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Best Way To Sleep With Occipital Neuralgia

In this article you will find out everything you need to know about the best way to sleep with occipital neuralgia.

Occipital neuralgia is a condition in which there is irritation of your occipital nerves. You will feel pain at the base of the skull, behind the eyes, and laterally across your eyes. You may suffer from severe migraines and headaches if you have this condition. Due to the extreme pain resulting from this condition, you will feel highly uncomfortable. The pain affects every aspect of life including the quality of your sleep.

Occipital nerves originate from the spinal cord, between the bones in your neck. After passing through some muscles in the back, they go into your scalp. Most sensations that you feel in the back and top of the head are due to your greater occipital nerves. Whenever there is damage or irritation of these occipital nerves, it causes pain in the area of distribution of these nerves. Some people feel numbness while others feel extreme tenderness. 

You may think that occipital neuralgia is due to neck injury. However, it is not always true. This headache feels like the pain of an electric shock or intense migraine, but it lasts only for a few seconds or a few minutes. In addition, you will be unable to sleep properly due to this pain. Migraine headaches are much more common than occipital neuralgia and they usually last longer.

In this article, you will get appropriate information about the causes and symptoms of occipital neuralgia and the best ways to sleep if you are having this condition.

Why does occipital neuralgia make sleeping difficult?

Occipital neuralgia is associated with pain during neck movements. Due to intense neck pain, you are to avoid moving the neck immediately. The pain radiates behind the eyes and the scalp(1). This results in the development of light sensitivity. Dental pain and scalp tenderness can make it impossible for you to find a comfortable position to sleep. Due to pain in the head and neck region, it becomes very difficult at times to get a good night’s sleep.

Whenever pain develops in any part of the body, it is natural that you experience a mild degree of sleeplessness. This is because the pain impulses pass from the spinal cord into your brain and stimulate your brain. Due to the constant stimulation of your brain, you feel difficulty in sleeping.

Why is quality sleep so important for occipital neuralgia? 

Sleep has positive impacts on almost all the systems of your body. It replenishes and prepares the nervous system to work properly again. Sleep gives your brain and body a chance to rest and is important for recovery. It also improves the ability of the body to heal itself(2). So taking a sound sleep at night is essential for you if you are suffering from any illness, especially occipital neuralgia.

People suffering from occipital neuralgia cannot sleep properly due to pain. Along with medications, sleep is one of the important things that helps you recover rapidly. Therefore, you should take certain steps to ensure good quality sleep if you want to get rid of this condition in a short span of time. 

Tips for Sleeping With Occipital Neuralgia

You should consult a doctor for the proper management of this condition. However, there are certain things that you should keep in mind if you are suffering from occipital neuralgia and you want to enjoy a good night’s sleep.

  • Place a cold pack on the back of your head and neck for approximately 15 minutes before bedtime. This will reduce the inflammation and the pain associated with it(3).
  • Always use a comfortable pillow that supports your head and neck properly. Moreover, consider trying a cervical pillow for this purpose.
  • Avoid sleeping with poor posture, as it is a top cause of occipital neuralgia, which causes tight neck muscles, strained muscles, and inflammation in nerves.
  • Keep your head elevated with supportive pillows while sleeping. Elevating the head helps in reducing tension on the nerves in your neck.
  • Avoid using caffeine or alcohol before bedtime, as they can interfere with your ability to fall asleep.

A lady treating her occipital neuralgia with a cold pack.

Best Way to Sleep With Occipital Neuralgia

If you sleep in the proper sleeping position, it will ultimately reduce the severity of your symptoms such as pain. Your main goal for sleeping position is to not sleep with your head raised. You should keep your head at the level of your body and keep such a position that aligns your spine. This will decrease the pressure on the muscles surrounding your nerves and it will have positive effects in reducing pain.

However, the best way to sleep with occipital neuralgia is to sleep on your back with a pillow that provides neck support. In addition, you can use memory foams because of their ability to adapt to the various contours of your head. Most orthopaedic doctors recommend cervical pillows for such purposes(4). If you are not feeling comfortable while sleeping on your back, the next best alternative is to sleep on your side.

Causes of Occipital Neuralgia

You should not confuse this condition with a migraine or regular headache because it is caused by problems specifically with the occipital nerves. Multiple causes of occipital neuralgia are there and if you know the cause, it will help you to create an appropriate treatment plan. Some of the causes are:

Head trauma or injury is the most common cause. This occurs due to the pinched nerve root or muscle tightness in the neck. The nerve passes between your neck muscles to reach your scalp. If there occurs any injury to the back side of the head, there is a high chance that your occipital nerve will be damaged.

