Guess I can't be on my back so much

July 20, 2009 2:59 PM

Do you have experience with training yourself to not sleep on your back?

I had a sleep study done recently, and the results showed that while I do not have obstructive sleep apnea, I do snore like a madwoman when I'm on my back and it's waking me up at night. I knew about the snoring, but did not know whether OSA was a factor.

Because of my results, my insurance won't cover a CPAP machine, so aside from moving on to an ENT my dr suggested "positional treatment", which means training myself to not sleep on my back. I don't fall asleep or wake up on my back, so I must be doing it when I am fully asleep and not aware of it. I Googled the term and am seeing suggestions like sewing a tennis ball to the back of your shirt, but that just sounds annoying. I'll do it if it works, but I'd rather not if it's useless. So...has anyone successfully trained themsleves to not sleep in a particular position?

posted by DrGirlfriend to health & fitness (29 comments total)

Having the person next to me poke me in the ribs (hard!) worked for me. Eventually.
posted by rokusan at 3:02 PM on July 20

Tape a tennis ball to the back of your shirt?
posted by kldickson at 3:10 PM on July 20

but that just sounds annoying
If you're asleep when you're moving position, I would assume that your body is finding a comfortable position. So having a small annoyance like this is exactly what you're looking for: making "on your back" an uncomfortable position.

On the other hand, rib-poking is also what worked for me, although it took a while.
posted by Paragon at 3:14 PM on July 20

I find that if I go to sleep on my side, I'm more likely to stay on my side if my top leg is bent at the knee and put out in front of me (sort of like the middle woman in this photo, but more on my side, not my stomach).
posted by ocherdraco at 3:22 PM on July 20

I trained myself not to sleep with my arms above my head (shoulder issues) by tying the offending arm to a bed-slat with the soft belt from my dressing gown. I could move it a few inches, but I couldn't raise it above my head. It took only a week or so to develop the habit.

A tennis ball sounds like overkill. Use a golf ball, a kneaded pencil eraser, or anything else small and firm that you can keep to the middle of your back. You don't want to be able to wiggle into a good position on your back because the tennis ball or whatever can slip out to the side.

Can you make sleeping on your side more comfortable and attractive? Would getting a second pillow to embrace help?
posted by maudlin at 3:23 PM on July 20

If your hair is long enough, you could wear a big barrette or hair clip on the back of your head - I know it would drive me nuts to try and sleep on it.
posted by The Light Fantastic at 3:24 PM on July 20

Apparently when sleeping on one's side one should put a pillow between one's knees to support the hips or something. So maybe your body is deciding "hey my hips are not happy, lemme switch to sleeping on my back." In which case such a fix might convince it otherwise. *Shrug*. Worth a shot...
posted by Jacen Solo at 3:25 PM on July 20

Do the tennis ball thing-- it works, according to a colleague who has similar problems. Additionally, follow all the sleep hygiene tips you've undoubtedly heard about: quality sleep, without alcohol prior to bed, weight loss if you're overweight, etc. You might also be able to find an orthodontist who could fit you with an oral appliance which pushes your lower jaw forward, which could help.

My own in-house retrospective study on various methods used to change sleeping position, where n=1, conclusively demonstrates that nothing else works. I cite three specific cases where such modalities may even be harmful. Here they are in a nutshell:

1. Nil-transient hyperacoustic stimuli. One summer, I would consistently find myself waking up from slumber without any sense of refreshment, and often would wake up in the middle of the night in a state of panic. I would wake up frequently through the night, with a pounding heart, a cold sweat, and a vague sense of doom. I thought maybe I was having heart problems, but couldn't make sense of it as I was young, healthy, and had no family history of heart issues.

So I talked to my roommate about it, and he pretty much avoided talking about it. I said it was serious. I said I had deep concerns. I braced him and told him I thought I was dying. And then he told me that every night he'd wake up from my snoring, and he'd very suddenly yell, whereupon I'd stop snoring, wake up briefly, and then fall back asleep without snoring for some period of time.

He felt very guilty about it, because over the course of the summer he crafted his yell to maximum effect. Rather than yell "HEY!" or "STOPIT!" or "JESUSCHRISTSTFU!," he'd imagine he was in a car about to crash into a wall, summon as much fear as he could muster, and yell one sudden, awful, frightened "AAaAaaaAAAAAHH!"

I think it was the trailing, crescendoing "aaaAAHHH!" that he felt most guilty about, because that's the part where the primitive brain would've gotten past realizing "HOLYFUCKSUDDENSTIMULUS" to "ahh, fuckitgonnadiedieDieDIEEEEE!" Anyway, it worked for short periods of time, but by the end of the summer he was still yelling, I was still snoring, and the only thing that changed was I'd sometimes say "sorry" after he yelled.

