Aching, throbbing, and constantly trying to change sleeping positions can make it hard to fall — and stay — asleep when experiencing occipital neuralgia. This can then become a cycle, as lack of sleep can make your condition worse.

If you’ve ever tried sleeping while in pain, you know how difficult this can be. The headaches and neck-area pains caused by occipital neuralgia are no exception, and the pain can often feel worse at night.

If you’re currently being treated for occipital neuralgia, consider speaking with a doctor about difficulties with insomnia. In the meantime, here are some ways you can help encourage better sleep while managing this painful nerve condition.

Since occipital neuralgia pain tends to start around the base of your head and spread, adjusting your sleep position may help prevent some additional pressure that can worsen head, neck, and scalp pain.

For some people, even the slightest movements may trigger occipital neuralgia symptoms. A comfortable sleep position can help reduce the tendency of tossing and turning at night, which may reduce your risk of subsequent head movement and pain.

Consider the following tips that can help:

  • Lie on your back: This reduces the risk of placing pressure on your nerves and subsequent pain. A 2019 study found that supine positions complement occipital nerve block treatments for certain types of headaches.
  • Use a supportive pillow: Supporting your neck with a pillow can help keep your head in place while also keeping your spine aligned.
  • Keep your bedroom comfortable: Dark, cool rooms encourage better sleep, which can also reduce your risk of making sudden movements at night.

A supportive pillow is one way you can help ensure that you stay in a comfortable sleeping position and minimize neck and head pain from occipital neuralgia.

When searching online, you’ll find a lot of pillows from companies that promise pain relief from conditions like occipital neuralgia. This may also require a bit of trial and error on your part until you’ve found the best match.

In general, though, an ideal type of pillow for occipital neuralgia is one that is:

  • made from either memory foam or latex
  • breathable or cooling
  • washable

In addition to specific sleep positions, there are other steps you can take to make yourself more comfortable at night to encourage better sleep. Consider the following ways you can help promote better sleep hygiene:

  • Try to get at least 7–8 hours of sleep every night.
  • Establish a regular sleep schedule, and stick with it on weekends.
  • Avoid alcohol, large meals, and excess fluids right before bedtime.
  • Limit caffeine intake to mornings only.
  • Avoid nicotine.
  • Turn off your phone, television, and other electronics devices 30 minutes before going to bed.
  • Keep your bedroom dark and at a cool temperature.
  • Try relaxing activities before bedtime, such as gentle stretching, meditation, or a warm bath.
  • Exercise regularly, but avoid working out in the evening hours, since this may disrupt sleep later on.
  • Apply a heat pad or warm compress to your neck for pain relief.
  • Take over-the-counter (OTC) pain relievers for acute pain (on an occasional basis, and only if recommended by a doctor)

If you’re still struggling to get sleep at night from occipital neuralgia, it may be time to contact a doctor for help.

These can be signs that your treatment plan may need adjustment. Treatment options for pain from occipital neuralgia may include:

You should also call a doctor even if you haven’t received a diagnosis of occipital neuralgia but think you may be dealing with possible symptoms at night. Pain from this rare nerve condition often starts in the base of your head, and may spread to your:

  • back part of your head
  • scalp
  • eyes
  • ears
  • forehead

Unlike migraine, the above symptoms aren’t accompanied by sensitivity to light, aura, or nausea.

Along with discussing your symptoms and treatment plan, consider talking with a doctor about the following frequently asked questions regarding sleep and occipital neuralgia.

Can you sleep on your side with occipital neuralgia?

Sleeping on your side may aggravate occipital neuralgia, especially if you experience facial pain. Usually, with this condition one side of your head is affected at a time, though it can sometimes spread to both sides.

But, if you’re normally a side sleeper and find it difficult to sleep on your back, try using pillows that support side sleeping. Placing a pillow between your knees can also promote spinal alignment while sleeping in this position.

What makes occipital neuralgia worse at night?

Occipital neuralgia stems from nerve damage that causes throbbing, burning, and shooting pain through the scalp. When you’re trying to sleep, you aren’t exposed to other stimuli that might otherwise distract you from pain, which can make it more noticeable.

Also, insomnia is a common trigger of headaches, which can partly explain why you might be experiencing worsening occipital neuralgia pain more generally.

There’s currently no cure for occipital neuralgia. Management depends on medications, therapies, and lifestyle adjustments.

Getting enough sleep can also help you manage occipital neuralgia related pain, but it can often be difficult to fall asleep with this condition. The right sleep positions, quality pillows, and good sleep hygiene techniques can all help.

If you still struggle with insomnia despite making these changes, consider seeing a doctor for help.