Sleeping Positions With CPAP: Tips for Side, Back and Stomach Sleepers

Why position matters for sleep apnea

For many people, sleep apnea is worse when lying on the back, because gravity lets the tongue and soft tissues fall back toward the throat. On CPAP, back sleeping may need more pressure, which auto machines handle by raising pressure. Side sleeping often reduces airway collapse. Some people have mainly position-dependent sleep apnea, which is why positional therapy exists as a treatment for some.

Side sleepers

Side sleeping is popular and often good for the airway, but pillows push masks out of place.

• Choose a smaller mask, such as nasal pillows or a minimal nasal mask.
• Use a CPAP pillow with cut-outs, or position a regular pillow so the mask overhangs the edge.
• A mask with the tube connecting at the top of the head lets you turn without pulling the mask.
• A firmer pillow can stop the mask being pushed sideways.

Back sleepers

Back sleeping makes mask fit easy and most styles work well. Because sleep apnea may be worse on the back, mention it if your data shows more events or higher pressures on nights you sleep this way. A slightly elevated head position helps some people.

Stomach sleepers

Stomach sleeping is the hardest position for CPAP. Nasal pillows are usually the most compatible. A thin, soft pillow, or a CPAP pillow, gives room for the mask, and running the hose over the headboard keeps it out of the way.

Managing the hose

• Route the tubing above you with a hose hanger or over the headboard so it does not drag.
• Use slim, flexible tubing if your provider supplies it, but keep the type your machine requires (heated tubes are model-specific).
• Swivel connectors on many masks reduce tug when you turn.
• Keep the machine at or below mattress level to reduce rainout.