Obstructive Sleep Apnea (OAS) and Back Sleeping

Obstructive Sleep Apnea (Apnoea)
Obstructive sleep apnea (or obstructive sleep apnoea) is a condition where your tongue and/or soft palate relaxes while you’re sleeping and drops back into your airway, either completely or partially obstructing your breathing. One little known second line of treatment for OAS is back sleeping on the proper pillow. If you put your head into very slight extension (chin off the chest) using an orthopedic pillow while back sleeping, you can open up the airway.
CPR head postion
Before we perform CPR, we are instructed to position the victim’s head into extension by tipping the chin up, while he is on his back, as this is the optimal position to open up the airway. Yet the first thing doctors tell OAS patients is that they must STOP sleeping on their backs. That’s because nearly everyone who sleeps on their back does so on the wrong pillow, positioning their neck into flexion (chin pointed all the way down towards the chest.) This improper neck position cuts off airflow, effectively helping to make the blockage even worse. It also damages the cervical spine.

Your neck with too high of pillows. Notice the kinked appearance.

Note how this patient (x-ray above) has cutoff his airway by kinking his neck forward? Even if he didn’t suffer from OAS he would find it hard to get air. Imagine how much this condition is exacerbated by not having the proper pillow!

One study, done in June 2001 in the Sleep Breath journal by Kushida, et. al. found that cervical position, namely very slight head extension while back sleeping lengthened the airways of adult volunteers suffering from OAS, and increased their oxygen intake significantly. Conversely, the researchers also found that neck flexion, usually done by piling up pillows, decreased airflow.

Doctors who treat sleep apnea rarely, if ever, talk about an easy, mechanical second line treatment for sleep apnea: positioning the patient’s head into very slight extension with a pillow, while his neck is still of course in proper alignment, simply by tipping the chin slightly up. A clue to that can be found in the study, which recommended a custom cervical pillow for mild to moderate OAS patients to hold that position through the night. A custom cervical pillow? Most people wouldn’t even know where to start. It’s easier to tell the patients to stay off their backs!

I assert that the Proper Pillow is a perfect product for correct neck position and lengthened airway. Check out these x-rays.

Proper Pillow neck x-ray
The above x-ray is of an adult patient sleeping on the Proper Pillow. Notice how the neck is lengthened, the chin is off the chest, and the airway opened up?

It’s easy to tell patients who suffer from obstructive sleep apnea to stay off their backs. But as a chiropractor who treats sleep injuries every day, I feel that the back position is the best sleeping position. The Proper Pillow opens up the airway, eliminating snoring and helping out patients who suffer from mild to moderate obstructive sleep apnea. Putting the head into very slight extension while back sleeping is an effective second line treatment for mild to moderate obstructive sleep apnea.