Why do apneas also occur in the prone and lateral position?

[selfhelpdevice]

Hello!

I'm sure you've all seen the pictures demonstrating how the tongue falls back into the throat and closes the airway in sleep apnea patients.
They typically show a person in the supine position. You never see a picture that shows why apnea also happens in the lateral position. Gravity is unlikely to cause the tongue to fall into the throat in this position.
But sleep apnea patients cannot simply stop their sleep apnea by sleeping on their stomach or side instead of their back. When I sleep on my side, I snore terribly loudly at first and when deep sleep sets in, I get apneas.

Do any of you know more about why and where exactly in the upper airway apneas occur in the lateral or prone position?

Thank you!

[paulag1955]

This may not be the case for most people, but I recently realized that I was chin tucking while lying on my side. I'm now working on changing my sleep position to eliminate that.

[Sleepster]

I'm sure you've all seen the pictures demonstrating how the tongue falls back into the throat and closes the airway in sleep apnea patients.
They typically show a person in the supine position. You never see a picture that shows why apnea also happens in the lateral position. Gravity is unlikely to cause the tongue to fall into the throat in this position.

Whether it's the tongue falling back to cause the blockage, or some other part of your throat anatomy closing off the air flow, it takes an effort on your part to operate the muscles needed to keep the airway open. When you fall asleep you abandon this effort, and tissue blocks the passageway. Yes, gravity will make you exert more effort to keep your tongue from falling backward when in the supine position; but it's the effort, whether exerted against gravity or not, that keeps the airway open in a person with OSA.

I sometimes wonder if this muscular effort that we exert during all our waking hours exercises those muscles, enlarging them, and making the OSA worse, in a vicious cycle.

[CPAPfriend]

The pathology of sleep apnea goes beyond anatomy. Passive tissue properties, traction effects, collapsibility, muscle tone, ventilatory control instability, and so on are all additional known causes.

[Sleeprider]

Read this and consider that perhaps, the tongue falling back in the throat is not as likely as your head and neck position becoming misaligned and causing obstruction, or "positional apnea". Many members of this board that presented with clusters of apnea and slept prone are simply turning their head to the side at such an acute angle, the airway obstructs. Similarly, sleeping laterally can encourage the "fetal position" with an acute chin-tuck that also positionally obstructs the airway. https://www.apneaboard.com/wiki/index.ph...onal_Apnea

[Deborah K.]

I sleep on my back almost all the time, but it does not increase apnea. I sleep on a small, flattish child's pillow with a ridge at the front that holds my head tipped just slightly back. That stopped positional apnea better and a lot more comfortably than a cervical collar did.

[selfhelpdevice]

Thank you all for your replies!
It is a complex issue and of course everybody's anatomy is different.
My apnea seems to be coming mostly from having a too large tongue (that is what the doctors told me).
There just seems to be not enough space in my mouth and throat and when everything relaxes during sleep, the airway allways gets blocked somewhere.
I really miss the days when I was young and could fall and stay asleep on my back the whole night. Maybe my only chance to get back there is to loose weight to the point where I am really skinny and my tongue lost all its fat. I am only 15 kilos overweight, but I think in my case bodyfat is an important factor as things go south as soon as I pass a certain bodyweight...

[Sleepster]

I really miss the days when I was young and could fall and stay asleep on my back the whole night. Maybe my only chance to get back there is to loose weight to the point where I am really skinny and my tongue lost all its fat. I am only 15 kilos overweight, but I think in my case bodyfat is an important factor as things go south as soon as I pass a certain bodyweight...

Possibly. We lose muscle tone as we age, too.