2. Subsensory threat response. I had another roommate who also had to live with my snoring. Anyway, the short version of this is that at the end of the year, as we were cleaning the room out, I moved my bed only to find this hidden treasure of 45s-- you know, vinyl records. I was very excited, and very puzzled, and as I was flipping through them to tell my roommate about the awesome find, he guility said something like "mmmyeah, I throw those at you when you snore." He worked at the radio station. I'd like to think that I returned them all. I remained puzzled at the fact that he was able to master the throws such that the records all fell down the crack between the bed and the wall, and am glad that I suffered no penetrating trauma from the corners of the sleeves from such a makeshift throwing star.

3. Feline companionship. This was during residency. I woke up in the middle of the night from a sudden, crushing, left-sided chest pain, with shortness of breath. By this time, I knew I had a snoring problem, and even had a sleep study showing I had sleep apnea. I knew the risks associated with untreated apnea, and thought that maybe I was indeed having heart problems. My diet was terrible. I was smoking. The most exercise I had was running up stairs to codes or commodes.

A few weeks later, during clinic, I had another episode of left-sided, crushing chest pain. The patient I was seeing asked if I was feeling ok. I felt a cold sweat develop. I excused myself and walked out into the hall, and the nurses asked if I was feeling ok. Everyone kept asking if I was feeling ok, and this made me feel not ok. An attending saw me, and checked me out. The pain was reproducible, though I had no evidence of any injury and could not recall any recent trauma or strenuous activity. He wanted to get an EKG. I began to feel worse.

EKG looked ok. I said I was fine, and proceeded to work. When the pain occurred again the next morning during hospital rounds, my attending called his cardiologist pal and they said I'd feel better after I got checked out. "I'm sure it's nothing, but I'm sure that getting a negative test result will make you feel better."

So I went to his office that afternoon, got half-naked, and got on a treadmill. Stress tests suck, and getting ultrasound goo rubbed on my body by the tech, while possibly arousing in a number of situations, is decidedly not stimulating in the context of chest pain.

Anyway, the stress echo was fine. I'm in great shape. I have a lovely heart. The folks said have a nice day, so I did.

I woke up in the middle of the night for some reason, and opened my eyes. I saw my cat sitting atop the wall which divided the loft. He jumped down onto my bed, next to me, and that's when I realized what the source of my chest pain was. The fucker was jumping off the wall onto ME!




Right. So give the tennis ball thing a shot. It may work. Also maybe look into finding an orthodontist who could give you a mouthguard that pushes your lower jaw forward so that you're less apt to snore. Good luck!
posted by herrdoktor at 3:35 PM on July 20 [21 favorites has favorites]

Because of my results, my insurance won't cover a CPAP machine,

Basic models cost $200 and up brand new (and they last a very long time), if you ever decide to try this route and need to pay out of pocket.
posted by availablelight at 3:37 PM on July 20

The tennis ball is the standard recommendation for this. Sew a pocket onto the back of a t-shirt.
posted by neuron at 3:51 PM on July 20

Put yourself in the safety position -- I would have linked that term but oddly enough can't seem to find a good page about it, despite having it drilled into my brain during freshman orientation in college. Basically, when putting a friend to bed who has had too much to drink, you want to make sure that they're on their side with the "top" leg flopped over far enough to steady them so they won't roll onto their back (then vomit, aspirate, and die). So try doing this with your own, sober self.
posted by telegraph at 3:55 PM on July 20 [1 favorite has favorites]

Just a thought, but maybe instead of the tennis ball, a thick pillow tucked behind your back (either on the bed or under your shirt, experiment) once you go to bed. Might be more comfortable for you, but if your body does try to roll over, it may decide 'ok, that's not so comfortable', and put you back on your side.
posted by hungrysquirrels at 3:59 PM on July 20

Try a fatter, firmer pillow which will keep your head at least 3-4" above the mattress when you have the full weight of your head on it.

With such a pillow, your neck would be pretty straight when you were on your side because of the width of your shoulder, but would be uncomfortably bent when you were lying on your back.
posted by jamjam at 4:07 PM on July 20

I fall asleep on my side anyway, but I've found that if I put my bottom arm under my pillow, with my head on top, I pretty much don't change position at all during the night - like I'm pinning myself into position.
posted by LolaGeek at 4:21 PM on July 20

I Googled the term and am seeing suggestions like sewing a tennis ball to the back of your shirt, but that just sounds annoying.

A stroke from OSA is even more annoying.

