Breathing Problems? Try These Sleep Positions

Sleep is essential to our well-being. But when you’re having trouble breathing, sleep can be elusive.

For some people, the problem is temporary — say, a cold that has your nose all stuffed up. For others, trouble breathing can make finding a comfortable sleep position a nightly struggle.

What’s the best position for sleeping with breathing problems? It depends, says sleep medicine specialist Nancy Foldvary-Schaefer, DO, MS.

“It can take some trial and error to see what works best for you,” she acknowledges. “But there are some best practices that work for a lot of people to breathe better at night.”

Dr. Foldvary-Schaefer walks us through some scenarios and what sleeping positions may help you catch your breath.

Why you may have breathing issues lying down

Any number of conditions (both temporary or chronic) can make breathing difficult. And make it harder to catch your breath when you’re trying to get your ZZZs.

That includes having conditions like:

• A respiratory infection, like a cold, flu, COVID-19 or RSV
• Allergies
• Pneumonia (or walking pneumonia)
• Deviated septum
• Sleep apnea
• Congestive heart failure
• Lung conditions, including asthma, chronic cough, COPD or cystic fibrosis

Best sleeping positions for breathing problems

For most people with breathing troubles, lying flat on your back isn’t going to help. Your body can’t as easily clear your airways like that. And sleeping on your stomach can cause a host of issues, like back and neck pain, for a lot of people.

In most cases, Dr. Foldvary-Schaefer advises that people with breathing troubles are best off lying on their side or sleeping propped up.

Let’s take a look at what works best and when.

Try your side

Side sleeping is one of the most comfortable and effective sleeping positions for many people — breathing problems or not.

“Sleeping on your side helps your spine maintain a neutral position, which can mean less strain on your back and neck,” Dr. Foldvary-Schaefer explains.

For optimal alignment, place a pillow between your knees to relieve any pressure from the weight of your top leg.

Side sleeping can be especially useful if you’re dealing with a respiratory illness or from conditions like a deviated septum, which can cause chronic congestion.

“Each of your nostrils has a cycle time where one gets more congested, and then the other,” Dr. Foldvary-Schaefer shares. “A lot of people find they can get relief from one-sided congestion by sleeping with their obstructed nostril on top.”

So, if your left nostril is congested, sleep on your right side. And vice versa.

Side-sleeping is also helpful for people who snore or have sleep apnea. That’s because sleeping on your back allows your tongue and soft palette to move backward toward your throat, constricting your airway. Sleeping on your side helps keep your airway clear.

For some people with sleep apnea, learning to sleep on their side can be an alternative to using a CPAP machine.

“There are times when side sleeping can be a reasonable way to treat mild sleep apnea without a CPAP machine or other therapies,” she notes.

Prop yourself up

While lying flat may leave you feeling short of breath, elevating your head can help.

“A lot of people with chronic heart or lung diseases sleep most comfortably when their head is elevated,” Dr. Foldvary-Schaefer states.

Here’s why: These conditions can cause fluid to build up in your lungs. And when you’re lying flat, that fluid can rise to your neck. It can also start to pool and put extra pressure on your lungs. All of which makes it harder to breathe.

Propping yourself up can help relieve the pressure.

There are a number of ways to prop yourself up comfortably when you sleep. You could try:

• A few pillows (or rolled up towels) under your head and neck
• Sleeping in a reclining chair (with your healthcare provider’s OK)
• An adjustable bed

For added comfort and to reduce stress on your back, try a pillow or bolster under your knees.

Other tips for better breathing

Breathing troubles don’t always start and end with bedtime. If you’re living with shortness of breath throughout the day, it’s important to talk with a healthcare provider to find out why and to learn strategies to manage it.

They may recommend things like:

• Breathing techniques: Try pursed lip breathing and diaphragmatic breathing.
• Seated positioning: Sit with your feet flat on the floor and lean forward slightly. Rest your elbows on your knees and your chin in your hands. Relax your neck and shoulders. Alternatively, rest your arms on a table and your head on your arms.
• Assisted standing: Rest your elbows or hands on a piece of furniture, just below shoulder height. Relax your shoulders and neck, bringing your head on your forearms.