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August 31, 2018

How side sleeping improves your nightly oxygen level

Research shows that most people can breathe better overnight by changing their sleeping position.

Sleep-disordered breathing affects about 90 million people across the United States. Some sleep-disordered breathing problems happen frequently and severely enough that they can decrease your nightly oxygen levels and prevent you from getting a restful night’s sleep. In some instances, they can also impair your long-term well-being.

Thankfully, sleeping on your side has been shown to greatly improve your nightly oxygen intake. Many people feel that they breathe better when sleeping on their side. But it’s more than just a feeling. According to one study, around 68 percent of those suffering from sleep apnea breathe better when they’re not on their back. Side-sleeping has long been known to protect the airway from collapse, increasing the number of healthy breaths of air taken in each night. This is because side sleeping reduces incidents of sleep apnea.

There are different kinds of sleep-disordered breathing. They can range from snoring at an especially loud volume to central sleep apnea (when your brain doesn’t send the right signal for your body to breathe) and obstructive sleep apnea, a more common occurrence where your respiratory path becomes obstructed. With obstructive sleep apnea, your body is unable to take full breaths while you sleep, despite its best efforts to do so.

In order to know why side sleeping can help improve your oxygen intake, you first need to understand what happens to your oxygen levels when you experience sleep apnea. Obstructive sleep apnea is a relatively common breathing-related sleep disorder affecting 54 million Americans, and is characterized by recurrent lapses in breathing during sleep.

When we’re awake, we’re typically upright, and this kind of posture helps support the muscles around the throat to help keep our airway open. But when we lie down to go to bed, the air sometimes doesn’t travel as easily. When we’re in a horizontal position, two things can make the passage of air more difficult.

First of all, gravity pulls the tongue and soft palate into the back of the throat. As everything shifts back in this direction, the throat can experience a blockage. This is even more likely if we have difficulty breathing through the nose and typically breathe through our mouths. A deviated nasal septum, allergies, or removing dentures at night may contribute to this occurrence, too.

Second, gravity also pushes any excess belly weight down on our diaphragms. As our diaphragms push up, the volume inside our lungs is reduced, making our breathing more shallow. Additionally, our muscles naturally relax during sleep, particularly during deeper sleep stages such as REM sleep.

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With the combination of gravity and relaxation, air does not flow as freely through our respiratory pathway. As a result, the flow of oxygen is diminished. And sometimes, it outright stops. A stopped breathing act is also known as an apnea event. When these apneas occur frequently enough during sleep, a formal diagnosis of sleep apnea from a sleep health professional can happen.

But there is good news. Promising research shows that side sleeping can help lessen the occurence of sleep-disordered breathing and improve your nightly oxygen levels and overall sleep health. Patients from this study experienced significantly better breathing patterns during their sleep when they slept on their sides as opposed to their backs or stomachs. Intentionally sleeping on your side to alleviate the effects of sleep-disordered breathing is also known as positional therapy.

Positional therapy research points to side sleeping as being very effective for treating sleep apnea. A recent study of 105 people with sleep apnea showed that 67 percent of them reduced their incidents of sleep apnea to less than five events per hour, consistent with normal breathing during sleep.

When sleep apnea causes breathing to stop, the brain realizes that something is wrong. This kickstarts an arousal (or awakening), triggering the act of breathing once again. This natural instinct interrupts deep sleep, causing people to wake up or enter a lighter sleep phase. These awakenings can happen dozens or even hundreds of times per night, usually without the sleeping person realizing they are waking up. As a result, sleep quality can really suffer.

Not sure if you have sleep apnea? A sleep doctor will be able to help you know for sure. About 80 percent of those who have sleep apnea are currently undiagnosed, so it’s best to get checked out if you have concerns. You can work with your doctor to assess your specific needs and create a program that will set you on a path to healthier oxygen intake, better quality sleep and improved overall health.


Brandon R. Peters, M.D., is board-certified in both neurology and sleep medicine and currently practices at Virginia Mason Medical Center in Seattle. He is also a Clinical Affiliate at Stanford University's School of Medicine in the Department of Psychiatry and Behavioral Sciences. His latest book, Insomnia Solved, is available on Amazon.