Waking up with a numb or tingling hand is a common complaint. It might be more than an awkward sleeping position if it happens often. Depending on the nerve being compressed, your symptoms may vary.
Common Causes:
Carpal Tunnel Syndrome: The median nerve is susceptible to compression at various points along the upper extremity. When the nerve gets explicitly compressed at the wrist level, it’s called carpal tunnel syndrome. Symptoms include numbness or tingling in the thumb, index, and middle fingers.
Ulnar Nerve Compression: The ulnar nerve is also susceptible to compression along the upper extremity, most commonly at the cubital tunnel (at the elbow) or Guyon’s canal (at the wrist). Pressure on the ulnar nerve can also cause numbness or tingling in the hand, but in the ring and pinky fingers. Sleeping with your elbow bent or wrist flexed may aggravate it.
Radial Nerve Compression: Less likely, but still possible, is compression of the radial nerve, which would cause numbness and tingling to the back side of your wrist and hand. In severe cases, if you’re sleeping hard or fall asleep with your arm hanging over a chair or armrest, you could temporarily lose the ability to bring your wrist and fingers back into extension. This condition has been termed “Saturday Night Palsy” or “Wrist Drop”.
What You Can Do:
- Wear a wrist brace to keep your wrist neutral at night. Ensure the brace is not too tight, and avoid braces with metal bars
- Avoid sleeping with elbows deeply bent or hands under pillows
- Avoid sleeping with your underarm draped over a hard surface
- Stretch and move your hands before bed
- Take breaks from repetitive hand tasks during the day
If symptoms continue into the day or worsen, a Certified Hand Therapist (like me!) can help with evaluation and non-surgical treatment. If the nerve has been compressed for a longer period, it may require additional interventions and manual therapy techniques. A CHT can use methods such as instrument-assisted soft tissue massage, cupping therapy, or dry needling to resolve the issue. If you’re struggling, let us help you regain restful sleep at night so you can thrive during the day!
Schedule a visit with a Spooner Hand Therapist today!