Cervical disc disease is another potential cause of the condition(5). The occipital nerve arises from the spinal cord at the level of your upper cervical spine. Any disease of the cervical vertebrae will irritate the nerve and will cause occipital neuralgia pain.

Moreover, any inflammatory condition of the vertebrae, or blood vessels also increases the chances of developing this condition. The inflammation is usually accompanied by swelling as well as the release of chemicals that can stimulate the pain endings. The swelling and irritation of the nerve contribute to the pain in the region to which the nerve supplies.

Signs and symptoms

Occipital neuralgia can cause sudden bursts of pain that generally starts at the base of the head and goes to the scalp. It’s a stabbing and intermittent upper neck pain, often at one or both sides of the head(6). The nerve pain may last a few seconds, but tenderness around the nerves may persist afterward.

The pain may affect the rear part of your eye on the affected side, and the scalp, especially where the occipital nerves connect on one side of the head.

Other symptoms may also be sensitivity to light, touch, soreness, and pain when you move your neck. Small movements can trigger a burst of pain while turning your head during your routine life activities. This pain can be intense and many people associate it with migraine or tension headaches even though they are different types of headaches and require different treatment. Therefore, it is important to consult your doctor to get proper treatment. 

Care and treatment

You have many treatment options available to get rid of your condition. Pain management strategies include conventional therapies such as warm compression of the affected area, taking over-the-counter medications(OTC), or anti-inflammatory pain relief medications like ibuprofen. Administration of steroid injection is also effective in reducing pain and inflammation.

Seeking help with physical therapies and trying massage therapies can also relieve pain or help relax the tight muscles that are putting pressure on your occipital nerves. You can also use antiepileptic and antidepressants to reduce the severity of the symptoms.

If these conventional methods and OTC treatments do not help, a doctor may prescribe muscle relaxants injections into the vertebrae. Injections also help reducing your inflammation, pain, or both. Some of the injectable drugs include anaesthetic drugs or nerve blocks such as occipital nerve blocks.

However, if you are going to have injection in your vertebrae, you need to consult your doctor as it is a procedure with high risk factors. A doctor will usually recommend this treatment only if other methods are not working. In addition, these injections will not cure neuralgia, and they do not have a long-lasting effect. Often times the pain returns a few months later.

Depending on the cause, the doctor prescribes surgery to decrease pressure on the nerves if the pain is severe and affecting your lifestyle. However, multiple methods like occipital nerve stimulation and spinal cord stimulation to block pain signals can relieve your symptoms for the time being.

Conclusion about the best way to sleep with occipital neuralgia

Occipital neuralgia is a type of pain that usually leads to headaches. It is a serious condition because it leads to pain in the wider area of your head. The pain interferes with your daily activities including the quality of sleep. Good night‘s sleep is essential if you want to recover from this condition quickly. And if you feel difficulty in sleeping, change your posture and sleep on your back. Use cervical pillows because they are also effective in treating this condition. Finally, if your pain doesn’t go away with these strategies then you should consult your doctor for proper medical care and management. 


  1. Dougherty, C. (2014). Occipital Neuralgia. Current Pain and Headache Reports, 18(5). https://doi.org/10.1007/s11916-014-0411-x
  2. Moldofsky, Harvey. “Sleep and the Immune System.” International Journal of Immunopharmacology, vol. 17, no. 8, Aug. 1995, pp. 649–654, 10.1016/0192-0561(95)00051-3. Accessed 28 Apr. 2020.
  3. Koç, M., et al. “Cooling for the Reduction of Postoperative Pain: Prospective Randomized Study.” Hernia: The Journal of Hernias and Abdominal Wall Surgery, vol. 10, no. 2, 1 Apr. 2006, pp. 184–186, pubmed.ncbi.nlm.nih.gov/16432641/, 10.1007/s10029-005-0062-2. Accessed 31 July 2021.
  4. Shields, N., et al. Are Cervical Pillows Effective in Reducing Neck Pain? Www.ncbi.nlm.nih.gov, Centre for Reviews and Dissemination (UK), 2006, www.ncbi.nlm.nih.gov/books/NBK73379/.
  5. Ehni, George, and Benjamin Benner. “Occipital Neuralgia and the C1–2 Arthrosis Syndrome.” Journal of Neurosurgery, vol. 61, no. 5, Nov. 1984, pp. 961–965, 10.3171/jns.1984.61.5.0961. Accessed 6 Dec. 2019.
  6. Latif, Usman. “A Patient with Chronic Pain in the Back of the Head.” Practical Chronic Pain Management, 2020, pp. 35–40, 10.1007/978-3-030-46675-6_6.

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