Sleep Apnoea: Signs, Risk factor and Best Sleeping Position for Sleep Apnoea.

Sleep apnoea is a common sleep disorder. Your breathing will stop temporarily and restart while you are asleep. It can become serious a problem if not treated.

The position in which you sleep will also play an important role. The best sleeping position for sleep apnoea can help you in getting relief from the episodes of sleep apnoea.

Sleep Apnoea is a common disorder. Right side sleeping is the best sleeping position for sleep apnoea with associated heart disease.

Types of Sleep Apnoea.

1. Obstructive sleep apnoea- Throat muscles relax and collapse during sleep resulting in cessation of breathing.
2. Central sleep apnoea- The brain does not send an adequate signal to the breathing muscles during sleep.
3. Mixed sleep apnoea

Obstructive Sleep Apnoea Syndrome (OSAS)-

The throat muscles narrow and relaxes during sleep to obstruct the air pathway interrupting normal breathing.

The period of cessation of breathing varies. If the cessation is for more than 10 seconds each time and occurs more than 5 times/hour, then it is very significant.

How many people affected?

Obstructive Sleep Apnea (OSA) is one of the most common respiratory disorders. A study was conducted with data from the United States and Europe in 2015.

The research suggests that between 14% and 49% of middle-aged men have clinically significant OSA.

Another research estimates sleep apnoea occurs in 3% to 7%, with some population subgroups with a higher risk factor.

What happens in Obstructive Sleep Apnoea Syndrome (OSAS)?

While sleeping, the throat muscles normally relax. Most of the time, this does not affect breathing.

If you have OSAS, your throat muscles become so relaxed during sleep that they cause a narrowing and blocking of the airway completely or partially. This results in an interruption of breathing.

Is Sleep Apnoea disturbing your sleep?
Is Sleep Apnoea disturbing your sleep?

People with OSAS will have two types of interruptions in breathing.

Apnoea- The muscles and soft tissues of the throat relaxes and collapse to block the airway sufficiently. For 10 seconds and more if the airway is blocked then it is called apnoea.

Hypopnoea- A partial blockage of the airway resulting in airflow reduction by 50% for 10 seconds and more.

The narrowed airway will restrict the airflow. At first, this causes snoring.

The complete or partial blockage will cause apnoea and hypopnea for around 10 seconds. Your brain detects a decrease in blood oxygen level.

The brain tells you to wake up and you make an extra effort to breathe. Then, with a few deep breaths, you start breathing again.

You might not be aware of the situation.

But trust your partner, if he or she tells you.

Someone watching you will notice a stoppage of breathing for a short time, followed by a loud snore. You might even sound like choking, briefly wake up and then get straight back off to sleep.

It is quite common to have the odd episode of apnoea when we are asleep, often finishing with a snore. This is of no concern.

If this episode increase, then the chances of Sleep apnoea also increase.

Do you snore? I suggest you read our article on snoring remedy.

How Can I Know I Have Sleep Apnoea?

You may complain of excessive daytime sleepiness often with irritability or restlessness.

But it is normally your bed partner, family or friends who notice the symptoms first. So don’t ignore them next time, if they complain about

• Nighttime gasping, choking or coughing.
• Irregular breathing during sleep (eg., snoring)

Do you feel the following?

Daytime sleepiness, e.g., falling asleep at work, whilst driving, during conversation or when watching TV. (Not to be confused with excessive tiredness, we all suffer from time to time).

Day time sleepiness.
Daytime Sleepiness.

• Morning headaches.
• Gastroesophageal reflux (GE reflux)
• Forgetting common stuff that you will generally remember.
• Irritability, short temper throughout the day.
• Changes in mood or behavior.
• Poor concentration and mental functioning during the day. This can lead to problems at work.
• Anxiety or depression
• Decreased interest in sex

Remember, not everyone who has these symptoms will necessarily have sleep apnoea.
Some of us can suffer from these symptoms from time to time.

People suffering from sleep apnoea will demonstrate some or all of these symptoms all the time.
Moreover, the intensity and severity of these symptoms increase with the disease severity.

Risk Factors for Sleep Apnoea.

AGE– OSAS can occur at any age, it’s more common in people who are above 60. (source)

Male– Both male and female are affected. Research suggests that males are most commonly affected.

But some research suggests that females are affected but are treated for other diseases which are the outcome or the reason for sleep apnoea. (source)

Obesity – Central adiposity, is consistently recognized as one of the strongest risk factors for sleep apnoea.

Excessive body fat deposition increases the bulk of soft tissue in the neck, which can place a strain on the throat muscles.

Excess stomach fat can also lead to breathing difficulties, which can make sleep apnoea worse. (source)

Alcohol – Drinking alcohol will worsen sleep apnea. Bedtime alcohol consumption will increase sleep apnoea. (source)

Smoking – Smoking will lead to sleep apnoea. An active and passive form of smoking both will affect. (source)

Your Anatomy– Having a large neck circumference (>17” men; >16” women) is, increased risk of developing OSA

Narrow airway, large tonsils, adenoids or tongue, or a small lower jaw will also cause sleep apnoea. (source)

Family history– Inherited genes can cause Sleep apnoea.  (source)
Nasal congestion– Nasal congestion can lead to sleep apnoea.
Menopause in case of women can lead to sleep apnoea.
Pregnancy can increase the chances of Snoring. Research has found the 10% of pregnant mothers develop sleep Apnoea.

Treatment and Diagnose

Sleep apnoea is a serious disorder. But we are fortunate that diagnosis and treatment both are available.

If you experience any of the above symptoms, then it is very important you should visit and get checked by a physician.

Apart from that, you would also like to get in contact with a Cardiologist.

