Best way to sleep with occipital neuralgia: 5 proven tips

Best way to sleep with occipital neuralgia

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Trying to sleep with occipital neuralgia?

Finding the best way to sleep with occipital neuralgia takes time and lots of trial and error. If you’re new to this painful condition or researching it for someone else, don’t worry… it is absolutely possible to reduce occipital pain significantly with some simple changes. We’ve spent years living and sleeping with this condition, purchasing anything that promised pain relief. Experience has taught us, however, that no matter where you are in the World, the two things you can do almost immediately that will have the most significant impact are changing your pillow and using a self-massager.

We wish we knew this 25yrs ago, as it would have saved us thousands of restless, painful nights. Trying to sleep doesn’t have to be a waking nightmare, look at our extremely popular sleeping with sciatica fix for example.

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What can cause Occipital Neuralgia?

The first thing to understand is that Occipital Neuralgia is not a migraine or typical headache. There are many potential causes, and identifying the root cause can help you develop a suitable treatment plan and discover your best way to sleep with occipital neuralgia. Potential causes may include some of the following:

  • Back of the head injuries
  • Neck muscles that are tight (very common)
  • Sleeping funny on your neck (very common)
  • Poor posture when using electronic devices (text neck, very common)
  • Cervical disc degeneration
  • Osteoarthritis
  • Inflammation of blood vessels
  • Conditions like diabetes or gout
  • Infections
  • Repetitive injuries like repeatedly bending the head forward or down at an odd angle
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You’ve got a nerve

The nerves can be injured directly, or pressure applied to the nerves due to tense muscles or inflammation. Occipital neuralgia pain is different from migraine pain. Sufferers often say it feels like two thumbs pressing hard into the base of your skull, sending horrible electric shock-type sensations upward and into the eye with a constant, pulsing heavy pain around the head. This is exactly how it feels for us. As you can see from the diagram below, there are many nerves that can become inflamed or compressed from surrounding muscles.

When you look at your occipital nerves in this way, you can see that relaxing your muscles and supporting your neck correctly in sleeping is of the utmost importance.

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The best way to sleep with occipital neuralgia

After suffering many years of sleepless, painful nights with this condition, we can say in all honesty that finding the right bed and pillow changed everything for us in terms of pain relief and subsequently had the biggest impact on quality of life. Changing your bed and pillow sounds simple right? It is, but not if you keep buying the wrong bed and pillows as we did! The right bed and pillow combination gives you the best chance of waking pain-free.

Is this your typical night in bed?

Have you got bed head?

We can’t discuss pillows before first mentioning your bed, it is the foundation of sleep. The quick quiz below was developed by Marc Werner, the CEO of Ghostbed. If there was ever a person who knew about neck pain and sleeping it’s Marc. After THREE neck surgeries he invented his own bed… because he couldn’t find one to help with his own pain. Now Marc is dedicated to helping fellow back, sciatica, neck and hip pain sufferers.

If you’d like to know which bed matches your specific pain, simply click below and it will take you to their website in a new window. Sleep experts are also on-hand for advice. Well worth a few minutes of anyone’s time.

Pillows for sleeping with Occipital Neuralgia

Occipital neuralgia pain can have a devastating effect on your sleep. With the base of your skull throbbing, a tender scalp, and pain shooting behind the eyes, getting a good night’s sleep is next to impossible… and let’s be honest, that is soul-destroying. If that’s not bad enough, we can amplify the pain by sleeping in the wrong position or by sleeping funny on our necks. For us at backpainsleep, sitting up in bed with a laptop or sleeping with bad neck posture and support is our number one trigger. Finding the best way to sleep with occipital neuralgia, or any neck pain for that matter, starts with your pillow; it can literally make or break you.

We’ve bought and tested many pillows for nearly 30yrs and can genuinely recommend the Therapeutica Pillow as our most used for flare-ups and preventing episodes of occipital neuralgia. Trying to find a position that doesn’t aggravate already inflamed nerves… especially when you’re exhausted, is a waking nightmare; investing in a dedicated pillow if you’re suffering can be the key to occipital pain relief, it also takes the guess-work out of finding a position for a painful neck.

Of course, pillows are very personal… especially when it comes to pain. What works for one may not work for another. Many people are now investing in adjustable pillows because they can increase/decrease the loft and firmness as required, we swap between the Therapeutica and an adjustable shredded and find the combination of the two serves us well. Below are our best-rated pillows that are worth exploring.

Our pillow of choice for Occipital Neuralgia


best way to sleep with occipital neuralgia
The perfect pillow for occipital neuralgia

So how do you try and sleep with occipital neuralgia flare-ups and find a position that doesn’t feel like someone is kneeling on the base of your skull?

Here are some essential tips:

  • Try and sleep on your back if you can
  • Use a pillow that supports the neck and keeps your head aligned with your body
  • DON’T sleep with your neck at an odd angle as it places more pressure on the nerves
  • If you’re a side sleeperthis pillow is dedicated to relieving pressure.
  • Please, please, pleeeassssee don’t sleep on your stomach.

Massage can feel like a miracle. 

Occipital neuralgia responds really, really well to massage. Tight, tense neck muscles apply constant pressure to your occipital nerves. The benefits of massage can’t be stressed enough, and the fact that we can administer this ourselves is a bonus. Yes, the ideal massage would be from a professional therapist, and if you can do (and afford) this regularly, then go for it. But what happens at 2 am when you’re in agony, sleep-deprived, and the walls are closing in on that dark, mentally destroying place we’re all familiar with?

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An excellent massager, perfect for:



Administering self-massage is ideal because we can do it when we want and where we want… and repeat when necessary. We know exactly where our suboccipital muscle trigger points are, so who better to place a dedicated massager on them? Yup.

We’ve invested and tested more massagers than you can shake a stick at on our life-long quest for pain relief and have fine-tuned them; you can view them here along with some other products we use on a regular basis.

Why is massage so good for Occipital neuralgia?

With massage, we can focus on our suboccipital muscle triggers, located below the occipital bone that makes up the skull base, and the suboccipital nerves supply these muscles. We can also use self-massage (with our hands) to work around our jaw muscles because suboccipital muscles are balanced and tethered toβ€”more on that in an upcoming post.

If you can see a professional therapist, that’s perfect, but having the convenience to massage at a moment’s notice is priceless. Massage is also fantastic for tension headache relief.

Gentle Exercises

You can read about some very simple exercises in a previous post here. A few minutes a day can make a big difference and help you manage your Occipital Neuralgia pain; it’s just about being consistent. Set a daily reminder on your phone.

Pain Relief Lotions

Some gels, creams, and lotions can help relieve occipital neuralgia pain and are available over-the-counter and prescription. Topical medications are simple to use by applying a thin layer to the target area and gently massaging in. Creams containing xylocaine, lidocaine, or prilocaine are mild local anesthetics and can help take the edge off if you’re having a distressing night; always talk to a medical professional before using these types of lotions, of course. CBD Topicals with Lidocaine are well worth looking at; you can review them here.

Talk honestly with your Doctor.

As Occipital Neuralgia sufferers know, the pain can be unbearable and test your mental health in the dead of night. If self-help methods aren’t working for you, speak to your doctor, who can advise about other treatments that can help you get control of this awful condition. Don’t suffer in silence, ever.

Last prices update on 2024-01-02

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