Cervical radiculopathy occurs when a nerve root in the cervical spine (neck region) becomes compressed, irritated, or inflamed, leading to symptoms like pain, numbness, and tingling that can radiate down the arm. Sleep can be significantly impacted by cervical radiculopathy, as certain positions can exacerbate symptoms while others can help alleviate discomfort and promote healing. Below, we’ll discuss how to sleep with cervical radiculopathy, the best sleeping positions, and the relationship between cervical radiculopathy and sleep apnea.

How to Sleep with Cervical Radiculopathy

• Choose a Supportive Pillow: A proper pillow is essential to maintain alignment in the neck and prevent aggravating nerve compression. Opt for a contoured pillow or a cervical pillow that supports the natural curve of the neck. Avoid overly soft or high pillows that can cause your neck to bend unnaturally.
• Maintain Neutral Spine Alignment: When lying down, it’s important to keep the spine in a neutral position, meaning the neck should not be excessively bent forward, backwards, or to the sides. This helps reduce pressure on the nerve roots.
• Avoid Sleeping on Your Stomach: Sleeping on your stomach can force your neck to twist to one side, which can increase compression on the cervical spine and exacerbate symptoms of radiculopathy. It’s best to sleep on your back or side instead.
• Use a Cervical Collar (if prescribed): Some individuals with cervical radiculopathy benefit from wearing a soft cervical collar while sleeping, which helps stabilize the neck and prevent awkward movements that might worsen the condition during sleep.

Cervical Radiculopathy and Sleep Apnea

• Sleep Apnea is a condition where breathing repeatedly stops and starts during sleep, and it can sometimes co-exist with cervical radiculopathy. The relationship between the two can be complex, but here’s how they may interact:
  • Neck Position and Airway Obstruction: People with cervical radiculopathy may experience discomfort or pain from neck movement during sleep, which could influence the position of their airway, potentially contributing to sleep apnea symptoms.
  • Pain and Sleep Disruption: The pain and discomfort caused by cervical radiculopathy can lead to restless sleep, increasing the likelihood of fragmented sleep, which may worsen symptoms of sleep apnea.
  • Treatment Considerations: Those with both cervical radiculopathy and sleep apnea should work with their healthcare provider to determine an appropriate treatment plan. This may include the use of CPAP machines (Continuous Positive Airway Pressure) for sleep apnea and neck pain management strategies to improve sleep quality.

Best Sleeping Position for Cervical Radiculopathy

• Back Sleeping (Supine Position): Sleeping on your back with a pillow that supports the natural curve of the neck is generally the best position for individuals with cervical radiculopathy. In this position:
  • The head and neck remain aligned with the spine.
  • A supportive pillow can help maintain proper neck alignment, reducing pressure on the nerve roots.
  • Consider placing a small pillow or rolled towel under the neck for added support if using a flat pillow.
• Side Sleeping: Sleeping on your side can also be beneficial for those with cervical radiculopathy, but it’s important to:
  • Use a pillow that keeps the head in a neutral position (not too high or low).
  • Ensure that the pillow supports the neck’s curve without tilting the head downward or upward.
  • If the pain is on one side, alternate sleeping sides to avoid putting constant pressure on the affected nerve root.

Cervical Radiculopathy Sleeping Position

• Neck Support: The most important factor for proper sleep with cervical radiculopathy is ensuring that the neck remains supported and aligned with the spine throughout the night. Here are some tips for achieving optimal neck support:
  • Back Sleepers: Use a cervical pillow or a pillow with a contour that supports the neck’s natural curve. Avoid pillows that are too thick or thin, which can cause the neck to bend unnaturally.
  • Side Sleepers: Choose a pillow that fills the space between the neck and the mattress, keeping the head level with the spine. You may want to use an orthopaedic pillow designed specifically for side sleepers.
  • Avoiding Neck Strain: Keep your neck in a neutral position while sleeping, and avoid tucking your chin too much or letting your neck extend too far backwards, as this can aggravate the nerve compression.

Conclusion

Sleeping with cervical radiculopathy requires attention to the position of your neck to avoid aggravating nerve compression. Choosing the right pillow, maintaining neutral spine alignment, and avoiding stomach sleeping are essential steps to alleviate symptoms and promote healing. Those with both cervical radiculopathy and sleep apnea may need additional adjustments to their sleep environment or treatment plans to manage both conditions effectively. A healthcare provider can offer personalized guidance on improving sleep quality and relieving pain from cervical radiculopathy.

References

1. Spine-Health, 2022. How to Sleep with Cervical Radiculopathy. Available at: https://www.spine-health.com/conditions/neck-pain/how-to-sleep-with-cervical-radiculopathy [Accessed 16 February 2025].
2. American Academy of Sleep Medicine (AASM), 2020. Sleep Apnea and Cervical Spine Issues: What You Need to Know. Available at: https://www.sleepeducation.org/essentials-in-sleep-apnea [Accessed 16 February 2025].
3. National Institute of Neurological Disorders and Stroke (NINDS), 2021. Cervical Radiculopathy. Available at: https://www.ninds.nih.gov/health-information/disorders/cervical-radiculopathy [Accessed 16 February 2025].