You’ve probably heard that getting enough sleep is essential for health. But what you might not know is that how you sleep—your sleeping position—could influence your risk of stroke, especially as you age.

While stroke risk is influenced by many factors, emerging research suggests that certain sleeping positions may affect blood flow to the brain in ways that could be significant for older adults. Here’s what you need to know.

The Sleeping Position That Raises Concerns

Sleeping on your back (supine position) has been the focus of recent research. Studies suggest that prolonged back sleeping may be associated with increased stroke risk in certain populations, particularly those with existing risk factors.

Why Back Sleeping May Be Problematic

When you sleep on your back:

• Gravity pulls on soft tissues in the throat, potentially worsening sleep apnea

• Sleep apnea is strongly linked to increased stroke risk

• Blood flow patterns may be affected in ways that could influence clot formation

The Sleep Apnea Connection

Sleep apnea—a condition where breathing repeatedly stops and starts during sleep—is a well-established risk factor for stroke. Studies show that people with untreated sleep apnea have a significantly higher risk of stroke, and back sleeping often worsens apnea symptoms.

What the Research Shows

A 2023 study published in the Journal of Clinical Sleep Medicine found that people with sleep apnea who slept primarily on their backs had higher rates of cardiovascular events, including stroke, compared to those who avoided the supine position.

Other research has noted that:

• Sleeping position affects brain blood flow – The brain’s glymphatic system (which clears waste products) works most efficiently during sleep, and position matters

• Nocturnal blood pressure patterns may be influenced by sleep position

• Patients with existing cardiovascular disease may benefit from avoiding prolonged back sleeping