Original Article | New York Times | March 30, 2026

Stiffness, achy joints, acid reflux, snoring — experts explain the pros and cons of the three main ways people sleep.

By Amanda Schupak

Ever wake up with a crick in your neck or a pain in your lower back? Are you roused from sleep by heartburn, or a partner complaining that you snore?

If you answered “yes” to any of these questions, your sleep position might be to blame.

There is no one “right” way to sleep, said Dr. Indira Gurubhagavatula, a professor of sleep medicine at the University of Pennsylvania Perelman School of Medicine.

But if you are waking up with discomfort or stiffness or having restless nights, certain adjustments to your sleeping posture may help. Here are some of the most common issues associated with how people sleep, and what to do about them.

On Your Side

Many of us sleep on our sides with no problem. But for some people — especially those with joint issues or who are older — it can put a lot of pressure on the shoulder, hip and knees, said Dr. Rohan Jotwani, a pain medicine specialist at NewYork-Presbyterian/Weill Cornell Medical Center in New York City.

Sleeping on top of a memory foam or gel mattress pad can help by distributing your weight more evenly, he said. Placing a pillow between your knees can also reduce hip, knee and lower back pain by keeping your legs and hips aligned.

When you’re on your side, using a pillow that is either too thick or too thin can force your spine out of alignment, leading to muscle and joint strain. Or it can put pressure on nerves, causing pain, tingling or weakness in your shoulders, arms or upper back, Dr. Gurubhagavatula said.

Those who have a deviated septum may find that sleeping on their side affects how well they breathe, said Dr. Gerald Suh, an ear, nose, throat and sleep specialist in Princeton, N.J. The condition occurs when the thin layer of cartilage and bone that divides the nasal cavity is off-center or crooked. It is common, he said, affecting probably more than 80 percent of people, though only about 30 percent notice an influence on breathing.

For some, it’s easier to breathe when they sleep on the side that the narrower nostril is on, allowing air to flow unimpeded through the wider one, Dr. Suh said.

On Your Back

The goal when sleeping is to maintain the natural curvature of the spine and neck “without creating too many bends and twists and turns,” Dr. Jotwani said. Sleeping on your back is best for maintaining this alignment, he said, but it can also cause or exacerbate other issues.

The symptoms of obstructive sleep apnea, for instance — which occurs when the muscles in the throat relax during sleep and cause snoring and temporary pauses in breathing — can worsen when lying face up, said Azadeh Yadollahi, a scientist who studies sleep and airway disorders at the University Health Network in Toronto.

If you have sleep apnea, sleeping on your side can help keep the airway open and let you breathe more freely, Dr. Gurubhagavatula said.

Sleeping on your back may also worsen acid reflux symptoms by allowing stomach acid to seep into the esophagus. And while any sleeping position can lead to nasal congestion, lying face up can cause you to feel even more stuffy, especially when dealing with a cold or allergies, Dr. Suh said.

Propping up the top half of your body with a pillow or a wedge-shaped bolster helps relieve acid reflux, Dr. Gurubhagavatula said. Or try elevating the head of your bed by putting blocks under the legs of your bed frame, she said. Some research also suggests that sleeping on your left side can help, too.

Pregnant women are often told to avoid sleeping on their backs after about 20 weeks to prevent the uterus from putting pressure on a large vein that carries blood from the lower body to the heart. That could restrict blood flow to vital organs or lower blood pressure, leading to lightheadedness.

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When pregnant, it’s safest to sleep on your side, especially the left side, as this moves the weight off the vein, Dr. Gurubhagavatula said. This should help with pregnancy-related acid reflux, too, she added.

On Your Stomach

This is the least common sleeping position, Dr. Gurubhagavatula said. It also tends to be the hardest on your spine.

Having your head turned to one side all night strains the neck, Dr. Jotwani said. And that can be compounded by a thick pillow that angles your neck upward.

The position can also hyperextend your lower back. In a review published in 2025, researchers found that sleeping on the stomach is associated with more lower back pain than sleeping on the back or side.

If you enjoy sleeping on your stomach but wake up with low back pain, it can help to put a small pillow under your pelvis. This prevents your abdomen from sinking into the mattress and putting too much arch in your back, Dr. Jotwani said. But if possible, he added, sleep on your back or side for better alignment.

How to Learn to Sleep in a Different Position

Switching to a new position “can be very daunting,” Dr. Jotwani said. He recommended identifying a new position and then trying to spend at least a little time in it each night. Over time, your body will get used to it.

Strategic placement of pillows, special cushions or devices can help keep you in one position throughout the night, Dr. Gurubhagavatula said. To stay on your side, try placing a body pillow behind you, she suggested. There are also cushions that strap onto your back to keep you on your side, and electronic devices that vibrate when they sense that you’ve rolled onto your back. They’re the technological equivalent of getting elbowed by your bed partner, Dr. Yadollahi said.

