Why is Neck Pain Worse at Night?

If you suffer from neck pain, you’ve likely noticed it tends to get worse when you’re trying to sleep. The aching and stiffness intensify as you lie in bed, making it difficult to get comfortable and fall asleep. But why does this happen? There are a few key reasons why neck pain tends to act up more severely at night.

One factor is simply gravity. During the day, gravity pulls your head forward and puts strain on the muscles and structures of your neck. But when you lie down, gravity pulls your head to the side or straight back into your pillow. This shifts the pressure points on your neck and places strain on areas that weren’t impacted as much when you were upright. The change in position can aggravate already tender muscles, joints, and nerves.

Your sleeping position or pillow set up may also contribute to the problem. If you sleep in an awkward position that twists or overextends your neck – especially if you have a preexisting neck injury – this can certainly trigger pain during the night. An improper pillow that fails to adequately support your head and neck can do the same thing. As you lie still for hours in an uncomfortable position, the prolonged irritation to tissues and nerves builds up and intensifies.

Another key factor is lack of movement. While sleeping, we tend to lie fairly still for lengths of time compared to how much we change position and move our neck during the day. This stillness causes muscles to tighten up. We also generate less internal body heat while at rest. The combination of immobility and cooling tissue temperature leads muscles to become cramped and inflexible overnight. Then, when you first start moving in the morning, the sudden stretching triggers neck pain.

Lack of distraction plays a role as well. During the day when your neck bothers you, you’re often focused on work, conversation, or other activities instead of the discomfort. But at night when you’re trying to sleep, there’s no distraction from the pain or stiffness, so you notice it much more acutely. Any minor ache can become magnified and frustrating when all you want to do is sleep.

Let’s not forget basic fatigue either. Over the course of a long day, both your body and mind grow tired out. Your nerves may become more sensitive. Localized areas can struggle to effectively receive oxygen-rich blood, which promotes healing. So nighttime is when the accumulative effects of strain, stress, and exhaustion finally catch up with you – and your sore neck suffers for it.

Finally, another potential piece of the puzzle? Your circadian rhythms. There are natural hormonal fluctuations in your body that correspond to times of day and night. Studies suggest that lower levels of cortisol (our primary anti-inflammatory hormone) during the late evening may lead to increased pain perception overnight. Additionally, your body’s natural pain relief responses may dip at night. These circadian variations may work in conjunction with other factors like fatigue, stillness, and awkward positions to further aggravate neck discomfort as you try to sleep.

The next time your neck bothers you more intensely than usual as you’re heading to bed, revisit this list. Identify anything that may be contributing to the problem, then make proper adjustments. Work on fixing your sleeping posture, get a more supportive pillow, take actions to reduce general muscle tension – like stretching before bed, adjusting your workstation setup, or trying therapeutic exercises. Hopefully, with some concentrated effort, you can find some relief and finally get a more restful night’s sleep.