<s>[INST] Hi -51 year old male when sleeping I wake with central chest pain but not all the time,get up and lay down on the couch which is more firm and it gets much better,lately when turning head to right seem to get central chest pain but not when turning left-no pains or numbness down arms-could this be muscular issues or a combination of things [/INST] Thanks for your question on Chat Doctor. I can understand your concern. Possibility of musculoskeletal pain is more in your case. Your pain is associated with movements. This is characteristic feature of musculoskeletal pain. So follow these steps for better symptomatic relief. 1. Avoid heavyweight lifting and strenuous exercise. 2. Avoid bad postures in sleep. 3. Avoid movements causing pain. 4. Start painkiller and muscle relaxant Chat Doctor.  5. Apply warm water pad on affected areas. Don't worry, you will be alright. Hope I have solved your query. Wish you good health. Thanks. </s>