If you’re new to sleeping on your back, Dr. Gurubhagavatula said you might be more comfortable with a small pillow under your knees, even if it feels awkward for the first few nights.

Your sleep position is just one of many factors that contributes to your overall sleep quality, Dr. Gurubhagavatula said. Maintaining a consistent sleep schedule, getting adequate exercise and keeping your bedroom dark and cool are all important.

But, she added, if getting a good night’s sleep can be “as simple as turning onto your side, then why not try it?”

A version of this article appears in print on April 7, 2026, Section D, Page 7 of the New York edition with the headline: Your Sleep Position May Cause You Pain. Order Reprints | Today’s Paper | Subscribe

Sleep Apnea: When the Body Interrupts the Unconscious

There are conditions that disturb the body… And then there are those that interrupt something deeper. Sleep apnea is one of them. It does not simply affect sleep—it disrupts the body’s ability to fully surrender, to restore, to return to a state of wholeness. And for many, it goes unnoticed for years, quietly shaping their energy, clarity, and presence in the world.

What Sleep Apnea Actually Is

Sleep apnea is a condition in which breathing repeatedly stops and starts during sleep. But beyond the definition, what matters is this: Your body is being pulled out of rest—again and again—throughout the night.

Not always consciously.
Not always dramatically.
But consistently enough to prevent true restoration.

There are different forms this can take:

• Obstructive patterns, where the airway collapses or becomes restricted
• Neurological patterns, where the brain fails to regulate breath rhythm properly

Either way, the result is the same: The body remains in a subtle state of interruption instead of repair.

The Experience Most People Can’t Name

Many people living with sleep apnea don’t realize that what they’re experiencing has a cause. They describe things like:

• Waking up tired no matter how long they sleep
• A sense of mental heaviness or lack of clarity
• Irritability that feels unprovoked
• A quiet disconnection from themselves
• The feeling of never fully “landing” in rest

This isn’t just fatigue. It’s fragmentation.

Why This Matters More Than Energy

When breath is disrupted, the body is deprived—not just of oxygen, but of rhythm. And rhythm is everything. Over time, this can affect:

• Cardiovascular function
• Cognitive clarity
• Emotional regulation
• The nervous system’s ability to settle

But even beyond the physical consequences, there is a deeper cost: You begin to normalize a diminished state of being.

Looking Beneath the Surface

Sleep apnea is often approached as a mechanical issue—and sometimes it is. But it can also reflect a broader imbalance within the system:

• Structural patterns in the body
• Chronic stress responses
• Dysregulation of the nervous system
• Long-standing disconnection from natural restorative cycles

This is why quick fixes don’t always create lasting change. The body is not just malfunctioning. It is responding.

Restoration Requires Awareness

Addressing sleep apnea may involve:

• Sleep studies and proper diagnosis
• Breathing support tools such as CPAP
• Structural or positional adjustments
• Intentional lifestyle shifts

But none of these are truly effective without awareness.

Because the goal is not simply to “fix sleep.”

The goal is to restore the body’s ability to enter a state of deep, uninterrupted repair.

An Invitation to Pay Attention

If your body is not allowing you to rest, there is a reason. Not one rooted in fear—but one that deserves your attention. There is a difference between pushing through exhaustion…and understanding what is creating it. And that difference changes everything.

You were not designed to live in a constant state of depletion. You were designed to restore, to recalibrate, to wake up clear.

If that hasn’t been your experience, it may be time to look deeper—not just at your sleep, but at what your body has been signaling all along.

Sleep apnea is more than just disrupted sleep—it’s a condition that can impact energy levels, focus, and long-term health if left untreated. The good news is that there are several effective treatment options available today, ranging from non-invasive lifestyle changes to advanced medical therapies. The right solution depends on the severity of the condition and the individual needs of each patient.

Below is an overview of the most common and effective treatments for sleep apnea.

Positive Airway Pressure (CPAP, APAP, BiPAP)

One of the most widely prescribed treatments for obstructive sleep apnea is positive airway pressure (PAP) therapy, commonly known as CPAP.

This treatment works by delivering a steady stream of air through a mask, keeping the airway open during sleep and restoring normal breathing. In fact, CPAP therapy can successfully normalize breathing in 90–95% of cases when used consistently.

However, while highly effective, it is not always easy for patients to tolerate. Some individuals experience discomfort from the mask, air pressure, or the overall setup, which can make long-term use challenging.

Oral Appliance Therapy (Dental Devices)

For many patients—especially those with mild to moderate sleep apnea—oral appliance therapy offers a comfortable and effective alternative.