It helps me to sleep holding another pillow in a spoon-like position. You can train yourself to seek out a pillow to spoon when you start rolling around in bed, but having a secondary reinforcer like a tennis ball is pretty much required at first.
posted by damn dirty ape at 4:27 PM on July 20

Thanks for all the suggestions! I will consider the tennis ball but will probably start with the various pillow arrangements mentioned. I'm also going to look into a mouthguard because I've noticed that when I jut my jaw out, I feel like my airway is less restricted.

The barrette idea is intriguing because I hate to lie back when I have a barrette or ponytail, but I fear that I will do the same to a barrette as I did to my retainer back when I was 12: rip it off and fling it across the room in my sleep.

Herrdoktor - I also did the AAAAHH!!! screaming at a snoring roommate. Except she didn't even wake up, she would just stop snoring. It was miraculous. Maybe I need a device that shoulds AAAHH!!! whenever I roll onto my back.
posted by DrGirlfriend at 4:31 PM on July 20

A stroke from OSA is even more annoying.

Fortunately, I do not have OSA; my brain does get oxygen. At this point it's a matter of getting a restful sleep.
posted by DrGirlfriend at 4:32 PM on July 20

Be glad you don't need a CPAP. I use one, and it's a pain.
posted by dogwelder at 5:12 PM on July 20

The tennis ball is supposed to be annoying.
posted by rhizome at 5:46 PM on July 20

You need a Vietnamese long body pillow. It is an elongated cylinder and provides support for the hips and provides something for your arms to either grip or rest upon when sleeping on your side. You can define the firmness when it is made. Softer, moldable ones are more for pregnancy since it supports the behemoth third trimester stomach on its side. Because you are holding the pillow it is difficult to sleep on your back; not impossible BUT it is not as startling as a tennis ball in your back.

You are too far for me to loan you a pillow to try but you could probably get someone to make you one on Etsy since Portland does not have a large Vietnamese community for you to buy the pillow immediately. You could, alternatively, just buy a standard body pillow though they are a bit squishy.
posted by jadepearl at 5:58 PM on July 20

I think the annoying part of the tennis ball suggestion is sewing a pocket for it to go in. It's a pain in the ass, and besides, who wants to have to wear the same sleep outfit night after night?

About 5 years ago I had to do the same thing, but instead of sewing I took a long piece of elastic, tied it into a circle and threaded it through the ball, to make a sort of backpack. Then I could use it whatever pajama-type thing I ended up in. Worked like a charm. I still sleep on my side.
posted by Stewriffic at 6:15 PM on July 20

Regarding the position for sleeping on your side that has been mentioned above. There is a yoga asana called Matsya Kridasana or flapping fish that is a comfortable lying on your side pose. An illustration and description of it can be found on this page.
posted by Sitegeist at 6:50 PM on July 20

I can't recommend the Sona pillow enough. My boyfriend uses one and it's amazing. It made a world of difference in his snoring (and probably saved our relationship because I couldn't take another sleepless night).
posted by whatideserve at 8:57 PM on July 20

a yoga asana called Matsya Kridasana or flapping fish (Sitegeist)

I had no idea I was doing yoga while I slept! That is exactly the way I sleep.
posted by ocherdraco at 9:02 PM on July 20

Due to back issues, I can't sleep on my back. I sleep on my side, and to keep my back happy, I sleep with a regular pillow between my legs. Body pillows can be good, but just a regular pillow between the legs (balances the hips when you're sleeping on your side) can be good for avoiding sleeping on your back. You'll realize it's not there if you move, and will move about to get it back between your legs. Give it a try. No extra cost, just swap a pillow around.
posted by Ghidorah at 10:01 PM on July 20

so even if you got one of those memory foam pillows you still would snore. I have a memory foam pillow and the big arch for the neck helps me greatly when i sleep on my back.
posted by majortom1981 at 5:27 AM on July 21

When you're pregnant, after a certain point in the pregnancy, you're not supposed to be on your back. So that was challenging because even though I wasn't a back sleeper, for some reason I just wanted to sleep on my back--all the time!

What worked for me are hugging pillows (or a snuggly dog) and also putting a pillow in between my knees, while on my side.

FWIW, if you want a second opinion about your need for a CPAP, and therefore make it eligible for insurance coverage, see another ENT. My husband has a CPAP, even though he was very borderline, and it has literally made him a new man. He has more energy during the day and feels more rested. You can always get a prescription for one and rent it from the doctor's office or a medical supply place, even if your insurance won't cover it, too.
posted by FergieBelle at 5:36 AM on July 21

Try one of those buckwheat husk pillows for your head, and a thick pillow between your knees. Face something like a book or a tv and drift off.
posted by rahnefan at 11:08 AM on July 21

An old bra and 2 tennis balls worn backwards would skip the need for sewing, and you wouldn't need to wear the same shirt all the time.
posted by skinnydipp at 11:10 AM on July 21