Have Trouble Breathing While Asleep? Here Are the Best Sleeping Positions
Key takeaways:
Sleeping on your side or stomach are the best positions for keeping your airway open.
Using extra pillows to lift your head can help with sinus congestion and ease breathing if you have a cold or sinus infection.
If breathing problems keep you up at night or leave you tired all day, talk to your primary care provider for help with better sleep solutions.
Table of contents
If you’ve ever felt more congested when your head hits the pillow, you’re not alone. The common cold, allergies, and sinus infections can leave you more stuffed up at night. And a number of other conditions that affect your breathing, like asthma and chronic obstructive pulmonary disease (COPD), can get worse at night.
Some breathing issues only occur when you’re asleep. For example, sleep apnea is an airway condition that interrupts your breathing only while you sleep.
But sometimes making one small change — such as adjusting your sleeping position — can improve your symptoms and support better airflow so you can get a good night’s sleep.
Best sleeping position for breathing problems
Your sleeping position can affect your airway, also called your windpipe or trachea. It leads from your throat to your lungs. If you have breathing problems, you want to sleep in a position that opens your airway and improves airflow.
Side sleeping
Side sleeping is generally considered the best position for breathing. Sleeping on your side naturally keeps your airway open. As a bonus, it’s often recommended because it can also keep your neck and spine aligned to reduce back pain.
Back sleeping
Sleeping on your back, or supine, isn’t generally recommended if you have breathing problems. Sleeping on your back may make breathing problems worse.
Too stuffed up to sleep? There are several strategies from natural remedies to decongestants that can help clear your nasal passages.
Does your partner snore? There are effective treatments that can help reduce snoring so you both can sleep better.
How to sleep with back pain: Certain positions and props can help ease back pain while you’re sleeping.
Here’s why: When you sleep on your back, pressure on the windpipe increases. This can make it more difficult for air to flow through. Also, when you’re flat on your back, your respiratory muscles, including your diaphragm, may not expand as much as they do in other positions.
Stomach sleeping
Stomach sleeping may be helpful in opening the airway if you have obstructive sleep apnea. But some people find it uncomfortable. And it may also cause a sore neck and back.
Propping your head up
Another strategy that’s helpful for many breathing issues is elevating your head with an extra pillow or two. This can improve congestion and help you take deeper breaths.
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How to sleep with different breathing problems
The best sleeping position for you depends on your specific breathing issue and its cause. Common causes of breathing difficulties at night include:
Sleep apnea
Asthma
COPD
A cold
Sinus congestion
How to sleep if you have sleep apnea
Sleep apnea is when breathing starts and stops frequently while you’re sleeping. These breathing disruptions happen when muscles and other structures in your throat, like your tongue and soft palate, relax or change position while you sleep. These changes can block your airway and temporarily prevent you from breathing (called apnea). Your brain signals your body to wake up, triggering you to breathe again.
Most research shows that sleeping on your back isn’t the best position if you have sleep apnea. When you’re on your back, gravity pulls your tongue and soft palate down, potentially blocking your airway. This can cause apnea and worsen snoring.
Instead, sleep on your side or stomach. These positions use gravity to keep your airway open to help prevent sleep apnea.
One way to treat sleep apnea is with a CPAP (continuous positive airway pressure) machine. This device keeps your airway open while you sleep. If you’re using a CPAP, it doesn’t matter if you’re sleeping on your back or side. There are different types of CPAP masks available for different sleeping positions.
How to sleep if you have an obstructive lung condition
Certain conditions, such as asthma and COPD, cause inflammation and mucus to build up in your lungs. These symptoms worsen during flare-ups and can make it harder to breathe.
Lying flat on your back can also affect your breathing. That’s because your respiratory muscles, including your diaphragm, can’t fully expand.
Sleeping with your head and shoulders propped up on a few pillows may help air move through your large airways more easily and drain mucus. This may improve sleep quality. There are certain types of pillows that can help keep you propped up, like wedge pillows.
How to sleep with a cold or sinus congestion
Your body needs extra rest when fighting off a cold. But it can be hard to get a good night’s sleep when your nose is stuffy and breathing is difficult. If your sinuses are inflamed, it can make breathing worse.
Gravity helps when you’re stuffed up. You’ve probably felt your head clear a little when you prop yourself up on a pillow. Raising your head helps drain your sinuses, making them less congested. It can also help with post-nasal drip, which is common with colds and sinus infections.
An extra pillow or rolled towel may work for you. Or you can try sleeping in a recliner while you recover from your cold.
What sleeping problems can be worsened by your sleep position?
You should avoid any sleeping position that impairs your airway or stops you from taking a deep breath. This depends on the breathing problem you’re dealing with and its cause:
Sleep apnea: It’s best to avoid back sleeping as it raises the chances of your airway closing.
COPD or asthma flare-up: If you have these conditions, you may want to avoid lying completely flat because it can prevent your lungs from fully expanding.
Cold or sinus congestion: Avoid lying completely flat, since this can increase congestion.
Should you try proning?
People who are hospitalized with serious respiratory illnesses often need a ventilator, a machine to help them breathe. This was common during the height of the COVID-19 pandemic.
Proning is when healthcare professionals roll someone over from their back to their stomach to improve oxygen levels. Research shows that proning helps improve breathing and survival in people with acute respiratory distress syndrome (ARDS). This is when breathing becomes too difficult to get enough oxygen into your body.
Proning is a unique intervention done in the hospital setting. At home, if you’re not seriously ill, you can think of proning as simply rolling over onto your stomach. You may find stomach sleeping helpful if you have sleep apnea. But stomach sleeping can cause a sore neck in some people.
When should you get help for breathing problems during sleep?
It’s important to talk with a healthcare professional if your breathing problems affect your sleep quality. Here are some signs of nighttime breathing problems:
Your breathing keeps you awake much of the night.
You have excessive daytime sleepiness. You find it hard to make it through your day without a nap.
You frequently wake your partner, common with snoring and breathing interruptions.
You have difficulty falling asleep because of breathing discomfort or shortness of breath.
Frequently asked questions
A normal adult respiratory rate is 12 to 20 breaths per minute. It’s normal for your breathing to slow to the lower end of this range while sleeping, especially during stage 3 or deep sleep.
A side-sleeping pillow is high and firm enough to support your head and neck without sinking. There are lots of side-sleeping pillows on the market. But the best pillow for side sleeping is one that keeps your head, neck, and spine aligned.
The best position to sleep in for oxygen flow depends on your breathing problems and their cause. Oxygen flows best when your airway is open and your lungs can fully expand. For most people, this means sleeping on your side or stomach. And for some, it's important to elevate your head, neck, and shoulders, too.
The bottom line
If breathing issues are keeping you up at night, adjusting your sleep position could make a difference. Side or stomach sleeping can help keep your airway open, while elevating your head can ease congestion. A few extra pillows may be all you need to breathe easier. But always talk with your primary care provider if breathing troubles are disrupting your sleep or you wake up tired in the morning. With the right sleep setup, you can improve your rest and start feeling better equipped to handle each day.
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References
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MedlinePlus. (n.d.). Tracheal disorders.
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