Recommended Sleep Positions for Snoring, Sleep Apnea and Pregnancy

Sleeping Positions and Health Effects

What Position Should We Sleep to Avoid Snoring?

Body position during sleep can have a significant effect on the occurrence of snoring and sleep apnea. When lying on your back, the tongue root and soft palate close backwards to facilitate the emergence of vibratory snoring. Likewise, in the deeper phase of sleep, tissue relaxation increases and muscle tone decreases, making airway closure and sleep apnea easier in these areas.

Which patients are more likely to have difficulty sleeping, snoring and sleep apnea whe they sleeping on their back?

The characteristics of individuals at risk for supine bed snoring and sleep apnea can be listed as follows:

Especially fat, short and thick neck patients
Patients with large tonsils
Patients with sagging soft palate
Patients with elongated uvula
Patients with small lower jaw
Children with adenoid and tonsil hypertrophy

In the presence of these features, patients may complain of difficulty in sleeping on their back, snoring and decreased sleep quality.

Factors Determining Our Sleep Position!

Position during sleep, airway structure in the throat and nose, personality characteristics, muscle joint diseases and habits may vary.

How does our nose and throat structure affect our sleep position?

I always said, "I can't sleep without listening to my heart, it's a habit!" or "I'm sleeping comfortably when I lie to the right". In fact, after summarizing the anatomical factors that determine our sleep position, I would like to talk about why we had to sleep in the right or left.

During sleep, our body finds the position where we can breathe most comfortably. We may even have to sleep without even realizing it, putting our cheek on the pillow and stretching our cheek to one side.

There are many anatomical expressions, latin terms on this subject, but without going into such details, we can summarize the changes in the position of our airways according to position and the sleep position as follows:

- In our throat, tonsils, soft palate, small tongue, tongue root and pharynx may undergo severe changes in sleep position. In the presence of abnormal anatomical changes in these structures, in these structures, in the supine position, severe closure can be seen:

. Soft palate sagging
. Tonsil growth
. Small language elongation
. Tongue root growth
. Small jaw
. Fat and thick chin gold

In the presence of these features, while lying on his back in the early sleep stage, only snoring and vibration is heard; during deep sleep, severe airway closure due to the effect of gravity and relaxation may occur. Therefore, patients with anatomical features in the above figure notice that they sleep more comfortably when lying on their "side" or "face down", and wake up more vigorously after waking.

People who sleep next to patients can also notice them!

Patients with the above anatomical features can easily recognize that sleeping partners, sleep apnea symptoms, or drowning-like conditions disappear when they turn sideways or face down (patients with these features cannot sleep supine and tend to "positional sleep apnea syndrome"). For the treatment of sleep apnea, vests with a tennis ball sewn on the back of a patient's spouse may be recommended for treatment. When you put on this vest, the patient who cannot lie on his back is obliged to snore and become less clogged, thus improving the sleep quality of the sleeping person.

- Cartilage curvature of our nose, valv problems and nasal flesh are also effective in determining sleep position. Our nose has a protective function for the lungs and plays a crucial role in the absorption of oxygen from the outside air. When air is taken from the nose, the air is heated, purified, humidified and pressurized. It also expands the airways in the lung (nasopulmonary reflex or nasoalveolar reflex). During sleep, the open nose is very important to ensure a quality sleep.

Patients with cartilage curvature of the nose, nasal flesh growth or nasal valve problems lie on the side of the nostril which is usually blocked. This issue can be simply expressed as:

- When lying on one side, the cheek area that touches the pillow is stretched, and the nose wing is pulled out. That is, in patients with cartilage curvature or a problem with the nasal flank, the occluded region is partially relaxed. For example, when a patient with a septum deviation to the right, lies on the right side, the air hole diameter of the right nostril partially increases. In addition, with the different mechanisms, the nose meat on the lying side grows and the nose meat remaining above becomes smaller. Nasal flesh on the opposite side of the septum deviation usually grows normally with reflex mechanisms. On the side of the cartilaginous curvature, the air hole of the obstructed part is partially opened, while the enlarged nose meat on the opposite side of the deviation also shrinks. In other words, two different mechanisms provide relief.

Apparatus such as snoring cushions, vests and T-shirts sewed with tennis balls and chin straps can be used for patients who have difficulty sleeping on their back.

Cottle Test (Cottle Maneuver)

Maurice H. Cottle (1898-1981) described a simple test that names as his surname.

As a simple diagnostic test for nasal valve problem and septum deviation, if the cheek area is pulled out and slightly upwards, if there is relief in the nasal breath, there may be an internal nasal valve problem on the pulled side. This maneuver, known as the C Cottle test ya or C Cottle maneuver, yaparak is already in sleep, unwittingly, and we find the appropriate sleeping position.

For a long time, patients with nasal obstruction due to septum deviation or internal nasal valve problems have patients with sagging and slack in the lying cheek area due to side-lying and pulling of the cheek area.

So our sleep position is not habitual; more stems from the effort to open the airway.

Despite positional changes in sleep, patients with symptoms such as sleep apnea and snoring would be the best option to consult an ENT specialist dealing with sleep medicine.

Personality Structure can also affect sleep position!

