At some point, we've all woken up from a deep sleep to discover a numb hand. Occasional numbness or pins and needles is normal. While numb hands can occur from anxiety or too much caffeine, it usually occurs when you snooze in a strange position that cuts off circulation and causes your hand to "fall asleep."
But if you tend to feel your hands falling asleep at night, or tingling and numbness in your fingers more frequently upon waking, you may be dealing with a larger issue.
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We spoke to two neurologists to understand why you may lose sensation in your hand when sleeping and what you can do to tone down the tingling and numbness.
When should you worry about hand numbness? If you experience persistent hand numbness along with any of the following symptoms, seek medical attention right away, says Nitin Butala, MD, a neurologist in Jacksonville, Florida:
- Numbness that lasts into the day
- Numbness across the body, not just in your hands
- Muscle weakness
- Clumsiness in your hands or fingers
- Sudden weakness or dizziness
- Pain in the arms and legs that won’t go away
- Any other new neurological symptoms (vision changes, muscle twitches, gait instability, pain, urinary or bowel incontinence, etc.)
1. You Sleep on Your Stomach or Side
If you sleep on your stomach, you may rest your hands underneath your head, causing them to lose feeling. Similarly, if you sleep on your side, you may tend to bend your arms and wrists in a way that restricts blood flow.
2. You Have Carpal Tunnel Syndrome
Your numb, tingly fingers at night may be related to a condition called carpal tunnel syndrome.
"Numbness in the thumb and first finger (and frequently the middle finger) is commonly due to compression of the median nerve in the 'carpal tunnel,' a narrow passageway composed of ligaments and bones on the palmar side of the hand," says neurologist Eva Feldman, MD, PhD, director of the NeuroNetwork for Emerging Therapies at the University of Michigan.
This nerve compression occurs when something repeatedly squeezes, puts pressure on or irritates the median nerve, per the Mayo Clinic. Any repetitive movement that involves frequent flexing of the wrist (think: using a mouse or other handheld tools nine hours a day) can cause or contribute to problems in the carpal tunnel space.
"Numbness usually is accompanied by tingling, and, in extreme cases, weakness of the thumb and fingers," Dr. Feldman says.
Fix it: While taking active pauses to stretch your hands and wrists throughout the day may help with the numbness, you may need to see your doctor to manage carpal tunnel tingling.
“Treatment includes using neutral wrist splints to keep the wrist from bending, along with steroid injections and, if required, a surgery to release the nerve in the tunnel,” Dr. Feldman says.
Most people with hand numbness usually experience symptoms in one hand to a much greater extent than the other hand, Dr. Feldman says.
3. You Have Another Compressed or Damaged Nerve
In addition to the median nerve, other nerves — when compressed or damaged — can lead to a lack of feeling in your hands and fingers too.
Indeed, the second most common cause of numbness in one hand is compression of the ulnar nerve (which runs from the elbow area to the fingers), Dr. Feldman says. This can happen if you put too much pressure on your elbow or your wrist while sleeping, according to the Sleep Foundation.
"In this case, numbness occurs in the little and ring fingers and sometimes the middle finger," Dr. Feldman says.
Though rarer, radial nerve damage can also trigger numbness. Your radial nerve — which extends from your upper arm to your forearm and wrist — can become compressed when you sleep in a position that places extreme pressure on your upper arm, Dr. Feldman says. Improper use of crutches can also constrict the radial nerve, she adds.
When the radial nerve is compressed or damaged, "a person can experience abnormal sensation on the back of the hand or in the thumb, and, in more severe cases, there is the loss of the ability to straighten your fingers or bend back your wrist," Dr. Feldman says.
Fix it: Sometimes, simply training yourself to sleep in a different position — that doesn’t put pressure or strain on your arm — can be enough to resolve the problem, according to the Sleep Foundation.
For instance, if your hands go numb while sleeping on your side, avoid lying directly on your arms and flexing the wrists, Dr. Butala says. Likewise, back sleepers should stop snoozing with their arms overhead. “Try keeping them next to you to reduce nerve pinching,” he says.
But if adjusting your sleep posture doesn’t do the trick, treatment may include supportive care with splinting at the wrist or elbow, Dr. Feldman says.
In more severe cases, a surgical intervention to release the nerve may be necessary, she adds.
4. You Have Cervical Spondylosis
Lack of feeling in your fingers may be a sign of cervical spondylosis, a condition characterized by the normal wear and tear of spinal disks in the neck that occurs with aging, according to the Mayo Clinic. Indeed, cervical spondylosis affects 85 percent of people older than 60.
While many people won't show symptoms, others will experience pain and stiffness in the neck as well as tingling, numbness and weakness in the arms, hands, legs or feet, per the Mayo Clinic. That's because cervical spondylosis can increase the pressure on your spinal cord and result in pinched nerves.
Other symptoms include lack of coordination, difficulty walking and loss of bladder or bowel control, according to the Mayo Clinic.
Fix it: If you have any of these symptoms, see your doctor, who can help properly assess and diagnose you. Depending on the severity of your symptoms, your doctor may prescribe medications such as nonsteroidal anti-inflammatory drugs, corticosteroids or even anti-seizure medicines and antidepressants, which can help relieve pain and inflammation, per the Mayo Clinic.
In addition, physical therapy, where you’ll learn exercises to stretch and strengthen the muscles in your neck and shoulders, can be helpful for managing cervical spondylosis.
