How to Sleep with Carpal Tunnel (10 Doctor-Approved Ways)

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  • This article was written by Dr. Sony Sherpa – a qualified and practicing medical doctor – to ensure the content is medically accurate.

Carpal tunnel syndrome is a condition that causes pain in the hands and arm due to compression of the median nerve that may be caused by inflammation, swelling, or conditions like rheumatoid arthritis.

Carpal tunnel pain is often worse at night due to reduced movement that causes stiffness and fluid build-up, whilst lying on the affected region can cause an increase in pressure that makes the pain worse.

So how can you sleep better when you have carpal tunnel pain at night?

The most effective way to sleep better with carpal tunnel is to lie flat on your back with your arms in a neutral position to reduce pressure and use pillows to stop you from rolling over. Wearing a compression garment, icing the area, and anti-inflammatory medication can also help.

In the rest of this article, I have used my expertise as a professional and practicing medical doctor to explain in more detail why it’s difficult to sleep with carpal tunnel at night.

I have also included 10 techniques that you can try to reduce carpal tunnel pain and sleep better at night.

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Why is it Difficult to Sleep with Carpal Tunnel?

Best Sleeping Position for Shoulder, Arm, Wrist Pain & Carpal Tunnel Syndrome

It is difficult to sleep with carpal tunnel syndrome because this condition results in pain, numbness, and tingling that is typically caused by a lack of movement and/or lying on your arms when you’re in bed.

More specifically, there is very little arm movement when you sleep and this increases the fluid in the muscle compartments [1].

This increases the pressure inside the wrist, which ends up increasing pressure, compressing the median nerve, and causing you to wake up in pain.

More details below.

Side Sleeping Can Make Carpal Tunnel Pain Worse

A recent study performed on sleeping positions and aggravation of symptoms of carpal tunnel syndrome found a clear link between increased carpal tunnel pain and side sleeping [2].

The fetal position was found to be especially harmful because the wrist is typically placed under a lot of pressure.

Sleeping on your front can also increase nerve pressure and make your carpal tunnel pain worse.

Sleeping on your side or front is more likely to cause you to sleep in a position where your wrist is bent which will make the pain worse.

Poor Sleep Quality Can Increase Carpal Tunnel Pain

According to a recent study, approximately 80% of people with carpal tunnel syndrome wake up during the night as a result of their symptoms [3].

When you can’t sleep well at night, your ability to function the next morning is reduced, and this can lead to stress, which aggravates pain [4].

10 Ways to Sleep Better With Carpal Tunnel

Below are 10 strategies that you can try and combine to help reduce your carpal tunnel pain at night:

1: Avoid Bending Your Arms While Sleeping

Bending the wrists is one of the main reasons why people experience tingling, numbness, and carpal tunnel pain because it increases the pressure on the nerves.

When your wrists are flexed or bent, the median nerve is compressed and under pressure in the carpal tunnel – causing a feeling of numbness or tingling, otherwise known as “falling asleep” or paresthesia.

The most effective way to stop your arms from bending at night is to lie flat on your back with your arms straight down by your side – placing soft pillows next to your hips and shoulders can stop you from rolling over on to your arms.

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2: Wear a Nightwear Splint or Brace to Keep Your Arms Straight

Wearing a splint or brace through the night will keep your wrist and arm aligned properly and help to reduce the pain of carpal tunnel.

A correctly aligned arm is exactly what you need to prevent flexion or hyperextension of your wrist [5].

My patients usually tell me that their carpal tunnel syndrome symptoms reduced significantly after they started wearing a brace. 

I always recommend that my patients invest in a splint or a brace that is designed specifically for nighttime use.

They are designed to cover quite a bit of the arm, while almost completely restricting arm and wrist movement.

They are also fully adjustable, making them usable for people of all shapes and sizes.

In my expert opinion, it is best to invest in a brace for each of your wrists if you have carpal tunnel syndrome in both hands. 

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3: Use a Pillow to Support Your Arm and Reduce Pressure

Supporting your affected arm with a pillow can help to reduce the pressure on your median nerve and reduce carpal tunnel pain.

One of the main mechanisms through which carpal tunnel syndrome causes pain is swelling, which develops as a result of inflammation of the tissues.

This swelling gets even worse when your arm is not supported and immobile throughout the night.

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4: Use a Compression Garment to Reduce Fluid Build Up

Wearing a compression garment can reduce the pain and discomfort of carpal tunnel by reducing swelling and improving blood flow.

Compression gloves can be worn throughout the day, not just at night.

When I make this recommendation, some of my patients worry about the restriction of motion in these gloves, but they are fingerless and only cover the wrist area, so your fingers are free to move as you please while wearing them. 

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5: Sleep on Your Back to Avoid Nerve Pressure

Sleeping on your back is the best position if you have carpal tunnel syndrome because it reduces the pressure on your arms, wrists, and hands.

You can also elevate your legs by propping them up on a couple of pillows or elevating the lower portion of an adjustable bed to support your spine.

You can also wear a brace, compression garment, or splint on your arms or wrist to maximize the effectiveness of sleeping on your back.

