The most effective ways to ease sleep apnea depend on its severity, but several strategies can meaningfully reduce the number of times your airway collapses during sleep. Sleep apnea is classified by how many breathing interruptions you experience per hour: 5 to 15 is mild, 15 to 30 is moderate, and 30 or more is severe. Mild and moderate cases often respond well to lifestyle changes and oral devices, while severe cases typically require a breathing machine or, in some situations, surgery.
Sleep on Your Side
One of the simplest changes you can make is switching from back sleeping to side sleeping. When you lie on your back, gravity pulls the tongue and surrounding tissues toward the back of the throat, narrowing or blocking the airway. Research using direct visualization of the airway shows that switching to a lateral position resolves tongue-base obstruction in about 95% of cases. That’s a dramatic improvement from a single positional change. The effect is weaker at other obstruction sites like the soft palate, where side sleeping resolves blockage in roughly half of cases, but the tongue base is the most common contributor to obstructive events.
If you naturally roll onto your back during the night, positional therapy devices can help. These range from simple foam wedges strapped to your back to wearable vibrating sensors that gently prompt you to turn over without fully waking you. A tennis ball sewn into the back of a sleep shirt is the low-tech version of the same idea.
Lose Weight if You Carry Extra
Excess weight, particularly around the neck and upper body, deposits fat tissue around the airway and increases the pressure needed to keep it open. A large meta-analysis of 27 studies found that reducing BMI by 20% was associated with a 57% drop in the number of breathing interruptions per hour. That’s a substantial improvement, enough to shift many people from moderate into mild territory or from mild into a normal range.
Interestingly, the benefits of weight loss follow a curve of diminishing returns. Losing beyond that 20% BMI reduction still helps, but each additional percentage translates to a smaller improvement in apnea severity. This means even modest, sustained weight loss can produce meaningful results. You don’t necessarily need to reach an ideal BMI to see a real difference in your sleep.
Avoid Alcohol Before Bed
Alcohol relaxes muscles throughout the body, and the muscles that hold your airway open are especially vulnerable. Research shows that alcohol suppresses the activity of the genioglossus, the primary muscle that keeps the tongue from falling backward during sleep. It does this by reducing excitatory signals from the brain to the nerves controlling the tongue, essentially dialing down the reflex that keeps your airway clear.
This effect is dose-dependent and time-dependent. Having a drink with dinner several hours before bed is far less disruptive than a nightcap right before sleep. A general guideline is to avoid alcohol for at least three to four hours before lying down. For people with existing sleep apnea, even moderate drinking close to bedtime can significantly worsen overnight breathing events.
Quit Smoking
Smoking causes chronic inflammation and swelling in the upper airway, thickening the tissue lining of the throat and nasal passages. This narrows the available space for airflow even before you lie down. Specifically, tobacco smoke triggers swelling in the uvula and soft palate through a neurogenic inflammation process, and it impairs the normal function of the tiny hair-like structures that keep nasal passages clear. The combined effect is a narrower, more collapse-prone airway. Quitting allows that inflammation to gradually resolve, improving both nasal breathing and overall airway size.
Clear Your Nasal Passages
Nasal congestion forces you to breathe through your mouth during sleep, which changes the position of your jaw and tongue in ways that make airway collapse more likely. It also creates negative pressure in the throat that can pull soft tissues inward. If you use a CPAP machine, nasal congestion is one of the top reasons people struggle to tolerate it.
Nasal steroid sprays are typically the first approach for chronic congestion. Saline rinses (using a neti pot or squeeze bottle) help flush out irritants and thin mucus. If seasonal allergies are a factor, antihistamine nasal sprays can provide additional relief. External nasal strips, the adhesive kind that pull your nostrils open, offer a drug-free option that some people find helpful, though the effect is modest compared to treating the underlying inflammation.
Try Mouth and Throat Exercises
Oropharyngeal exercises, sometimes called myofunctional therapy, strengthen the muscles that hold the airway open. These exercises target the tongue, soft palate, and throat through repetitive movements like pressing the tongue firmly against the roof of the mouth, practicing exaggerated swallowing, or inflating a balloon using circular breathing. The goal is to improve the resting tone and endurance of these muscles so they’re less likely to collapse during sleep.
Programs vary in structure. Some are guided by a speech pathologist, while others use smartphone apps for self-directed practice. Most protocols involve daily sessions, and consistency matters more than intensity. The evidence is strongest for mild to moderate sleep apnea, and the exercises work best as a complement to other strategies rather than a standalone treatment.
Oral Appliances for Mild to Moderate Cases
A mandibular advancement device is a custom-fitted mouthpiece that holds your lower jaw slightly forward during sleep, which pulls the tongue away from the back of the throat and widens the airway. These devices are recommended as a first-line treatment for mild to moderate sleep apnea and as an alternative for severe cases when someone can’t tolerate CPAP.
CPAP machines reduce breathing events more effectively on a per-night basis, but oral appliances often match them in real-world outcomes because people actually wear them. Five-year follow-up data from one large study found that improvements in symptoms and quality of life were similar between the two approaches, largely because adherence with oral appliances is significantly better. The devices are fitted by a dentist with sleep medicine training and need periodic adjustment as your jaw adapts.
Getting the Most From CPAP
For moderate to severe sleep apnea, CPAP remains the most effective treatment. It delivers a steady stream of pressurized air through a mask, physically splinting the airway open. The clinical standard for adequate use is wearing it at least four hours per night for at least 70% of your total sleep time. Many people fall short of this, and comfort issues are the main reason.
If your CPAP feels intolerable, the fix is often adjustable rather than abandoning the device entirely. Mask fit is the most common problem: a mask that leaks air, presses into the bridge of your nose, or feels claustrophobic will undermine your sleep rather than improve it. Most sleep clinics offer multiple mask styles, from full-face to nasal pillows that sit just inside the nostrils. Heated humidifiers built into modern CPAP machines reduce the dry mouth and nasal irritation that drive many people to stop using them. Auto-adjusting machines that vary pressure throughout the night can also feel more natural than fixed-pressure models.
When Surgery Becomes an Option
For people with moderate to severe sleep apnea who can’t use CPAP or oral appliances, surgical options exist. One of the more notable is hypoglossal nerve stimulation, an implanted device that senses your breathing pattern and delivers mild electrical stimulation to the nerve controlling the tongue, moving it forward with each breath to keep the airway open. The FDA has approved this for adults 22 and older with an AHI between 15 and 100 and a BMI up to 40. It’s not a first-line treatment, but for people who’ve genuinely tried and failed other approaches, it offers a viable path.
Other surgical procedures aim to remove or reposition tissue in the throat, correct a deviated septum, or reduce the size of the tonsils or soft palate. These are typically considered on a case-by-case basis depending on where the obstruction occurs.
Combining Strategies Works Best
Sleep apnea rarely has a single cause, and the most effective approach is usually a combination of interventions. Someone who loses 15% of their body weight, switches to side sleeping, and stops drinking alcohol in the evening may see their breathing events drop enough to move from moderate to mild, or from mild to a clinically insignificant level. Adding a nasal steroid spray or daily throat exercises can push the improvement further. The key is identifying which factors are contributing most to your specific pattern of obstruction and addressing them systematically rather than relying on any one change alone.