John Wooden, UCLA’s legendary basketball coach was a stickler for fundamentals. He looked down on trick plays, fancy footwork, or high-tech strategies. Similarly, before looking for state-of-the-art treatment options for obstructive sleep apnea, you should always first consider the fundamentals.
If you’ve been newly diagnosed with obstructive sleep apnea, you’re likely to be told to lose weight, diet and exercise. Everyone know this already. Drinking alcohol before bedtime is another big no-no, since it relaxes your throat muscles.
One option that is mentioned only casually is to avoid sleeping on your back. This is because being on your back allows your tongue and soft tissues of your throat to fall back more severely. When you add muscle relaxation during deeper levels of sleep, then you’ll either snore, or stop breathing altogether (called an apnea).
In sleep studies, you’ll routinely see that in most cases, being on your back can lead to double, or even triple the number of apneas on your back compared to sleeping on your side or tummy. One study showed that sleep positioning was almost as good as CPAP.
Many people know not to sleep on their backs. The problem is that in most cases, you can’t control your sleep position all night long.
If you are one of these people, then there’s an opportunity to use gravity to your advantage.
One of the oldest recommendation is to sew a tennis ball inside a sock to the back of your pajamas. This may work sometimes, but more often than not, you’ll just sleep on top of it, or it’ll keep annoying you causing you to wake up. One of my patients misunderstood me and filled an entire backpack with tennis balls during sleep, and it worked well for him.
There are now multiple options for keeping you off your back during sleep. One popular option is the Rematee Anti-snore shirt. It’s a vest that you wear at night with pockets in the back that’s filled with inflatable bumpers.
Another variation is the isidesleep mattress, which is an inclined wedge with a cutout at the top that allow you to drop your arm below the mattress, which cradling your head on a pillow that sits above the cutout.
If you have shoulder or back problems and you can’t sleep on your side, then sleeping on your back on a incline is another option. There are a number of different options that you can find including this wedge pillow. This can be also be good for acid reflux. It’s also why some people can only sleep on recliners.
If you must sleep on your back, then it’s important to use a pillow that will tilt your head back somewhat, which will open up your airway. This is similar to what you do as the first step in CPR, but not as far back. There are many of these “contour memory foam” pillows that are promoted to reduce snoring. It’s not going to cure your sleep apnea, but used in conjunction with various other methods, it can help to various degrees.
Two of my patients wore neck braces (one soft and one hard) with some success. This may work by preventing your chin from dropping forward, while keeping your neck extended.
If you must sleep on your back, there aren’t too may options. One desperate patient actually bought a massage table and slept tummy down with his face inside the hole.
As a last resort, you can always fly into space, where there’s no gravity. In fact, it’s been shown that astronauts have less snoring and apneas while in space compared to levels found back on earth.
If none of these options work for you, then it’s time to see a sleep physician. If you’re already using CPAP or an oral appliance, you can supplement positional therapy to your current regimen. Oftentimes, you’ll have to combine multiple options for better results.
I’m sure that many of you have tried other creative ways to get rid of snoring using positioning devices or contractions. If so, please share what worked for you in the comments area below.