Better Breathing, Better Sleep, Better You.

Positional Therapy

Jun 3, 2020 | By Rohit Budhiraja, M.D.

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In over half of the people with OSA, snoring and the sleep apnea become worse when they sleep on their back. This may happen because of gravity pulling the lower jaw and the tongue backward, causing the back of the throat to become narrower, thus blocking the flow of air. For people who have sleep apnea mainly on their back, positional therapy may be an option.

The goal of the positional therapy of sleep apnea is to help people stay off their back during sleep. Several different interventions have been tried for this purpose. The ‘tennis ball technique’--sewing a tennis ball to the back of the pajamas--has been suggested widely in the past. However, it can be uncomfortable, and the results are often not satisfactory. Commercially available positional therapies incorporate foam or similar soft material or inflatable bags for discouraging sleeping on the back. Some people use body pillows, side-sleeper pillows or wedge pillows to keep them off their backs. 

Newer devices try to achieve this goal with less discomfort. These devices include elastic chest bands or neck collars with position sensors, which start vibrating when the person goes on their back. The more advanced amongst these can progressively increase the intensity of vibrations until the person changes position. Some also collect data--such as time spent on back and the number and strength of vibrations--which can be downloaded and analyzed to help monitor effectiveness. If interested in this therapy, it is best to speak with your health care provider about how likely you may be to respond, whether this type of treatment should be used in combination with other treatments or as a sole therapy, and to learn which devices may work best for you.