Nighttime Compression Garments for Lymphedema

How It Differs from Daytime Garments and Common Nighttime Options

Compression garments are a common part of lymphedema management, but not all compression is designed to do the same job. One of the most common sources of confusion I see in clinical practice is the difference between daytime compression and nighttime compression, and when each is appropriate.

Understanding this distinction is essential for safety, comfort, and long-term effectiveness.

Daytime vs. Nighttime Compression: What’s the Difference?

Daytime compression garments are designed to contain swelling while you are upright and moving through your day. Their primary role is to help maintain the limb or region at roughly the size it is when you wake up, limiting further fluid accumulation as gravity, activity, and posture come into play.

Nighttime compression serves a different purpose. These garments are designed to support the body’s natural processes during rest, with the goal of encouraging a reduction in swelling or softening of tissue while you may be less active or lying down. Because of this, nighttime garments are constructed differently and are bulkier than daytime garments.

It is important to note that some nighttime compression garments may be worn for extended periods, including daytime use, when clinically appropriate, but daytime compression garments are not intended for overnight use (i.e., while sleeping). When worn during sleep, daytime garments may create uneven pressure or constriction and can contribute to additional lymphatic challenges.

Compression Is Not One-Size-Fits-All

Compression garments exist, or can be made, for nearly every area of the body, including:

• Upper and lower extremities

• Flank and breast

• Abdomen

• Pelvis

• Head and neck

There are many off-the-rack (ready-to-wear) options available, particularly for the arms and legs, as well as compression bras designed for chest and breast support. In many cases, these are sufficient. However, some individuals may require custom or semi-custom garments to ensure appropriate compression, comfort, and safety.

Areas with greater variability in contour or tissue presentation - such as the head and neck or more complex presentations - may sometimes benefit from a customized approach. In these situations, working closely with a certified lymphedema therapist and an experienced DME fitter helps ensure that the garment is both effective and well tolerated.

A properly fitted garment matters. Ill-fitting compression can be ineffective at best and problematic at worst.

A Note on Safety

If you believe you may need compression, it’s always important to consult with a certified lymphedema therapist and your medical team before starting or changing garments. There are situations where compression is not appropriate, or where certain types of compression may pose risks.

Safety should always come first.

The Gold Standard: Short-Stretch Bandaging

Short-stretch, multi-layer bandaging - one of the pillars of Complete Decongestive Therapy (CDT) - remains the gold standard for both daytime and nighttime compression when reduction is the primary goal. When applied correctly and consistently, it is highly effective.

However, not everyone can tolerate bandaging, apply it independently, or has access to assistance. In these cases, nighttime compression garments may be a helpful alternative or supplement.

Common Types of Nighttime Compression Garments

There is no single “best” nighttime garment. Options vary widely, and what works well for one person may not work for another. Common types of nighttime garments include:

Quilted or channeled garments
Often pull-on styles with internal channeling that helps guide fluid movement. These are frequently used for maintenance and comfort and are often well tolerated during sleep. They often have a compression over-sleeve worn over the main garment. Some designs also incorporate Velcro-based components, creating hybrid options.

Velcro-based garments
These allow for adjustability and can be particularly useful for individuals who need more control over compression levels or who experience fluctuations in swelling. Some designs have overlapping “arms” to provide compression similar to how multi-layered short-stretch bandages are applied.

Foam-based or hybrid garments
Garments with built-in foam chips or textured materials may help soften fibrotic tissue and support fluid movement. These are often used when tissue stiffness or fibrosis is a concern.

In many cases, people use different garments at different times, depending on their symptoms, tolerance, and goals.

The Most Important Factor: Consistency

In practice, the most effective nighttime compression garment is often the well-fitting one you can - and will - use consistently. Comfort, ease of application, and how a garment fits into your life matter just as much as its technical features.

Individual needs vary, and garment selection should always be guided by clinical input and personal experience.

Final Thoughts

Nighttime compression can be a valuable part of lymphedema care when used appropriately. Understanding how it differs from daytime compression, and knowing that options exist for nearly every body area, can help you make informed decisions in collaboration with your care team.

If you’d like to see examples of common nighttime compression garments and hear more about how they differ from daytime options, you can watch our video in the Videos section of our website.

This article reflects the clinical perspective of Rebecca Smith, LMT, Certified Lymphedema Therapist, and was developed as part of BCMT’s clinical education library.