It can be treated in many ways. The more common way is by CPAP. Doctors are better informed and equipped to educate you and help you with the treatment.

But on my behalf, I do want to present some insight on positional therapy and sleep apnoea.

Throat Exercise

Along with treatments, you can check out Natural sleep aids, like postural therapy ( sleeping position) and also threat exercises.

Throat exercises are easy to do. They are time-tested remedies to get rid of Sleep Apnoea. this exercise will definitely help you if you have mild to moderate Sleep Apnoea.

Best Sleeping Position for Sleep Apnoea.

Positional therapy or postural therapy deals with the change in your body position while you sleep. As you might already know that our body is affected by the way we sleep.

A sleeping position that will help you reduce the episodes of apnoea and improve your sleep quality will thus be the best sleeping position for sleep apnoea.

The best sleeping position for sleep apnoea will thus be positional therapy.

Who will be more beneficial in Sleep Apnoea with changes in sleeping position? (Postural Therapy)

Postural therapy will it help everyone suffering from Sleep apnoea or some of them.

This is a common question to ask.

So let us see what research has to say.
Study 1 
An NIH study on 30 patients with episodes of apnoea during sleep, checked the severity depending on sleep position.

They conclude that changes in sleeping position can alter sleep apnoea even in non-obese patients.

Study 2 

This study explains how less obese people with apnoea are going to be more benefitted by changing on sleep positions.

Based on these studies we can conclude that
• Non-obese or people with mild to moderate degrees of obesity can benefit from sleep apnoea with a sleeping position change.
• Those patients whose sleep apnoea is dependent on position will also benefit from positional therapy.

How different sleep position affects apnoea.

Generally, we sleep in three postures or a combination of them
The three basic sleeping positions are
• Sleeping on stomach
• Sleeping on back
• Side sleeping position.

Sleeping on the stomach

While sleeping on your stomach the episodes of apnoea can decrease. But the chances of getting affected by neck pain and back pain will increase.

That is the reason it is not considered a healthy position to sleep in.

Since sleep apnoea affects mostly the elderly, stomach sleeping will not be a good option.

Sleeping on back

It is considered a healthier option. But if you are suffering from sleep apnoea Sleeping on the back will not be healthy.

While sleeping on the back you are twice as likely to experience sleep apnea. You are also likely to snore.

The reason behind this is the crowding of your upper airway tissues (tongue, uvula, soft palate, and adenoid).

Your tissues especially your tongue will fall back and will create upper airway obstruction. So, sleeping on your back is not the best sleeping position for sleep apnea.

sleeping on back.
Sleeping on the back.

“Try sleeping on your side”

The best sleeping position in sleep apnoea is to sleep on your side.

But in case you don’t want to sleep on your side, you can try sleeping on your back with the head of the bed elevated. This will be a more upright position.

This position will not allow your tongue to fall back and create an obstruction. You can argue that it is more of a sitting position than a sleeping position.

But if you feel comfortable in this position then you can give it a try.

Research shows that sleeping on the back at a 60-degree angle has helped some patients to get relief from sleep apnoea symptoms.

You can use a wedge pillow or an adjustable bed to achieve this elevation.

Sleeping on your side.

Sleeping on your side will give you relief from the episodes of sleep apnoea. In this position, your tissues of the upper respiratory tract will not create an obstruction.

A case study of a 37-year-old overweight individual suffering from sleep apnea shows that side sleeping is beneficial.

The episodes of sleep apnoea decreased in this person improving the sleep quality.

This study is also important because after the individual decreased his weight by 7 kg, the symptoms further improved.

Side sleeping: Best Sleeping position for Sleep Apnoea.
Side sleeping: Best Sleeping Position for Sleep Apnoea.

From this research and many other studies, we can suggest Side sleeping is the best sleeping position for sleep apnoea.

But you should avoid the fetal position. It is the second-worst position to sleep in. It will increase the chance of neck pain and backache.

Fetal position among side sleeping positions is not the best sleeping position for side sleeping.
Now next step, which side to sleep in.

Right or Left

Side sleeping is the best sleeping position for sleep apnoea. Right side or left side you choose according to your comfortability.

But there are some conditions which you should be choosy about the side.

Let us see these conditions.

Heart Conditions

If you are suffering from heart conditions, then you should choose the right side. I know this goes in the opposite direction from other articles.

But I am suggesting based on facts.
Hypertension, coronary artery disease, heart failure, and arterial fibrillation are commonly associated with sleep apnoea.

Cardiovascular diseases are one of the major causes of mortality with sleep apnoea.

Research study shows that left-side sleeping has adverse effects on the heart.

The apex of our heart is situated on the left side. While sleeping on the left side there will be compression and it will result in discomfort.

Secondly sleeping on the left side will activate the sympathetic system which will affect patients with heart failure. This is what a research study concludes.

Furthermore, another study suggests that patients with heart failure spend less time on the right side while sleeping.

They pointed out the patients feel uneasy so automatically change their position to their left side.

Research has also shown that the risk of coronary artery disease decreases while sleeping on the right side.

Thus Right side sleeping is the best sleeping position for sleep apnoea with associated heart disease.

Pregnant lady

If you are a pregnant lady, then the left side sleeping will be the best sleeping position for sleep apnoea or any other conditions.

Conclusion

In conclusion, I want to say Sleep apnea is a serious disorder. If you experience any symptoms, then you should get in touch with a doctor.

Positional therapy has shown to be effective in helping some people with sleep, apnoea. Side sleeping is the best sleeping position for sleep apnea. You can choose to sleep on your side as a positional therapy.

But before you do you should consult a physician and also a cardiologist. Depending on their output you make changes to your daily routine.

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