These custom-made devices are worn during sleep and work by gently repositioning the jaw and tongue forward, helping keep the airway open. Many patients find them significantly easier to use than CPAP machines, with studies showing strong compliance and comfort.

When properly fitted, oral appliances can:

• Reduce or eliminate symptoms
• Improve sleep quality
• Restore more normal breathing patterns

They are also small, portable, and ideal for travel—making them a practical long-term solution for many individuals.

Tongue Retaining Devices (TRD)

Another non-invasive option is a tongue retaining device, which works by holding the tongue in a forward position to prevent airway obstruction.

While not as widely used or as effective as oral appliances, these devices can be helpful for individuals who:

• Cannot tolerate CPAP
• Are not candidates for traditional oral appliances
• Have limited dental structure

Custom versions tend to be more comfortable and effective than over-the-counter options.

Lifestyle Modifications

In cases of mild sleep apnea, lifestyle changes can play a meaningful role in reducing symptoms.

These may include:

• Weight loss
• Reducing alcohol consumption
• Quitting smoking
• Changing sleep position (such as avoiding sleeping on the back)

For some individuals, these adjustments alone can significantly improve breathing during sleep.

Positional Therapy

Some people experience more severe symptoms when sleeping on their back. Positional therapy focuses on training the body to sleep on the side, which can help reduce airway obstruction.

This can be achieved with:

• Specialized pillows
• Wearable devices
• Simple techniques to discourage back sleeping

In certain cases, this approach can reduce the severity of sleep apnea to a more manageable level.

Combination Therapy

Sleep apnea is not always solved with a single treatment. Many patients benefit from a combination approach, such as:

• Oral appliance therapy paired with CPAP
• Oral appliances combined with lifestyle changes
• Adjunct therapies like nasal breathing support

Combining treatments can improve overall effectiveness and provide better symptom relief.

Surgical Options

For patients who cannot tolerate other treatments, surgery may be considered.

One common procedure is uvulopalatopharyngoplasty (UPPP), which removes excess tissue from the throat to widen the airway. However, surgical outcomes can vary, and success rates may be relatively low compared to other treatments.

Newer surgical and implant-based options are emerging, but these are typically reserved for specific cases and should be carefully evaluated with a specialist.

Emerging and Alternative Therapies

Advancements in sleep medicine continue to expand treatment possibilities. Some newer or alternative approaches include:

• Tongue stimulation devices to improve airway muscle tone
• Oral appliances with advanced monitoring capabilities
• Adjunct techniques like guided breathing support

While promising, many of these options are still being studied and may not be appropriate for every patient.

Finding the Right Treatment

There is no one-size-fits-all solution for sleep apnea. The most effective treatment is the one that fits your lifestyle, comfort level, and medical needs—and one you can consistently use.

For some, CPAP may be the ideal solution. For others, oral appliance therapy or a combination of approaches may provide better long-term success.

Final Thoughts

Sleep apnea is highly treatable, and with the right approach, patients can experience deeper sleep, improved energy, and better overall health.

If you or a loved one is experiencing symptoms of sleep apnea, consulting with a qualified provider is the first step toward finding a treatment plan that restores not just sleep—but quality of life.

Sleep is sacred. It restores our energy, sharpens our focus, and cultivates a deep sense of well-being. But for millions of people living with obstructive sleep apnea (OSA), that healing rest is interrupted night after night by interruptions in breathing that leave them fatigued, strained, and longing for relief.

Obstructive sleep apnea isn’t simply “loud snoring” or “restless sleep.” It’s a condition where the muscles and soft tissues at the back of the throat relax too much during sleep, collapsing and blocking the airway. These recurrent pauses in breathing can happen dozens of times per hour, reducing oxygen levels and forcing the brain to briefly wake the body to resume breathing. Over time, untreated OSA can affect heart health, metabolism, mood, and cognitive function.

Beyond CPAP: A Gentle, Patient-Focused Alternative

The gold standard in OSA treatment for many years has been Continuous Positive Airway Pressure (CPAP) therapy. While highly effective, CPAP requires wearing a mask connected to a machine that delivers constant, pressurized air to the airway. For some, this can feel restrictive, uncomfortable, or difficult to tolerate long-term.

This is where oral appliance therapy (OAT) shines as a life-changing, patient-centered option.

What Is an Oral Appliance?

An oral appliance is a custom-fitted device that you wear during sleep, similar in appearance to a mouthguard or orthodontic retainer. Its purpose is as elegant as it is effective: by gently repositioning your lower jaw and tongue forward, it helps keep your airway open and unobstructed throughout the night. This simple, natural repositioning can dramatically reduce breathing interruptions and snoring.

These devices are crafted specifically for each individual by trained dental sleep professionals, giving them both precision and comfort that off-the-shelf alternatives can rarely match.

