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Use sleep positioners to help you sleep better

What is a sleep positioner? 

A sleep positioner is a device that helps someone control what position their bodies are in when they sleep.

There are a wide variety of sleep positioners available, and for good reason: an estimated 90 million people in the United States struggle with sleep-disordered breathing, a condition that can often be treated by using a sleep positioner.

The effects of breathing on your health

Generally speaking, sleep-disordered breathing is an umbrella term for any breathing difficulties that arise when someone is asleep. Some examples include loud snoring and sleep apnea.

Sleep apnea is a condition characterized by reduced or stopped breathing during sleep. The effort to breathe persists, but with the upper airway blocked, oxygen levels drop and carbon dioxide levels rise. These blockages involve the throat, soft palate, uvula, and tongue base. They are more likely to occur when sleeping on your back. When the occurrence of these interruptions— referred to as apneas—are in excess (more than five times per hour of sleep), a formal diagnosis of sleep apnea from a doctor can follow.

In your own research, or perhaps during consultations with a sleep health professional, you may have come across information on how the position you sleep in can affect the way you breathe.


Taking a position

There are nuances to be aware of regarding the position of your head as you sleep, and how it relates to the way you breathe.

Side sleeping - Research shows that side sleeping is the most advantageous position for breathing for most sleepers. This position alleviates the effects of gravity on the airway, allowing for better oxygen delivery. If you have a form of sleep-disordered breathing, depending on other medical issues you may be facing, sleeping on a specific side (right vs. left) may be advised.

The position of your body makes a huge difference for those suffering from breathing-related sleep disorders like sleep apnea. But the position of your head matters most. If a person is sleeping on their side, but their head is tilted towards the ceiling, the effects of gravity pushing their tongue and soft palate back into their airway will still be felt. Conversely, if they are sleeping on their back, but their head is tilted to the side, they will be less likely to have an obstruction.

Supine (back) - Generally speaking, sleeping on your back is the least recommended position for treating sleep apnea and sleep health professionals often advise against it. That said, if you do sleep on your back, make sure you use a pillow that supports your neck and helps open your airway.

Prone (stomach) - While people who sleep on their stomachs are less likely to experience sleep apnea, this position is still not as ideal as side-sleeping. The lungs may be partially collapsed and this reduces airflow with breathing. Still, some find stomach sleeping to be more comfortable. Speak with a sleep health professional if back or neck pain arises from sleeping in the prone position.  

A little assistance

Most people can’t simply command their body to stay in one position during the entire duration of their sleep period. And those who claim to sleep in the same position all night are often proven wrong during lab testing: invariably, a person may roll around all night in bed only to wake up by chance in the same position they fell asleep in. This is one reason why doctors specializing in sleep health sometimes recommend sleep positioners to treat sleep apnea.

The good news is that there are a lot of methods available for those who want to gently yet effectively remind their body to stay in their desired sleeping position. Some can be made at home, some can be purchased online, and others require a doctor’s prescription.

Tennis, anyone?

A long-standing homemade remedy for sleep positional therapy often purported in popular culture is the tennis ball method. This involves filling a tube sock with tennis balls and affixing the sock down the center on the back of a slim-fitting shirt to prevent the wearer from rolling on to their back while sleeping.

Fans of the tennis ball method like it’s affordability and simplicity. Critics of this method say that while it may prevent sleeping in a supine position, the effect of accidentally rolling over onto one’s back is so jolting that it will wake the wearer. And although they may fall asleep immediately after, this could happen dozens of times per night, leaving the wearer bereft of both a good night’s sleep in the short term, and better health in the long term. 

A recent study of the tennis ball method showed that in the short term, the subjects of the experiment adopted this treatment with ease, and it did show reductions in their sleep apnea. That said, long-term adherence to the method was low and a treatment is only as effective as a person’s commitment to it.

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Different kinds of sleep positioners

Pillows and Pads: These make sleeping on your side more comfortable.

  • The home remedy of strategically placing pillows in bed to support side sleeping is easy to try. Body pillows, with their longer shapes, are specially designed to support comfortable side sleeping.
  • Sleep Yoga Side Sleeper Arm Rest Pillow - A line of contoured pillows that promote and support side sleeping. Widely available and well reviewed.

Wearable belts: These discourage back sleeping by making it uncomfortable.

  • Rematee - These bumper belts and shirts are purchased over the counter. The smooth, bumpy pads, worn on the back, keep the sleeper from rolling into anything other than a side or stomach sleeping position.
  • Slumberbump - An air bladder in the rear compartment creates a wedge that prevents the user from rolling into the supine sleep position.
  • Zzoma - An angled wedge made of soft foam, Zzoma was one of the first products to be specifically marketed for the treatment of sleep apnea. Available by prescription only, Zzoma works by ensuring the user sleeps only on their stomach or side.

Position Trainers: have alarms or buzzers meant to train the sleeper to avoid back sleeping.

  • NightShift Sleep Positioner - A sleep position therapy device that aims to discourage the sleeper from rolling on to their back using gentle vibrations when it senses your body is becoming supine. The vibrations’ intensity increases until you roll over to your side or stomach.
  • NightBalance - This device is about the size of a cell phone and is worn on the front of the body in an adjustable chest band. When the person wearing it rolls over to an undesired sleeping position, the device sends out gentle vibrations to coax you back into sleeping on your side.

Some people prefer to begin their sleep apnea treatment incrementally, and it’s not uncommon for sleep positional therapy to be used in conjunction with other treatments for sleep apnea.

Ultimately, a medical sleep professional may be able to best assess your situation and make recommendations to best treat your sleep apnea and get you on the road to better sleep 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.

July 13, 2018