Have you ever woke up with your hands numb, tingling, or in pain? You may be sleeping in a compromised position that could be causing your symptoms. Numbness in the arm and hand is caused my nerve compression that can occur at the neck or throughout your arm. Our sleeping positions greatly affect the tension that is applied to our nerves. Nerve tension basically refers to the nerve being stretched for too long. The way we are sleeping can also cause nerve compression. Prolonged pressure on a nerve is like bending and squeezing a water hose to decrease the water flow. When compression or tension occurs to our nerves, they send a sensation of tingling in the forearm and hand. Long term compression could cause numbness and even permanent damage to the nerve leading to surgery.
There are three major nerves in our arm. Nerves not only control what you are feeling but they also receive the signal from your brain to tell your muscles to move. The most common nerve injury is the Median nerve, what you would know as Carpal Tunnel Syndrome. If this nerve is irritated you will feel tingling or numbness in the palm, thumb, index finger, middle finger, and possibly part of the ring finger. Compression of the Median Nerve while we are sleeping is typically caused by sleeping on your side with your hands under your head or with our wrists bent like sleeping curled in a ball. The Ulnar Nerve is another major nerve in the arm that could cause tingling and numbness in the ring finger and little finger. This nerve can also be affected in the sleeping positions already mentioned but most commonly irritated when you sleep on your back with your arm resting with the elbow bent over your head. Another position that can irritate the Ulnar Nerve is sleeping with your elbows bent such as on your back, side, or stomach with your hands by your face. The least common nerve that can be affected with our sleeping positions is the Radial Nerve. Compression of this nerve would cause tingling and numbness on the top of the forearm, hand, thumb, and part of the index finger. Long term compression of this nerve can even cause the inability to lift up your wrist and fingers. This is typically caused by falling asleep in a seated position while resting your head on the back of your hand, like falling asleep at a desk.
So, how can we prevent nerve irritation while sleeping? First, don’t fall asleep at your desk. Second, you should only use one pillow that positions your neck comfortably with your head in line with your body. Third, is positioning your arms and legs properly. If you are a side sleeper, try placing a pillow between your legs to level your spine which will decrease tension on your neck. Also hug a pillow (place the pillow by your chest and rest one arm underneath and the other on top comfortably). If you sleep on your back, try placing a pillow or two under your knees. This will level your spine and provide more support. You can place a pillow underneath both arms or just chose the one that causes you discomfort.
Changing your sleeping habits won’t be easy but over time it should help decrease your numbness, tingling, or pain. If it doesn’t then seek help from an Occupational Therapist that specializes in treating hand conditions (also known as Certified Hand Therapists). Some insurances require a doctor referral but some do not and you can make an appointment directly with the therapist. A Hand therapist can instruct you in specific exercises and possible splinting to help reduce or eliminate your symptoms. If your symptoms are severe, been present for a long time, or do not improve with therapy then you will need to seek care from a specialized hand doctor that can perform further tests.
DeNeah Cox, MS, OTR
