Sleeping well with sleep apnea comes down to a combination of the right treatment, the right sleep position, and a few targeted habits that keep your airway open through the night. Whether you’re newly diagnosed, struggling with a CPAP machine, or looking for additional strategies, there are concrete steps that make a real difference in how you sleep.
Sleep on Your Side
Sleeping on your back lets gravity pull your tongue and soft tissues backward, narrowing or blocking your airway. Switching to your side is one of the simplest changes you can make. For many people with positional sleep apnea, side sleeping alone cuts the number of breathing disruptions significantly. The effect varies from person to person, but a large portion of apnea patients have notably worse symptoms on their back than on their side.
If you naturally roll onto your back during the night, a few tricks can help. Sewing a tennis ball into the back of a sleep shirt is the classic approach, but you can also buy positional therapy belts that serve the same purpose more comfortably. Some people place a firm body pillow behind them. The goal is to make back sleeping just uncomfortable enough that your body stays on its side without fully waking you.
Elevate Your Upper Body
If side sleeping isn’t comfortable or sufficient, raising the angle of your upper body helps reduce airway collapse. Research has found that tilting the body just 7.5 degrees reduces apnea severity by roughly 32% on average. Greater angles produce greater effects: at 10 degrees of incline, snoring stopped in about 22% of people, and at 20 degrees that number jumped to 67%.
You can achieve this with a wedge pillow, an adjustable bed frame, or even by placing risers under the headboard legs. Stacking regular pillows tends to bend your neck rather than elevating your whole torso, which can actually make things worse. The incline should run from your hips to your head in a gradual slope.
Getting Comfortable With CPAP
CPAP is the most effective treatment for moderate to severe sleep apnea, but up to half of patients struggle to use it consistently. If putting on the mask feels suffocating or claustrophobic, a gradual desensitization approach works far better than forcing yourself to wear it all night from day one.
Start by simply holding the mask to your face during the day, without connecting it to anything. Do this for a few minutes over one or more days until it feels unremarkable. Next, wear the mask with the machine turned on while you do something relaxing: watch TV, read, scroll your phone. Aim for 20 to 30 minutes a day for about a week. Then extend those sessions to an hour or two, and try lying down or reclining while wearing it. Once that feels normal, try napping with it on. Finally, wear it to bed, starting with however many hours feel manageable and gradually working toward the full night. Four hours is the minimum threshold most sleep specialists consider effective, but more is better.
A few practical tips speed this process along. If you tend to pull the mask off in your sleep, practice adjusting it with your eyes closed so the motion becomes automatic. If the mask dislodges when you roll over, practice lying down and shifting positions while wearing it during the day. And if even seeing the machine on your nightstand makes you tense, keep it in your bedroom for a few days without using it so it becomes part of the furniture.
Managing CPAP Humidity
Dry, irritated nasal passages are one of the top reasons people abandon CPAP. Most modern machines have a built-in heated humidifier, and finding the right setting makes a big difference. If you live in a dry climate, run forced-air heating, or notice dryness during winter, you’ll likely need a higher humidity setting. But there’s a trade-off: setting humidity too high in a cold bedroom causes condensation to collect inside the tubing, a problem called “rainout.” Heated tubing prevents this. If you don’t have heated tubing, lower the humidity setting until the condensation stops, or try insulating the hose under your blanket.
Oral Appliances as an Alternative
If you’ve tried CPAP and can’t tolerate it, a custom oral appliance is worth considering. These devices look like a mouthguard and work by holding your lower jaw slightly forward, which keeps the airway behind your tongue from collapsing. In clinical trials, about half of patients with mild to moderate apnea saw their breathing normalize completely with an oral appliance, compared to just 11% using a placebo device. On average, the number of breathing disruptions per hour dropped from about 15.6 to 6.7.
CPAP is still more effective at eliminating apnea events, but patients consistently prefer oral appliances, and the adherence numbers reflect that. Nonadherence rates for oral appliances run between 10 and 24%, while CPAP nonadherence can reach 50%. A device you actually wear every night does more good than one collecting dust. Oral appliances work best for mild to moderate cases. For severe apnea, complete resolution is less likely, so CPAP or other treatments remain the stronger option. These devices are fitted by a dentist trained in sleep medicine and require follow-up to check the bite and jaw comfort.
Throat and Tongue Exercises
The muscles that hold your airway open can be strengthened like any other muscle in the body. A set of exercises called myofunctional therapy targets the tongue, throat, and face to improve muscle tone and encourage proper tongue posture during sleep.
One basic exercise: place the tip of your tongue where your upper teeth meet your gums, then slide it backward along the roof of your mouth. Repeat for three minutes a day. Another involves sticking your tongue out and reaching it upward toward your nose, which targets the base of the tongue. Even regular singing exercises, practiced daily over about three months, have been shown to reduce snoring frequency, severity, and loudness while improving mild to moderate apnea symptoms. These exercises won’t replace CPAP or an oral appliance for more severe cases, but they can meaningfully complement other treatments.
Nasal Breathing Strategies
Anything that improves airflow through your nose helps reduce the likelihood of mouth breathing, which worsens apnea. External nasal strips (like Breathe Right) and internal nasal dilators (small cones or clips worn inside the nostrils) both work by physically widening the nasal passages. In studies comparing the two, internal dilators produced a 110% improvement in nasal airflow, significantly outperforming external strips.
For apnea specifically, the evidence is modest. Nasal dilators reliably reduce snoring and improve nasal breathing during sleep, but their direct impact on apnea events is small. They’re best used as an add-on, particularly if nasal congestion is making your CPAP uncomfortable or if you tend to breathe through your mouth at night. Saline rinses before bed and keeping bedroom humidity adequate also help keep nasal passages open.
Lifestyle Changes That Affect Your Airway
Alcohol relaxes the muscles in your throat, making your airway more likely to collapse during sleep. Even a moderate amount can worsen apnea and snoring noticeably. To minimize the effect, stop drinking at least three to four hours before bedtime. This gives your body enough time to metabolize most of the alcohol before you fall asleep.
Excess weight, particularly around the neck and upper airway, is the single biggest modifiable risk factor. Losing even 10% of body weight can substantially reduce apnea severity, and in some mild cases, it can resolve the condition entirely. Sleeping pills, sedatives, and antihistamines that cause drowsiness also relax airway muscles in much the same way alcohol does, so it’s worth discussing alternatives with your provider if you use them regularly.
When CPAP and Appliances Aren’t Enough
For people with moderate to severe apnea who can’t use CPAP or oral appliances, a surgically implanted nerve stimulator is an option. The device, most commonly known by the brand name Inspire, stimulates the nerve that controls tongue movement, gently pushing the tongue forward with each breath to keep the airway clear. To qualify, your body mass index needs to be under 35, and your apnea severity needs to fall between 15 and 65 breathing disruptions per hour. A sleep endoscopy is also required to confirm that your airway collapse pattern is the type the device can address. The implant is controlled by a small remote, and most patients describe the sensation as a mild tingling that becomes unnoticeable over time.