But if numbness and tingling in your limbs persist, you may need surgery to make more space for your spinal cord and nerve roots, according to the Mayo Clinic.
5. You Have Diabetic Neuropathy
If you have diabetes, you may experience neuropathy, or nerve damage, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).
"People with diabetes, either type 1 or type 2, are more susceptible to compression neuropathies," Dr. Feldman says. That's because certain diseases like diabetes boost your risk of nerve damage, including injury to your median nerve, according to the Mayo Clinic.
This may cause you to feel hand numbness upon waking, or during sleep.
Fix it: While you can take vitamins for nerve damage, this is only a preventative. In fact, there is no guaranteed method to reverse nerve damage, especially if the damage is severe. Instead, you'll need to talk to your doctor about how to prevent further damage and manage your symptoms.
Treatments to help manage symptoms include over-the-counter pain medication, antidepressants, topical creams and sprays that have lidocaine. You can also wear a splint or brace.
To prevent further damage or complications of neuropathy, check your skin regularly for changes — this can help you avoid ulcers, wounds or infections. You should also talk to a diabetes expert about your exercise routine, as some physical activities aren't safe when you have neuropathy, according to the American Diabetes Association.
6. You Have Thoracic Outlet Syndrome
Sometimes numb hands are a symptom of a rare disorder called thoracic outlet syndrome. This condition occurs when the blood vessels or nerves that lie in the area between your first rib and your collarbone become compressed, Dr. Feldman says.
"Most cases of thoracic outlet syndrome are caused by whiplash or other neck trauma," Dr. Butala says. "Sometimes the disorder is caused by repetitive motions or, less commonly, by having an [anatomical defect such as an] extra rib," he adds.
There are several types of thoracic outlet syndrome, so symptoms can vary, depending on which nerves or blood vessels are compressed. In addition to numbness or tingling in your fingers, some signs may include (among others), per the Mayo Clinic.
- Pain or aches in your neck, shoulder or hand
- Weakening grip
- Discoloration or lack of color in your fingers or your hand
- Arm pain and swelling
- Weak or no pulse in the affected arm
- Cold fingers, hands or arms
- Arm fatigue with activity
- Weakness of arm or neck
- Throbbing lump near your collarbone
Fix it: Always consult a doctor about these symptoms, Dr. Feldman says. Your doctor may prescribe anti-inflammatory drugs, pain medications or muscle relaxants to reduce pain and inflammation.
Physical therapy can also be an effective treatment. Performing exercises that strengthen and stretch your shoulder muscles can help open the thoracic outlet, and, as a result, reduce the pressure on your blood vessels and nerves, according to the Mayo Clinic.
7. It's Your Medication
Certain drugs can affect your nerves and cause tingling or pins and needles in the hands or other body parts, according to the National Library of Medicine. It's more common that many nerves are involved, but the hands may be one of the first body parts affected.
Medications that can lead to this kind of neuropathy include:
- Some heart or blood pressure drugs
- Infection-fighting medications such as chloroquine and thalidomide
- Drugs that fight autoimmune diseases, including Arava, Enbrel and Remicade
- Some anti-seizure meds
- Medications for HIV/AIDS
- Drugs for alcohol use
- Colchicine, which treats gout
Fix it: If you suspect your numb hands are a side effect of your medication, talk to your doctor about whether you should adjust your dosage or try a different medication altogether.
8. You Have Another Underlying Health Condition
Numb hands while sleeping can also be a side effect of another more serious chronic health issue. According to the Mayo Clinic and National Library of Medicine, these can include:
- Rheumatoid arthritis
- Multiple sclerosis (MS)
- Vitamin B deficiency
- An infection, such as HIV, shingles or Lyme disease
Hand numbness can also be a result of alcohol use disorder (a side effect called alcoholic neuropathy, according to the National Library of Medicine).
Fix it: Again, talk to your doctor, who can help identify any underlying issues that may be causing your hand numbness. Often, by treating the root cause, you can get rid of (or reduce) the numbness and tingling in your fingertips.
How to Prevent Hands Falling Asleep at Night
If you have ruled out the above causes with your doctor and still experience numb hands at night, there are certain things you can do to improve circulation in your hands while sleeping.
These include, per the National Sleep Foundation:
- Trying a new sleep position
- Avoiding laying on your arms under your pillow
- Stretching your hands and wrists before sleeping
- Wearing a wrist brace to bed
If the numbness and tingling is affecting your daily routine, you can also try working with a physical therapist, who can assign exercises to help reduce your symptoms.
- Sleep Foundation: “Numbness in Hands While Sleeping: Why It Happens and What It Means”
- Mayo Clinic: “Carpal Tunnel Syndrome”
- Mayo Clinic: “Cervical spondylosis”
- Mayo Clinic: “Thoracic outlet syndrome”
- National Institute of Diabetes and Digestive and Kidney Diseases: "What Is Diabetic Neuropathy?"
- National Library of Medicine: "Alcoholic Neuropathy"
- National Library of Medicine: "Numbness and Tingling"
- National Library of Medicine: "Neuropathy Secondary to Drugs"
- American Diabetes Association: "Steps to Prevent or Delay Nerve Damage"
Is this an emergency? If you are experiencing serious medical symptoms, please see the National Library of Medicine’s list of signs you need emergency medical attention or call 911.