Pillows for Snoring, Reflux and Mild Breathing Trouble

Why snoring and breathing trouble increase with age

• Muscle tone falls. The muscles of the throat relax more in sleep with age, letting the airway narrow and vibrate.
• Weight and neck size. Extra weight around the neck narrows the airway.
• Nasal blockage. Allergy, infection or a deviated septum increase mouth-breathing and snoring.
• Alcohol and sedatives relax the throat further.
• Lying flat. On the back, the tongue and soft palate fall backwards.
• Heart and lung disease. Heart failure and COPD can cause breathlessness when lying flat; see heart failure at home guide and COPD at home guide.
• Reflux. Stomach acid rising into the throat can cause cough, throat clearing and a feeling of breathlessness at night; see acidity and reflux in older adults.

What changing position and pillows can do

Simple measures can reduce simple snoring and help with reflux and some mild congestion.

Side sleeping. Sleeping on the side stops the tongue and soft palate from falling back. Many people snore far less on the side. A body pillow behind the back, or a small backpack-style roll, discourages rolling on to the back.

Raising the head and chest. An upper-body wedge or a bed head raise of about 15 to 20 cm opens the airway slightly, reduces reflux and eases breathing for some people. See wedge pillows.

A supportive head pillow that keeps the neck aligned and does not push the chin towards the chest. A pillow too high closes the airway; too low tilts the head back.

Special anti-snore pillows. Contoured pillows designed to tilt the head slightly or hold the neck in a neutral position. Evidence is limited, but some people find them helpful.

Keeping the nose clear. Treat allergy or congestion as advised by a doctor; see pillow hygiene, dust mites and allergies.

None of these treat sleep apnoea.

Snoring or sleep apnoea?

Simple snoring is noisy breathing without pauses, without daytime sleepiness and without any other symptoms.

Obstructive sleep apnoea (OSA) involves repeated pauses in breathing for 10 seconds or more, often ending with a snort or gasp. Signs reported by a partner or family:

• loud, habitual snoring;
• pauses in breathing, choking or gasping at night;
• restless sleep, frequent waking and night-time urination;
• morning headaches and a dry mouth;
• daytime sleepiness, dozing off while sitting, reading or watching television;
• difficulty concentrating, forgetfulness or low mood; and
• high blood pressure that is hard to control.

OSA is common in older adults and is often undiagnosed. It is associated with a higher risk of heart disease, irregular heartbeat, stroke, diabetes, confusion and car accidents. It is treatable. See sleep apnoea in older adults.

If your parent has any of the OSA signs, ask the doctor about a sleep test. A pillow will not fix it.

Positioning for breathlessness lying flat

Some people cannot breathe comfortably lying flat, a symptom called orthopnoea, often a sign of heart failure or lung disease. Raising the head and chest with a wedge or pillows can help, but the symptom itself must be assessed by a doctor.

Tell the doctor if your parent:

• needs more pillows than before to sleep;
• wakes at night short of breath or has to sit up to breathe;
• has swollen ankles, weight gain or reduced exercise tolerance; or
• has a cough or wheeze that is worse at night.

For positions that ease breathlessness in the daytime, see breathlessness: positions and breathing techniques that help.

Practical positioning guide

For simple snoring:

• Try sleeping on the side with a body pillow behind the back.
• Raise the head of the bed or use a wedge.
• Avoid alcohol and sedatives in the evening, unless prescribed.
• Keep the nose clear.
• Maintain a healthy weight; see nutrition and dietician support.
• Keep a regular sleep routine.

For reflux:

• Raise the upper body with a wedge, not just the head.
• Avoid large meals within three hours of bedtime.
• Sleep on the left side if helpful, as advised by some doctors.
• See a doctor for persistent symptoms.

For night-time congestion:

• Raise the head and treat allergy or infection as advised.
• Keep the room ventilated and humidity moderate.

For people with breathing disease:

• Follow the doctor's plan, including oxygen if prescribed; see oxygen concentrator safe use at home.
• Keep medicines and a phone within reach.

Things that are not recommended

• Stacking many ordinary pillows, which bends the neck forward, narrows the airway and can worsen breathing.
• Sleeping propped with the chin on the chest.
• Taping the mouth or using unproven gadgets without medical advice.
• Sedatives or sleeping tablets for snoring.
• Ignoring symptoms because they are "only snoring".

Using a pulse oximeter

A home pulse oximeter can show oxygen saturation, but it is not a reliable test for sleep apnoea and a normal daytime reading does not exclude it. If your parent has breathing problems, ask the doctor how and when to use one; see pulse oximeters: how they work and how to use one.

Warning signs: see a doctor

Seek medical help promptly for:

• witnessed pauses in breathing, choking or gasping in sleep;
• excessive daytime sleepiness, especially when it is a risk, such as while driving;
• breathlessness lying flat, or waking suddenly short of breath;
• chest pain at night;
• swollen legs with night breathlessness;
• loud snoring with high blood pressure, irregular heartbeat or confusion;
• blue lips or confusion with breathlessness (call 112); or
• persistent night cough, wheeze or reflux.

What to tell the doctor

Before the appointment, collect a few simple facts. Ask a family member to listen for a night or two and note how loud the snoring is, whether there are pauses, gasps or choking, and how often your parent wakes. Record how sleepy your parent is in the day, whether they doze during conversation, television or meals, and whether they have morning headaches. Note weight changes, alcohol use, medicines that cause drowsiness, and any swelling of the ankles or breathlessness on lying flat. If you have a phone, a short audio recording of the night is useful, with your parent's agreement. Bring the list of medicines and the readings of any blood pressure or oxygen devices. The doctor may arrange a sleep study at home or in a clinic, and may suggest weight management, positional measures or treatment with a breathing device at night. Do not stop or start any medicine on your own, and avoid sleeping tablets and alcohol before bed unless your doctor says otherwise.

When to ask a professional

A doctor can assess snoring and breathlessness, arrange tests and treat conditions such as sleep apnoea, heart failure, COPD, reflux and allergy. A sleep specialist can arrange a sleep study. A nurse or physiotherapist can advise on positioning and breathing techniques. Our care advisors can arrange a nurse visit and help choose positioning aids.