Click here to see the best adjustable beds to buy for carpal tunnel and back pain.

6: Mobilize Your Wrists to Improve Blood Flow

5 Best Carpal Tunnel Syndrome Stretches & Exercises – Ask Doctor Jo

Performing light wrist mobilization exercises before bed can help to increase blood flow, reduce fluid build-up, and lessen the pressure that is causing your carpal tunnel pain.

Practicing wrist movements right before you fall asleep can relieve the pressure and significantly improve the blood flow through your arm.

This reduces the inflammation, distributes the fluid buildup, and alleviates the pain and discomfort. 

You can also do these movements if you wake up in the middle of the night with numbness as a result of carpal tunnel syndrome.

See the video above for the best wrist mobility exercises for carpal tunnel syndrome to perform before bed.

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7: Massage Your Wrist to Relieve the Pain

If you wake up in the middle of the night due to wrist pain or numbness, a slight massage will help reduce the pressure inside the wrist and improve blood flow which can reduce the pain.

You should do this frequently to get the blood flow going, especially if you have spent a long time with your arms immobile. 

You can massage your wrists at any time of the day to help with the pain of carpal tunnel syndrome, but massaging just before going to bed or when you wake up in the middle of the night is a great way to reduce the pain so that you can get to sleep.

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8: Ice Your Wrist to Reduce the Swelling

Icing your wrist helps to reduce the nerve irritation and inflammation of carpal tunnel syndrome.

If you ice your wrists for approximately 10 to 15 minutes just before you go to sleep, you will reduce some of the inflammation in the wrist and relieve the median nerve irritation.

I also recommend that my patients with carpal tunnel sleep in a warmer room – even though ice is being applied to the painful area.

The reason I recommend both hot and cold therapies – and why both of them work – is because they focus on different causes of pain.

For example, when you are sleeping in a warm room, you are improving blood flow.

Whereas icing the wrist before you go to bed reduces the inflammation and irritation of the median nerve itself.

Both of these can cause pain and need to be worked on for you to be able to sleep properly.

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9: Take Anti-Inflammatory Medications Before Bed

Taking anti-inflammatory medication before bed can significantly reduce carpal tunnel pain at night.

However, you should be careful that you do not become reliant on these medications – talk to your doctor for the best treatment plan.

You should also consult your doctor before taking any pain medications if you are already on other medications in order to prevent interactions.

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10: Perform Yoga Throughout the Day to Relieve Pain

Hatha Yoga with David Procyshyn: Yoga for Carpal Tunnel Syndrome

The video above shows you a yoga routine that can be performed during the day or just before bed to help reduce carpal tunnel pain.

Yoga and stretching reduce the stiffness of the muscles in your wrist, along with the median nerve irritation. 

Yoga, in general, is something I recommend to all my patients that complain of issues with their sleep.

Proper sleep hygiene, in my opinion, should include yoga as a way to calm your nerves, and wind down.

When you suffer from carpal tunnel syndrome, it is even more beneficial, as it will relax the tight muscles in your wrist, and reduce the inflammation of your muscles.

This will help reduce the pain, while also making you feel drowsy so that you can fall asleep right after you are done with yoga. 

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Conclusion: Combine Techniques

Carpal tunnel syndrome causes numbness, pain, and tingling sensations, as a result of compression of the median nerve.

Sleeping in a warm room, on your back, while using a wrist brace or splint, after having done yoga or wrist exercises, will reduce the pressure in the wrist, as well as nerve irritation and inflammation, resulting in a better night’s sleep.

I highly recommend that you combine the above-mentioned tips for the best results.

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Sources & References

1. Evans, Roslyn B. “Therapist’s Management of Carpal Tunnel Syndrome: A Practical Approach.” Rehabilitation of the hand and upper extremity. T. M. Skirven  (2011). Philadelphia, PA, 2011. 666-677. Elsevier Mosby.

2. Mccabe, Steven J., Amit Gupta, David E. Tate, and John Myers. “Preferred Sleep Position on the Side Is Associated with Carpal Tunnel Syndrome.” Hand 6.2 (2010): 132-37. Web.

3. Patel, Jay N et al. “Characteristics of sleep disturbance in patients with carpal tunnel syndrome.” Hand (New York, N.Y.)vol. 7,1 (2012): 55-8. doi:10.1007/s11552-011-9373-1

4. Goorman, Angela Messer et al. “Association of Sleep and Hand Function in People With Carpal Tunnel Syndrome.” The American journal of occupational therapy : official publication of the American Occupational Therapy Association vol. 73,6 (2019): 7306205050p1-7306205050p7. doi:10.5014/ajot.2019.034157

5. Rubin, Guy et al. “The effectiveness of splinting and surgery on sleep disturbance in carpal tunnel syndrome.” The Journal of hand surgery, European volume vol. 43,3 (2018): 286-289. doi:10.1177/1753193417729110

Medical Disclaimer

No part of this website offers medical advice – always consult with a qualified medical professional for the best guidance.

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Main image: ‘Young woman sitting on the bed with muscle pain. Fibromyalgia concepts.’ by nenetus (used with permission and commercially licensed through Envato Elements).