I would like to share with you an article on the subject I read on "bbc.co.uk". According to the results of a study conducted by Professor Chris Idzikowski "sleep position gives personality clue / sleep position gives clues about personality" article "http://news.bbc.co.uk/2/hi/health/3112170.stm" link You can read.

According to this, people sleep in 6 different positions. Only 5% of people sleep each night in a different sleeping position. You can find the picture of each position in the photo below.

1. Fetus Position - Sleep Position of "Tough Looking but Sensitive People"

41% of every 1000 people sleep in this position. This was the most common sleeping position, "like the fetus in the womb". The view from the outside is hard, however; more comfortable people often slept in this position after meeting

2. Tree Stump Position - "Social, Pure and Easily Part of the Crowd" People's Position

15% of every 1000 people sleep in this position. Generally, it was the position of people who could easily adapt to the crowded place, who could easily rely on foreigners and be a little naive - well-intentioned. In this way, the two arms should be extended downwards and the skill needs some skill :)

3. The Yearner Position (Missing or Longing) - The Sleeping Position of "Cynical and Skeptical People"

13% of every 1000 people sleep in this position. In this position, he sleeps with his hands forward. It was the sleep position of hard-minded and hard-to-change people.

4. Soldier Position - Position of "People who don't like the fuss and live according to the high standards of others"

8% of every 1000 people sleep in this position. As if there were hands and feet attached to the bed, the arms extended to the side, the toes pointing downwards. Difficult shape :) I didn't sleep at all like this frankly. They usually sleep quietly and separately. As is often understood by the name, the deal was the sleeping position of people living according to the high expectations and rules of the people.

5. Free Fall Position - The Sleeping Position of "People with Aggressive or Arrogant Looks, but Who Can Be Tense and Delicate in Their Inner World"

7% of every 1000 people sleep in this position. Sleeping position with prone and hands on head. In fact, many people with cartilage curvature can also sleep in this position. These people had little tolerance and criticism (I actually couldn't stop saying "come on").

6. Starfish Position - Sleep Position of "People Who Can Help and Be Good Friends"

5% of every 1000 people sleep in this position. In this position, people who always listen to others and are ready to help prefer to sleep. They usually don't like being the center of attention. A position with the supine and arms up. The patients who have the features that narrow the throat structure mentioned above, although helpful; can not sleep in this position for a long time!

This is a nice animated video about sleeping positions:

Obviously, the airway characteristics of the upper airways are more decisive in these positions. Considering the overall average and the average position of sleep, it can be seen that these positions return to the sleeping position where the airway is most comfortable opened.

Look at the position figures in the photo; if you do some of them for a long time, it may even cause pain in the joints!

Health Effects of Sleep Positions

Although "Starfish" and "soldier" positions are useful for digestion; I would like to emphasize that it can cause snoring and poor sleep quality. Especially in patients with anatomic stenosis in the throat region, airway closure increases in the supine position.

A nice article link on the Mayo Clinic website, which you can read about recommended sleep position patterns that reduce back pain and reduce stomach complaints >> www.mayoclinic.org/diseases-conditions/back-pain/multimedia/sleeping-positions/sls- 20076452

Sleep Position in Pregnancy

When lying to the right during pregnancy, the large balls are pressed against the inferior vena cava. During pregnancy, left-sided hospitalization is recommended. It is recommended to increase the blood supply of the baby and decrease the mother's body edema. Again during pregnancy, lying on your back can cause compression of the main vessels.

Pregnant Women With Nasal Obstruction Should Be Treated Before Pregnancy

Pregnant patients with cartilage curvature to the right or valv problems in the right nostril can be distressing to lie on their left sides. In this position, nasal congestion may increase. However, in the last 3 months of pregnancy the nasal flesh can swell due to hormones (pregnancy rhinitis). Nasal congestion may increase. Pregnant mothers who are suffering from nasal obstruction and who are considering babies should be treated for these problems before pregnancy.

Benefits of Left-Side Sleeping

In fact, the presence of cartilage curvature or valve stenosis in our nose affects which side we can lie on more comfortably. For example, a patient with cartilage curvature to the left can sleep more comfortably when he has his left cheek touched by the pillow.

A few benefits of sleeping on the left side, in particular, can be written as follows (but if you have a septum deviation to the right, it's hard to sleep in this way):

Increase in lymphatic circulation.
Facilitation of pumping blood downwards
Facilitation of spleen functions
Facilitation of digestion
Increased circulation in tissues at the back of the heart
Relief in bile flow
Reduced acid reflux and associated chest burn
In pregnant women, the blood circulation of the baby increases during the left side of the bed (in the following months of pregnancy, supine bed joint pain, compression of large blood vessels can cause many harmful effects, as well as sleeping on the stomach can cause adverse effects on stomach emptying.

Further information on the topic at link of >> "What's the best sleep position during pregnancy?" link). Sleeping to the right may cause an increase in gastric reflux.

Arm and shoulder pain may occur in all lying positions. Source link >> 8 Sleeping Positions and Their Effects on Health - Daily ...

Murat Enoz, MD, Otorhinolaryngology, Head and Neck Surgeon - ENT Doctor in Istanbul

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Address: İncirli Cad. No:41, Kat:4 (Dilek Patisserie Building), Postal code: 34147, Bakırköy - İstanbul
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Ear Nose and Throat Doctor - Otorhinolaryngologist in Istanbul

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