Sleep Positions

by Eric Falcon, MD

It is widely accepted that sleeping on your back tends to worsen all forms of sleep-disordered breathing, including UARS, sleep apnea, and snoring. Sleeping on the back allows gravity to pull the soft tissues of the palate, or the tongue, down into the back of the throat and cause airway narrowing, or as in the case of sleep apnea, complete obstruction.

Some doctors will even go so far as to advise patients with sleep-disordered breathing to sew a pocket into the back of their pajamas so that a tennis ball may be kept in it at night. After rolling onto your back at night during sleep and repeatedly experiencing the discomfort of the tennis ball continuously there, you soon "train" your subconscious mind to learn to avoid this sleeping position all together.

An easier alternative to sewing a pocket in the back of your pajamas is to just go out and buy a Dickies T-shirt or other type of T-shirt (which you can usually find in the men's section of K-mart) that has a pocket in the front upper left of the shirt. Simply put the shirt on backwards and place the tennis ball in the pocket, which is now in the upper right of the back. You get the same effect!

Sleeping on your side is preferable to sleeping on your back. When sleeping on your side try to keep your head, torso, and pelvis all in a straight line (when viewed from behind), which is a neutral anatomical position that will help to keep your spine in alignment. You can achieve this result by using a pillow of the proper height under your head and also by placing a flat pillow between your knees. Also, keep your knees and hips in a relaxed but flexed position and bent at 90 degree angles.

Many authorities feel that sleeping on the stomach, known as the "prone" position, is not a good idea. The reason for this is because it can lead to improper alignment of the spine, and because it can also place excessive pressure on the gastrointestinal organs throughout the night.

Yet doctors routinely advocate that patients with sleep-disordered breathing sleep on their stomach or side, however, and avoid sleeping on their backs. By sleeping on your side, or on your stomach with your head turned off to the side, this elicits the pull of gravity to cause the soft tissues of the palate and the tongue to fall somewhat forward and away from the back of the throat, preventing them from narrowing or obstructing the airway.

Believe it or not there actually is a PRONE sleeping position I have found which I believe retains the beneficial effects of gravity on the tissues of the back of the throat and tongue, as well as maintains some degree of proper spinal alignment, and also avoids excessive pressure on the internal organs.

This is called the FALCON SLEEPING POSITION.

Here's a complete description of the FALCON SLEEPING POSITION: To start out with, first lay flat on your belly for a second and turn your head to the left. Now, bring your left arm up so that your upper arm is extending out at a ninety degree angle to the side of your torso, and your left elbow is bent ninety degrees, with your left hand pointing up away from your feet. (Your left hand ends up being next to your face, in this position.)

Next, extend your right arm out to the opposite side of your body at a ninety degree angle and bend your right elbow ninety degrees as well, with your right hand pointing down towards your feet.

Next, bring your left thigh up so that your left hip and knee are each bent at ninety degree angles. Keep the right leg extended straight downward, with no bend at the knee or hip. In this position you will find that your abdomen/belly and chest will be lifted slightly off of the bed, so that there is not a feeling of excessive pressure on your gastrointestinal organs. For added support and comfort, you can place a pillow under the left half of your chest and abdomen.

I find this to be an incredibly comfortable position which I can remain in all night long with no discomfort. By the way, no pillow is used under the head in this sleeping position. The side of your face rests directly on your flat bed and the spine of your neck, torso, and hips should all line up in a straight line.

You can also switch to the exact opposite side, using the Falcon sleeping position, so that you're looking to the right instead, with your right hand now up in front of your face and your right knee and hip bent, and your left leg straight. Basically just use the same steps as I described above but replace the terms "left" with "right" and vice-versa.