Can a Sleep Apnea Position Pillow Improve Sleep Quality?

Obstructive sleep apnea (OSA) is a common sleep disorder where the airway becomes partially or completely blocked during sleep, causing breathing pauses that can last several seconds or longer. These interruptions reduce oxygen levels and fragment sleep. Over time, OSA can contribute to high blood pressure, heart disease, and significant daytime fatigue.

In many individuals, the severity of OSA depends on sleeping position. Those with positional obstructive sleep apnea (POSA) experience significantly more breathing interruptions when lying on their back compared with sleeping on their side or stomach. This is often due to gravity causing the tongue and soft tissues in the throat to collapse backward, narrowing the airway.

Because of this, therapies designed to help people avoid sleeping on their back, known as positional therapy, have gained interest as an alternative or supplement to continuous positive airway pressure (CPAP) treatment.

Instalab Research

What Is a Sleep Apnea Position Pillow?

A sleep apnea position pillow is designed to encourage sleeping positions that reduce airway blockage. Some are contoured to support the head, neck, and shoulders in a way that keeps the airway more open. Others make back-sleeping less comfortable so the sleeper naturally turns to a side position. There are also advanced “smart” pillows that detect breathing patterns and gently shift position or vibrate to prompt a change in posture.

By altering sleep position, these pillows aim to reduce the number and severity of apnea events, improve oxygen levels, and promote more restful sleep.

Research Evidence on Position Pillows

Studies have shown that positioning pillows can improve both breathing and sleep quality in patients with POSA:

One prospective study followed 28 patients diagnosed with POSA who used a sleep-positioning pillow (Posiform®). Researchers found significant reductions in time spent sleeping on the back, apnea-hypopnea index (AHI), oxygen desaturation events, and sleep fragmentation. These improvements were sustained after one month, and participants also reported better sleep quality and less daytime sleepiness. Satisfaction and adherence remained high even at six months.
In another study of the SONA Pillow®, which is designed to facilitate side sleeping, patients with mild to moderate OSA experienced a drop in AHI from an average of 17 events per hour to fewer than 5. Oxygen levels improved and snoring was reduced or eliminated in most cases.

The Rise of Smart Pillow Technology

Technology is now bringing new solutions to positional therapy. Smart pillows incorporate sensors to detect snoring or breathing interruptions in real time. When an event is detected, the pillow automatically changes its shape or angle to encourage a position that reduces airway obstruction. In one trial with 40 patients, a smartphone-connected auto-adjustable pillow reduced both apnea duration and total apnea events by more than 50%.

These devices can be used at home, are non-invasive, and may be more comfortable than other positional devices. However, comfort, personal preference, and cost remain important factors when deciding whether to use them.

Important Limitations

Not all studies have shown equal benefits. For example, a recent randomized crossover study compared a positional pillow with a vibrating positional belt for home use. The vibrating belt produced a greater reduction in back-sleeping time, while the pillow showed no statistically significant change compared to baseline.

Positional pillows may also be less effective in severe OSA cases, where CPAP therapy is still considered the most effective treatment. In addition, some patients may find them uncomfortable or difficult to adapt to at first, although most adjust over time.

Who Might Benefit

Patients diagnosed with POSA, particularly those who cannot tolerate CPAP, may be good candidates for a sleep apnea position pillow. This therapy tends to be most effective for mild to moderate cases where sleeping position plays a major role in symptom severity.

Before trying positional therapy, it is essential to confirm whether apnea events are position-dependent. If you suspect you have sleep apnea or want to know if your symptoms are position-related, an at-home sleep apnea test can provide the answers you need. These tests are simple, comfortable, and can give you and your doctor the information required to select the most effective treatment.

References

Chen, W., Lee, L., Chen, N., Fang, T., Huang, C., Cheng, W., & Li, H., 2015. Treatment of snoring with positional therapy in patients with positional obstructive sleep apnea syndrome. Scientific Reports, 5. https://doi.org/10.1038/srep18188.
Chung, T., Lee, M., Ku, M., Yang, K., & Wei, C., 2021. Efficacy of a Smart Antisnore Pillow in Patients with Obstructive Sleep Apnea Syndrome. Behavioural Neurology, 2021. https://doi.org/10.1155/2021/8824011.
Newell, J., Mairesse, O., & Neu, D., 2018. Can positional therapy be simple, effective and well tolerated all together? A prospective study on treatment response and compliance in positional sleep apnea with a positioning pillow. Sleep and Breathing, 22, pp. 1143-1151. https://doi.org/10.1007/s11325-018-1650-6.
Pelaez, A., Carlier, S., Mettay, T., Vulcan, R., Newell, J., Bruyneel, A., & Bruyneel, M., 2025. Comparison of a Vibrating Belt Versus a Positional Pillow for the Treatment of Positional Obstructive Sleep Apnea in a Real-World Setting: Results of a Prospective Randomized Crossover Trial. Cureus, 17. https://doi.org/10.7759/cureus.81666.
Zhang, J., Zhang, Q., Wang, Y., & Qiu, C., 2013. A real-time auto-adjustable smart pillow system for sleep apnea detection and treatment. 2013 ACM/IEEE International Conference on Information Processing in Sensor Networks (IPSN), pp. 179-190. https://doi.org/10.1145/2461381.2461405.
Zuberi, N., Rekab, K., & Nguyen, H., 2004. Sleep Apnea Avoidance Pillow Effects on Obstructive Sleep Apnea Syndrome and Snoring. Sleep and Breathing, 8, pp. 201-207. https://doi.org/10.1007/s11325-004-0201-5.