Why Choose Oral Appliance Therapy?

Oral appliance therapy brings several meaningful benefits that speak directly to people’s desire for comfort and freedom:

• Comfort-First Design: Unlike masks and hoses, oral appliances fit seamlessly inside your mouth. They are quiet, unobtrusive, and many patients find them easier to adapt to over time.
• Portability: Traveling with a CPAP machine can be bulky and inconvenient. An oral device slips into any nightstand or suitcase with ease.
• Natural Breathing: By keeping your jaw and tongue in a forward position, these devices support unobstructed airflow, creating calmer sleep with fewer awakenings.
• Welcoming for Mild to Moderate OSA: For many people with mild to moderate obstructive sleep apnea, oral appliances offer a highly effective alternative to CPAP that fits beautifully into everyday life.

Is an Oral Appliance Right for You?

Oral appliance therapy isn’t a one-size-fits-all solution, but for the right candidate, it can bring transformative improvement to sleep quality and daytime vitality. It’s particularly valuable for those who struggle with CPAP, have mild to moderate OSA, or simply seek a more comfortable route to uninterrupted rest.

A trusted dental sleep specialist will evaluate your unique needs, guide you through the process, and craft a device that supports your journey toward peaceful nights and brighter days.

A Path to Renewal

At its heart, oral appliance therapy is more than a device — it’s a bridge back to restful sleep, renewed energy, and the confidence that comes from waking refreshed. When breathing flows freely and nights are truly restorative, every sunrise feels a little brighter and every moment a little more alive.

Source: Rutgers UniversitySummary: New research reveals how dental check-ups could be the first line of defense against deadly sleep disorders.

Click here for the original article.

A patient dozes off in a dental chair despite the anxiety of an impending procedure. A seemingly unremarkable act but — for dentists versed in the latest sleep research — this red flag hints at a life-threatening condition.

In a research review published in the Journal of the American Dental Association, Rutgers Health researchers identified dentists as an unexpected player in the battle against life-threatening sleep disorders.

The review suggests dental professionals have unique opportunities to screen for conditions such as obstructive sleep apnea, a disorder that affects millions of Americans and is linked to serious health risks, including cardiovascular disease and neurodegeneration.

It also challenges dentists to look beyond teeth and gums to the broader landscape of patient health.

“We have a great opportunity to change lives for the better,” said Davis Thomas, a clinical associate professor at the Rutgers School of Dental Medicine and senior author of the review. “Dentists can be the first line of defense in identifying sleep disorders. They often see symptoms long before physicians. Indicators like tooth grinding, tongue scalloping or even a patient dozing off in the chair can be early signs that something more is going on.”

Sleep disorders such as obstructive sleep apnea affect more than half of Americans at some point in their lives. Many cases go undiagnosed, but dentists can play an important role in reducing those numbers.

The review outlines several key indicators that dental clinicians should look for during examinations, including enlarged jaw muscles, scalloped tongue edges, white lines on the cheeks, restricted visibility of the throat, dental wear patterns and tiny cracks on teeth.

These physical signs, combined with patient history and simple screening tools, can help dentists identify at-risk patients with up to 80 percent accuracy.

“It’s not just about looking at teeth anymore,” Thomas said. “We need to observe the whole patient, from their behavior in the waiting room to the subtle signs in their oral cavity.”

Another sign of concern, according to the review authors, is bruxism, commonly known as teeth grinding. Contrary to long-held beliefs, the studies suggest teeth griding is often a symptom of underlying sleep issues rather than a standalone problem caused by dental misalignment.

“We’ve been treating the symptoms without addressing the root cause for far too long,” Thomas said. “By understanding the neuroscience behind sleep disorders, we can provide more comprehensive care and potentially prevent serious health complications.”

This shift in perspective could have far-reaching implications. By identifying patients at risk for sleep disorders, dentists can facilitate early intervention, potentially preventing complications such as hypertension, heart disease and stroke.

To implement these findings, Thomas and his team propose a simple protocol for dental practices: Incorporate sleep-related questions into patient history forms. Other recommendations include training dental staff to recognize physical signs of sleep disorders and using validated screening tools like the STOP-BANG (snoring, tiredness, observed apnea, blood pressure, body mass index, age, neck size, gender) questionnaire, which screens for obstructive sleep apnea and establish referral networks with sleep medicine specialists.

“We’re not asking dentists to diagnose sleep disorders,” Thomas said. “We’re asking them to recognize the signs and make appropriate referrals. This simple act can be lifesaving.”

Thomas recommends that dentists looking to incorporate sleep screening into their practices start with education.

“Attend sleep medicine conferences, take continuing education courses, and stay up-to-date with the latest research,” he said. “The more we learn, the more we realize how much we don’t know — and how much we can do to help our patients.”