Sleep can be challenging when you are struggling with Thoracic Outlet Syndrome (TOS). Finding a position of comfort can be difficult.
Thoracic Outlet Syndrome (TOS) is a condition characterised by nerves and/or blood vessels being compressed within the Thoracic Outlet. This leads to symptoms such as pain, pins and needles, numbness or weakness in the arm.
Understanding TOS
TOS can be caused by a variety of reasons including poor posture, muscle imbalances and anatomical abnormalities.
For a full understanding of the condition, including common symptoms and how to treat it read my article here: Thoracic Outlet Syndrome Tips for Management and Relief
The Ultimate sleeping position
The Thoracic Outlet is a narrow area between the first rib and the collarbone. It is occupied by nerves, blood vessels and muscles. The symptoms arising from compression of the structures within the thoracic outlet can often be exacerbated by poor or inefficient sleeping postures.
The best sleeping position is firstly one that keeps the space between the clavicle and the first rib as open as possible and secondly puts the nerves and blood vessels in the thoracic outlet in the position of least tension.
If your symptoms are being aggravated at night in bed, I recommend the following sleeping position:
Technique
1. Lie on your “Good Side”
This reduces the compression on the affected Thoracic Outlet. Support your head with firm pillows. Arrange the pillow(s) so that your neck is in slight ipsilateral flexion (tilted slightly towards the affected shoulder).
2. Elevate your Shoulder
Lifting your shoulder towards your ear elevates the clavicle and widens the Thoracic Outlet.
3. Protract your Shoulder
With the shoulder elevated now protract the shoulder. This is the process of moving the scapula away from the spine. This is another technique that raises the clavicle.
With the shoulder elevated and protracted, support the arm on a pillow to maintain the position.
4. Bend the Knees and Hips
Bend your hips and knees to approximately 90 degrees, this will help to stabilise your upper body
5. Breathing techniques
We can use breathing techniques to influence the first rib. Once you have set yourself up in the above ultimate sleeping position you should try this breathing technique to stabilise and even lower the first rib.
– Breathe in through your nose for 2 seconds
– Breathe out through your mouth for 4 seconds
– Continue for 1-2 minutes
If you find this cycle helpful you can repeat it several times
The Ultimate sleeping position
The Thoracic Outlet is a narrow area between the first rib and the collarbone. It is occupied by nerves, blood vessels and muscles. The symptoms arising from compression of the structures within the thoracic outlet can often be exacerbated by poor or inefficient sleeping postures.
The best sleeping position is firstly one that keeps the space between the clavicle and the first rib as open as possible and secondly puts the nerves and blood vessels in the thoracic outlet in the position of least tension.
If your symptoms are being aggravated at night in bed, I recommend the following sleeping position:
Technique
1. Lie on your “Good Side”
This reduces the compression on the affected Thoracic Outlet. Support your head with firm pillows. Arrange the pillow(s) so that your neck is in slight ipsilateral flexion (tilted slightly towards the affected shoulder).
2. Elevate your Shoulder
Lifting your shoulder towards your ear elevates the clavicle and widens the Thoracic Outlet.
3. Protract your Shoulder
With the shoulder elevated now protract the shoulder. This is the process of moving the scapula away from the spine. This is another technique that raises the clavicle.
With the shoulder elevated and protracted, support the arm on a pillow to maintain the position.
4. Bend the Knees and Hips
Bend your hips and knees to approximately 90 degrees, this will help to stabilise your upper body
5. Breathing techniques
Check out my full article on breathing techniques here for my complete strategy.
We can use breathing techniques to influence the first rib. Once you have set yourself up in the above ultimate sleeping position you should try this breathing technique to stabilise and even lower the first rib.
– Breathe in through your nose for 2 seconds
– Breathe out through your mouth for 4 seconds
– Continue for 5 minutes
If you find this cycle helpful you can repeat it several times
- Alternative sleeping positions
- Use a flat pillow that supports your head and your neck.
- Place a small pillow under your knees if you feel any tension in your lower back.
- Place a pillow under your affected arm to lift it off the bed and to reduce the pressure on the Thoracic Outlet.
