When obstructive sleep apnoea (OSA) is influenced by sleeping on your back, using positional therapy can reduce airway obstruction and improve sleep quality. Here’s a clear guide for U.S. readers on how it works, for whom it is effective, and what to consider.
Overview of Positional Therapy and OSA
Positional therapy involves changing sleeping position—especially avoiding the supine (on-the-back) posture—to reduce airway collapse. Studies show that in certain patients, apnoeas occur predominantly while sleeping on the back.
Who Benefits from Positional Therapy?
- Individuals diagnosed with positional sleep apnoea (apnoeas primarily in supine position).
- Patients with mild to moderate OSA who seek a non-CPAP or adjunctive solution.
- Those willing to commit to behavioural changes (sleep posture, possibly using positional aids).
How Positional Therapy Works
The basic principle is simple: by limiting time spent on the back during sleep, you reduce the gravitational collapse of the airway tissues, which often happens in supine position. Some positional devices or techniques encourage side-sleeping, which can moderate the apnoea-hypopnoea index (AHI) in selected cases.
Limitations & Realistic Expectations
While positional therapy can help, it is **not a substitute** for first-line treatments such as CPAP for severe OSA. Its efficacy tends to be lower and long-term compliance may drop.
How to Use Positional Therapy Effectively
- Begin by tracking how often you sleep on your back—some smartphones or wearable apps help with this.
- Use side-sleeping pillows or positional alarms/devices that gently prompt turning away from the back.
- Maintain consistency: Habit change over successive nights is key to benefit.
- Combine with lifestyle changes (weight management, avoid alcohol at bedtime) to enhance effect.
When to Consult a Specialist
If you continue to experience pauses in breathing, excessive daytime sleepiness, or your partner reports loud snoring with gasping, you should consult a sleep physician. Positional therapy may be part of the strategy—but only after or alongside professional evaluation.
