Body position plays an important role during sleep and can often make the difference between having a good night’s sleep or not. For snorers, this is a particular problem as several studies have found that individuals who sleep on their back are more likely to snore than those who sleep on their side.
The physiological mechanism for this is most probably due to the effects of gravity on the upper airway. When sleeping on your back, gravitational forces increase the tendency for the tongue and soft palate to fall back into the throat. This creates a narrowing of the airway and the likelihood of airway obstruction that leads to a number of breathing abnormalities. The airway tends to be more stable in the lateral position and less likely to collapse.
The clinical evidence, regardless of opinion, is unanimous in suggesting that both sleeping position and sleep stage have a considerable impact on snoring. Although it would seem desirable to prevent snorers from sleeping on their back, in practice this is rarely achieved. Most studies have confirmed that positional therapy is ineffective.
Sleep stage seems to have more of an effect on snoring independent of body position. Sleep stage affects snoring time and intensity. However, there are differing opinions as to what stage of sleep is of more significance. Some studies report snoring is more prominent in SWS (slow wave sleep), followed by Stage 2 and least in Stages 1 and REM (rapid eye movement). Other studies report snoring is more prevalent during REM sleep. One study reported a higher prevalence of continuous snoring in SWS than in REM and concluded that this could be due to a higher airway resistance in SWS or to the regularity of the breathing pattern. During Stages 1 and 2 of sleep, breathing is frequently periodic and in REM it is irregular with more pauses. Consequently, during light and REM sleep, the incidence of respiratory arrhythmias (changes in breathing pattern) would be high but continuous snoring would be unlikely.
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