Breathing

Congestion, allergies, and sinus issues can restrict nasal airflow causing mouth breathing during sleep.15 Using saline sprays, antihistamines, and breathing strips can help open nasal passageways.

The Role of Bedding in Sleep Quality

A comfortable, high-quality mattress and pillow are essential for those with sleep apnea to get truly restorative sleep. Having the best mattress for sleep apnea paired with supportive bedding optimizes sleeping positions and head alignment to minimize apneas.

The Casper Original memory foam mattress strikes the ideal balance between comfort and support. The Zoned Support system provides softer foam by the shoulders for optimal pressure relief while firmer foam by the hips and core reinforces proper spinal alignment for side sleeping.

The perforated foam allows for cool airflow to prevent overheating, and the seamless mattress design minimizes pressure points for uninterrupted sleep. Plus, with Casper’s 100-night risk-free trial, what’s there to lose?

Elevate Your Sleep Experience with Casper 

Sleep position and quality bedding play a key role in effective sleep apnea management. Casper bed mattresses perfectly complement your sleep apnea management strategies. Choose Casper and witness an unprecedented difference in your rest, translating to better health.


  1. Cleveland Clinic. Sleep Apnea. Cleveland Clinic. Published March 3, 2020. 
  2. Villines Z. Types of sleep apnea: Obstructive, central, and complex. Published February 26, 2021. 
  3. Johns Hopkins Medicine. Obstructive Sleep Apnea. 
  4. Mayo Clinic. Sleep apnea – Diagnosis and treatment – Mayo Clinic. Published 2018. 
  5. Goyal M, Johnson J. Obstructive Sleep Apnea Diagnosis and Management. Missouri Medicine. 2017;114(2):120-124. 
  6. McCann A. Best Sleeping Positions for Sleep Apnea. Blog. Published December 26, 2020. 
  7. Cherney K. Side Sleeper: Benefits, Drawbacks, How to Do it, Which Side Is Best. Healthline. Published September 25, 2019. 
  8. Amsterdam University Medical Center. Sleeping on the left side reduces acid reflux. Published November 8, 2022. 
  9. Khan A. 5 Reasons Why Sleeping on Your Left Side Is Good for You. eMediHealth. Published January 25, 2023. 
  10. Prone Sleep Position: Uncovering the Pros and Cons. Manta Sleep. Published March 22, 2023. 
  11. Carey E. Sleeping on Your Stomach: Is It Bad for You? Healthline. Published September 12, 2014. 
  12. Armin Bidarian-Moniri, Nilsson M, Rasmusson L, Attia J, Hasse Ejnell. The effect of the prone sleeping position on obstructive sleep apnoea. Acta Oto-laryngologica. 2014;135(1):79-84. doi: 
  13. Mayo Clinic. Obstructive Sleep Apnea – Symptoms and Causes. Mayo Clinic. Published 2018. 
  14. Sleep Apnea – Causes and Risk Factors | NHLBI, NIH. Published March 24, 2022. 
  15. Cleveland Clinic. Mouth Breathing: What It Is, Complications & Treatments. Cleveland Clinic. Published April 11, 2022. 

Casper Editorial Policy

Casper blog articles are written by skilled authors and periodically reviewed by our team of sleep experts at Casper Labs. Driven by comprehensive research and evidence-based practices, we ensure that the content we publish is reliable, actionable, and practical for enhancing sleep quality and wellness.

Our articles incorporate trusted third-party sources, cited within the content and listed at the end for easy reference. At Casper we strive to be an authority and trusted resource for all things sleep.