how do you specify left or right wrist?

You don’t have to. It fits either wrist. I use it on both of my wrists when needed. How this helps

can I wear while sleeping?

I do. I put the ice in before I go to bed and it gradually melts. Sometime during the night I remove the gel pack an re-wrap the wrist guard without it. It helps to stabilize my wrist so I don't make any awkward movements during the night.

Wrist/Hand Hot & Cold Wrap

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