why does my hand get numb when i sleep
Hand Numbness and Tingling, by David Katz, MD
P P P P P P Do your hands ever go numb and tingly? Do you wake up at night with a dead hand and have to shake it out to get it to wake up? Do your hands fall asleep while driving a car or holding a cell phone? If so, then you may have increased pressure on a nerve in your palm a condition called Carpal Tunnel Syndrome. PPPPPPPPPPP Carpal Tunnel Syndrome (CTS) is the most common cause of numbness and tingling in the hand. As a result of pressure on the median nerve, one may experience pain, weakness, and numbness in the hand and fingers. This typically affects some combination of the thumb, index, middle, and ring finger. The causes of carpal tunnel are varied, but most of the time there is no obvious reason. Women are more commonly affected than men, and the incidence increases with age. CTS can be associated with a number of prevalent medical conditions including: obesity, diabetes, hypothyroidism, rheumatoid arthritis, alcoholism, and drug toxicity. Pregnancy has also been associated with CTS typically during the third trimester and may be related to fluid retention. PPPPPPPPPPP The diagnosis of CTS is based largely on the symptoms experienced as well as the exam performed by a physician. As mentioned above, most people relate symptoms that wake them from their sleep.
Daytime activities such as holding a steering wheel or a book for an extended period of time may exacerbate the numbness and tingling as well. It is common for both hands to be involved though one side may be more symptomatic. With longstanding compression, patients often complain of decreased grip strength and difficulty holding on to objects. PPPPPPPPPPP During a visit to your physician, you may be asked to perform several tests that will help determine whether or not CTS is the correct diagnosis. Your doctor will search for other possible causes of numbness and tingling including pinched nerves in the neck or elbow. They will also test the small muscles in your hand for any loss in strength (more commonly seen in chronic cases), as well as the feeling in your finger tips for any loss in sensation. PPPPPPPPPPP If your physician is concerned about CTS, he/she may send you for a nerve study. This test involves stimulating the median nerve and taking measurements which tell us how well the nerve is conducting its signal. The second portion of the test involves testing the electrical activity of the small muscles in the hand. PPPPPPPPPPP Treatment of CTS typically begins with nonsurgical options (except in longstanding cases with muscle weakness or significant loss of sensation).
Most commonly this will involve wearing wrist splints at night time and intermittently during the day. Other treatment options include: anti-inflammatory medications (ibuprofen, naproxen, etc. ), steroids (either oral or injections), ultrasound, and occupational therapy. When these conservative measures fail to relieve symptoms, your physician may recommend surgery. While there are several different techniques to performing a carpal tunnel release, they all involve releasing the pressure on the nerve by cutting the ligament that sits above the nerve. This can be done with modern, minimally invasive techniques that serve to relieve symptoms (especially at night) and ease recovery. If you have hand numbness and tingling, you may have CTS. Talk to your physician about this treatable condition. I am regularly woken at night from a sound sleep because my hands have also gone to sleep. They become very heavy and numb and sometimes a little painful. I have to shake them around to get the feeling back. Why is this happening? Numbness of the arms, hands, or fingers that comes on during sleep is another of those very annoying problems, like leg cramps at night, that become increasingly common as we age.
Unlike the leg cramps, which develop for reasons that are not clear to us, the immediate cause of the numbness is clear. It is not, as many people have asked me, due to poor circulation, but is caused by pressing on or stretching the nerve going to the area that becomes numb. Many people have had the experience, even when young, of falling asleep with their arms behind their head, and awakening later with numbness in both arms. Holding the arms motionless behind the head has stretched the nerves that run down to the arms, interfering with their ability to conduct sensations, and that creates the numbness. Another common type occurs when someone sleeps on their side with one or both hands up under their cheek. This bends the elbows close to their maximum and stretches the ulnar nerve where it loops around the elbow on the inside. This typically causes numbness running down the inside of the arm to the little finger, and perhaps the next two fingers. Why are we being plagued by these things now, when we slept in all kinds of strange positions as children and never had this happen? As we age, our tissues become less resilient, less bouncy than children s tissues. We tend to develop little, hard outgrowths on our bones that constrict or press on the nerves more easily.
And probably our nerves are not as stretchy as those of children and tolerate that abuse less well. Fortunately, this type of numbness, which disappears quickly as soon as one changes the position of the numb part, does not indicate serious illness or a stroke. The event that can be a precursor to a stroke is a transient ischemic attack or TIA, and this can cause temporary numbness, but it has nothing to do with sleep or the position of the limbs. TIAs may come on at any time, usually involve numbness of half the face or half the body, may last for minutes to hours, and do not go away promptly when one changes position. So what about those night cramps, you re saying? Can anything to be done about them? Again, they don t indicate any serious problem, although we don t know why people get them. They can often be controlled by taking a calcium supplement; I take two 600mg tablets of calcium carbonate with vitamin D at night to prevent the cramps I am otherwise prone to get. Taking them with food may increase the absorption. Drinking several glasses of milk daily may also be effective. Since almost all of us, and especially women need to be taking calcium supplements as we grow older, this should be part of our daily routine.
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