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When Carpal Tunnel Causes Insomnia

Dr Brutus - March 26, 2021

Waking up in the middle of the night may seem common, but it is actually a symptom many patients with Carpal Tunnel Syndrome will experience. Around 80 % of CTS patients complain of waking due to pain and numbness in their hand. 

A person’s sleep impacts their overall quality of life, and CTS can greatly interfere with one’s ability to sleep. On average, adults should strive to get 7 to 9 hours of sleep every night, as recommended by the National Sleep Foundation. If you find that you wake up constantly with the urge to shake out your hand and wrist to relieve your discomfort,  it can also be a sign you may be suffering from Carpal Tunnel. 

How Does Carpal Tunnel Affect Sleep? 

There is little research about how CTS affects sleep and overall health, but one study performed in 2011 revealed promising findings about the true impact. Researchers found that the carpal tunnel patients averaged 5.5 hours of sleep per night. That’s 1.5 hours less than the minimum recommendation of 7 hours per night. 

The study also revealed carpal tunnel symptoms affected the length of time it took patients to fall asleep, the number of times they woke during the night, and the severity of the sleep disturbances. These patients also complained of increased drowsiness during the day. 

Why is Carpal Tunnel Worse at Night?

It is not uncommon for CTS patients to complain of worse symptoms at night rather than during the day. Why? Because when our bodies settle down for the night, the tissue fluid within our muscles is distributed differently without an active muscle pump. This leads to a buildup of fluid and therefore more pressure on the median nerve. There are also several external factors which may worsen a patient’s carpal tunnel symptoms at night: 

Fewer Distractions

The activities and chaos of one’s day may distract them from the pain their carpal tunnel is causing. When you are relaxing and getting ready to sleep, your brain is more likely to tap into that pain because it is no longer focused on outside distractions. Instead of winding down and preparing for sleep, you may be kept awake by your pain. 

Colder temperatures

Colder temperatures are a known agitator for injuries to joints and nerves. This is because damaged nerves interpret cold differently and send out pain signals to the body. Some patients find that the cold agitates their condition even more. 

Improper Sleep Position

Not much is known about the effect of sleep position on carpal tunnel and how they are related. Some research has shown a strong association between sleeping on your side and worsened carpal tunnel symptoms. 

When you sleep on your side, you put pressure on the wrist and hand. Your wrist is also constantly being flexed instead of being put in a neutral position. It is unclear if this can cause carpal tunnel syndrome, but the research strongly suggests that it may agitate the existing condition. 

How Can I Improve My Symptoms?

Physical Therapy

Recent studies have suggested that physical therapy can be a great treatment for carpal tunnel symptoms. Physical therapists may recommend typical stretches and exercises associated with relieving carpal tunnel symptoms, but they can also tailor a routine that will benefit your specific pain the most. As with anything, if you find your pain is not getting better or is getting worse, you should consult your physician immediately. 

Proper Sleep Positions 

Sleep position greatly impacts the rest of your body including the wrists. Two optimal sleep positions to ease pressure are: 

  • -On your back 
  • -Holding a pillow

When you sleep on your back, there is decreased pressure on the cervical spine and therefore less chance of compression throughout the body. To ease more pressure, propping up the legs with a pillow works great. 

Holding a pillow is great for those who really find the most comfort sleeping on their sides. A pillow is a great way to stabilize your position and prevent you from moving around too much, which can put pressure on your nerves. It will also prevent you from putting pressure directly on your wrist if you normally use it to prop your head up. 

Wrist splints

Wrist splints are an effective but not permanent way to treat carpal tunnel symptoms. Splinting keeps the wrist in a stable position and prevents it from flexing. While wrist splints may be worn during the day, Dr. Brutus only recommends wearing one at night, and for a maximum of 4-6 weeks, to get the best possible effect. 

OTC Relief

Anti-inflammatories such as ibuprofen may help patients sleep, especially when taken right before bed. Over the counter drugs should not be taken for more than a few days. You should also consult your physician to ensure they will not interact with any other medications you may be taking.

Vitamins such as magnesium and B6 may provide relief from carpal tunnel symptoms. These should only be taken if you have a deficiency. Your doctor can order a blood test to determine if you should be taking these vitamins.  


Surgery is the only way to permanently treat carpal tunnel. There are two types of surgery, both of which can be discussed with your physician. A study performed in 2018 showed that patients who had successful carpal tunnel surgery found immediate and lasting improvements to their quality of sleep. 


Final Thoughts: Carpal Tunnel and Insomnia

Research has shown a strong association between carpal tunnel and insomnia, but not much is known beyond this. Studies are still being conducted but they have all shown that decreasing pressure on the median nerve is the only way to relieve symptoms. 

There are several factors which may lead to worsened symptoms at night but there are also ways to combat this. Prolonged numbness and pain may be a sign of permanent nerve damage. You should consult a physician if you find no relief in any treatments.

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