2. Pauses in breathing during sleep
A partner may notice that the person suddenly stops breathing for several seconds before snorting, gasping, or resuming normal breathing.
These episodes should not be dismissed as ordinary sleep behavior.
3. Waking up gasping or choking
Repeated episodes of waking up short of breath may indicate a breathing problem that needs evaluation.
4. Excessive daytime sleepiness
Someone who sleeps for many hours but still feels exhausted during the day may not be getting restorative sleep.
Older adults may attribute this to aging, but persistent daytime sleepiness can have several causes, including sleep apnea, medication effects, depression, and other medical conditions.
5. Morning headaches or difficulty concentrating
Some people with sleep apnea experience headaches upon waking, impaired concentration, irritability, or memory difficulties.
These symptoms are not specific to sleep apnea, so a healthcare professional should consider the full clinical picture.
Why sleeping on the side may help some people
For certain people with obstructive sleep apnea, sleeping on the side can reduce airway obstruction compared with sleeping flat on the back.
When a person lies on their back, gravity can allow the tongue and soft tissues of the throat to move backward, narrowing the airway. This is especially relevant for people whose sleep apnea becomes worse in the supine position.
Side sleeping may help keep the airway more open in these individuals.
However, the benefit varies. Some people experience breathing interruptions in every position, while others have predominantly position-dependent sleep apnea.
Side sleeping is therefore not a substitute for proper diagnosis or treatment.
If a healthcare professional suspects sleep apnea, they may recommend a sleep study. Depending on the circumstances, this may involve monitoring at home or an overnight study in a sleep laboratory.
Treatment depends on the severity of the condition and the person's individual needs. Options may include positive airway pressure therapy, oral appliances, weight management when appropriate, and other interventions recommended by a clinician.
Continuous positive airway pressure, commonly known as CPAP, uses gentle air pressure to help keep the airway open during sleep. For people who need it, using prescribed therapy consistently can improve symptoms and sleep quality.
Treatment decisions should be individualized. A person should not stop using prescribed equipment or replace it with a different sleeping position without discussing the change with their healthcare professional.
What if you sleep alone?
People who live alone may not have anyone to notice breathing pauses during the night.
In that situation, persistent snoring, unexplained daytime fatigue, morning headaches, or waking up with a sensation of choking may be clues worth discussing with a doctor.
Some people with sleep apnea have few obvious symptoms, so the absence of dramatic warning signs does not always rule it out.
The important lesson is not to become frightened by every night of poor sleep. Instead, recognize persistent patterns and seek help when symptoms suggest that breathing may be disrupted.
Sleep apnea is a treatable condition, and identifying it can improve sleep quality and overall health.
For older adults concerned about stroke, this is a far more meaningful step than worrying about whether they happened to sleep on the left or right side.
But breathing is only one part of the picture. Another common question concerns whether the left side, right side, or back is best for the heart and blood vessels.
Chapter 3: Left Side, Right Side, or Back—Which Position Is Best?
When people search for the healthiest sleeping position, they often expect a straightforward answer. They want to know whether they should sleep on their left side, their right side, or their back to protect their heart and brain.
Unfortunately, there is no single position that has been proven to prevent stroke in the general population.
Each position has potential benefits and limitations. The most appropriate choice depends on breathing, medical history, joint comfort, reflux symptoms, and personal preference.
Sleeping on the left side
Side sleeping is comfortable for many people and may help reduce snoring or positional airway obstruction.
For individuals with acid reflux, sleeping on the left side may also reduce nighttime reflux symptoms compared with sleeping on the right side. This is related to the anatomy of the stomach and the position of the junction between the stomach and esophagus.
Less nighttime reflux can mean fewer interruptions to sleep.
Some people also find that sleeping on the left side is comfortable because it reduces pressure on certain painful areas. Others find the opposite, particularly if they have shoulder or hip problems.
There is no convincing evidence that left-side sleeping universally protects against stroke or that every older adult should adopt it.
People with heart or lung conditions should follow individualized medical advice rather than assuming that one side is always best.
Sleeping on the right side
The right side is another common and generally acceptable sleeping position.
For many healthy adults, sleeping on the right side does not create a known stroke risk simply because of the side chosen.
Some people find the right side more comfortable because of shoulder pain, hip discomfort, pregnancy-related needs in younger adults, or personal preference. Others prefer the left.
The important consideration is whether the position supports comfortable breathing and allows the person to remain asleep without unnecessary discomfort.
People who experience significant reflux may find that right-side sleeping worsens their symptoms. If this occurs regularly, a clinician can help them consider practical adjustments.
But a person who sleeps comfortably on the right side should not assume that they are putting their brain at risk.