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Key Takeaways
  • Numbness in hands while sleeping is usually caused by nerve compression or damage.
  • Adjusting your sleeping position can alleviate pressure on your hands and wrists.
  • Side sleeping is considered the least likely to produce hand numbness.
  • Consult your doctor if numbness or tingling persists to rule out any other issues.

Have you ever woken in the night to find that your hand has gone numb or “fallen asleep”? If so, you’re not alone. About a third of adults wake up at least once a week with numbness or tingling in their arms, wrists, or hands—a phenomenon known as nocturnal paresthesias.

For most people, waking up with numb hands once in a while is not cause for concern. However, if your symptoms greatly interfere with sleep or persist after you are up and moving, it may be time to see a doctor.

Illustration of woman sleeping on arm.

What Typically Causes Hand Numbness?

Numbness—and the tingling or “pins and needles” feeling that often accompany it—is usually the result of nerve compression, nerve damage, or another problem that interferes with the nervous system.

If you wake up with hand numbness, your body is sending you a message. It’s important to figure out what’s causing the numbness so that you can take action to relieve your discomfort and protect your nervous system.

Sleeping Position

Certain sleeping positions can compress nerves in the hand, wrist, arm, or elbow, producing numbness and tingling. Additionally, some positions can cut off or reduce blood flow to the hands, causing the nerves in that area to temporarily stop sending signals.

You’re more likely to experience nerve compression or lack of blood flow that leads to hand numbness if you sleep with your:

  • Wrists curled inward
  • Hands under your face or head
  • Head on your forearm
  • Torso on top of your arm
  • Head on a pillow that causes misalignment of the spine

Stomach sleeping has been associated with nerve compression, and while the research on side sleeping is mixed, some experts say this position is least likely to produce hand numbness, as long as your wrists are straight.

Is Your Sleep a Problem?

While numbness in your hands is generally caused by the position you sleep in, disrupted sleep in general is often a result of deeper sleep-related issues. Answer three questions to understand if you should be concerned.

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Carpal Tunnel Syndrome

Carpal tunnel syndrome is a very common nerve injury that causes numbness, tingling, and pain in the wrist, thumb, index finger, and middle finger. It occurs when tendons in the wrist become inflamed and compress the median nerve. People with carpal tunnel syndrome often find that their symptoms get worse at night and that they experience relief when they shake their hands.

Injuries can cause carpal tunnel syndrome, but it may also develop as a result of activities that require repetitive movements of the hand and wrist, such as working on an assembly line, knitting, or playing golf. Additionally, people with the following medical conditions are particularly vulnerable to carpal tunnel syndrome:

Peripheral Neuropathy

Peripheral nerves allow your body and brain to communicate with each other, and if something damages those nerves, you might experience tingling, burning, or numbness in your extremities. This condition is called peripheral neuropathy.

Potential causes of peripheral neuropathy include diabetes, infections, autoimmune disorders, vitamin deficiencies, side effects from medications, alcohol use disorder, and exposure to toxins.

Lack of Blood Supply

When an area of your body doesn’t receive enough blood, the nerves there stop functioning properly, causing numbness and tingling sensations. 

Restricted blood flow can be the result of body positioning—such as sleeping on your arm or hand. The resulting sensations are meant to get you to move into a position that restores normal circulation.

However, some medical conditions can cause chronic circulatory problems that make hand numbness an ongoing issue. These conditions include:

  • Plaque buildup in the arteries
  • Blood vessel inflammation
  • Raynaud disease 
  • Damage caused by frostbite

Injuries

Some injuries can damage nerves, causing numbness in the hands. Wrist injuries, for example, can lead to carpal tunnel syndrome, but injuries as far away as the neck can also affect nerve function in the hands. If you’ve experienced whiplash in a car accident or injured your elbow in a fall, that could be the source of your nighttime hand numbness.

Numbness, Tingling, Pain – How to Make it Stop

Depending on the cause, you may be able to reduce numbness in your hands while sleeping a few ways. First, it may help to have a pillow and mattress that are supportive yet soft, so pressure points are less likely to develop in your neck or shoulders. Supporting the neck and spine is an important step to getting good rest. You can also try the following:

  • Wear a wrist brace to bed to help stabilize your wrist during sleep.
  • Try a new sleeping position, particularly on your side.
  • Avoid any sleeping positions that put pressure on the hands or arms. 
  • Avoid laying on your arms under your pillow, which can compress nerves.
  • Make sure your wrists remain unflexed, since flexing can lead to tingling.
  • If you often sleep on your back with your arms overhead, try keeping them next to you to reduce nerve pinching.
  • Try stretching your hands and wrists before going to sleep.

If these efforts do not relieve your symptoms, it’s important to talk to a doctor to rule out any other underlying disorders.

“Don’t sleep on your sleep problems.”
Headshot of Dr. Abhinav Singh
Dr. Abhinav Singh
Sleep Medicine Physician, MD

When to Talk to Your Doctor

Sometimes hand numbness is a symptom of a more serious medical condition. It’s important to see your doctor if you also feel pain in your hand, forearm, or neck, urinate more frequently than usual, or have a rash, dizziness, or muscle spasms.  

Seek emergency medical attention if you have hand numbness immediately following an injury to your back, neck, or head or if you any of these symptoms occur alongside hand numbness: 

  • An inability to move parts of your body
  • Uncontrollable movements in your arm or hand
  • Weakness
  • Confusion
  • Difficulty talking, walking, or seeing
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References
7 Sources

  1. Roth Bettlach, C. L., Hasak, J. M., Krauss, E. M., Yu, J. L., Skolnick, G. B., Bodway, G. N., Kahn, L. C., & Mackinnon, S. E. (2019). Preferences in sleep position correlate with nighttime paresthesias in healthy people without carpal tunnel syndrome. Hand (New York, N.Y.), 14(2), 163–171.

    https://pubmed.ncbi.nlm.nih.gov/29020829/
  2. A.D.A.M. Medical Encyclopedia. (2022 December). Carpal Tunnel Syndrome. MedlinePlus., Retrieved December 7, 2023, from

    https://medlineplus.gov/carpaltunnelsyndrome.html
  3. Sharrak, S. & Das, J. (2023, August 8). Hand Nerve Compression Syndromes. StatPearls.

    https://www.ncbi.nlm.nih.gov/books/NBK547683/
  4. A.D.A.M. Medical Encyclopedia. (2022, April 25). Peripheral neuropathy. MedlinePlus., Retrieved December 7, 2023, from

    https://medlineplus.gov/ency/article/000593.htm
  5. A.D.A.M. Medical Encyclopedia. (2022, April 29). Numbness and tingling. MedlinePlus., Retrieved December 7, 2023, from

    https://medlineplus.gov/ency/article/003206.htm
  6. Fundaun, J., Kolski, M., Baskozos, G., Dilley, A., Sterling, M., & Schmid, A. B. (2022). Nerve pathology and neuropathic pain after whiplash injury: a systematic review and meta-analysis. Pain, 163(7), e789–e811.

    https://pubmed.ncbi.nlm.nih.gov/35050963
  7. Lleva J.M.C., Munakomi S., Chang K.V. (2023, August 13). Ulnar Neuropathy. StatPearls.

    https://www.ncbi.nlm.nih.gov/books/NBK534226/

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