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Konstantin Buteyko discovered that the best position to sleep was on the left hand side or on the tummy. Ventilation is reduced while sleeping on the left-hand side given the position of the heart and on the tummy given the weight of the body restricting breathing. Many studies show that sleeping on the back (supine position) is most contributory to snoring and sleep apnoea for both children and adults. Here, we examine the available research.

Pereira et al. conducted research to determine the effect of body position on sleep apnoea in children younger than three years. Polysomnographies of 60 children were analysed for data on respiratory disturbance index, time spent in each position, number of apnoeic episodes in each position, oxygen saturation, and time spent in each stage of sleep. Researchers concluded that “there is an increase in the RDI (respiratory disturbance index) with increased time spent in supine sleep in very young children with obstructive sleep apnoea.”

A study of fifty children, 31 with habitual snoring and 19 with obstructive sleep apnoea, found that there were more apnoea hypopnea events when patients slept on their backs as opposed to on their sides. Davvat et al. assessed 430 children with obstructive sleep apnoea. The effect of different sleeping positions was examined in obstructive sleep apnoea, and in relation to obesity and tonsillar size. Children with OSAS were found to spend more time than controls sleeping on their backs, and that apnoea index was significantly greater in the supine position than in the side position.

During a study of 574 patients with OSAS that was published in the medical journal Chest, researchers found that there were at least double the amount of apnoeas/hypopnoeas when patients slept on their back rather than their sides. The paper concluded that “body position during sleep has a profound effect on the fre- quency and severity of breathing abnormalities in OSA patients.”

During an assessment of 2077 OSA patients over a period of ten years, it was found that 53.8% had at least twice as many breathing abnormalities while sleeping in the supine (back) position compared with sleeping on their side. The paper concluded that “since avoiding the supine posture (back) during sleep may significantly improve the sleep quality and daytime alertness of many positional patients, it is imperative to carry out a high-quality study to evaluate if this is a real therapeutic alternative for many positional patients.” A Japanese study of 72 patients and published in the journal Sleep found that most subjects in the snoring group decreased snoring both in time and intensity while sleeping on their side versus sleeping on their back.

Another paper entitled “Association of body position with severity of apnoeic events in patients with severe nonpositional obstructive sleep apnoea” and published in the medical journal Chest evaluated the apnoeic events of 30 sleep apnoea patients when sleeping in either the supine position (back) or the lateral position (side). The researchers found that “even in patients with severe OSA who have a high number of apnoeic events in the supine and lateral posture, the apnoeic events occurring in the supine position are more severe than those occurring while sleeping in the lateral position. Thus, it is not only the number of apnoeic events that worsen in the supine sleep position but, probably no less important, the nature of the apnoeic events themselves.”

Szollosi et al. found that sleeping on the side reduces the severity of central sleep apnoea with cheyne-stokes respiration. The researchers found that “compared with supine position, lateral position reduced the apnoea-hypopnea index in all sleep stages” and that the “lateral position decreased desaturation independent of apnoea type.”