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Why Do My Arms Fall Asleep at Night?

By: SleepScore Labs  |  April 19th, 2021

Have you ever woken up in the middle of the night to a bizarre “tingling” sensation in your arm or hand? It almost feels like “pins and needles” have flooded that area. Your limb goes numb, it feels floppy yet immovable, and – especially as a kid – you may even worry that you’ve lost feeling permanently. After a few minutes of changing positions and squirming, the feeling in your limb finally returns, a sigh of relief follows, and back to sleep you go.

So, what is that tingling sensation you experienced? More importantly, is the sensation a potential sign of an underlying medical issue? In this article, we’ll unravel answers to these questions, provide sleep-related tips to prevent your limbs from falling asleep at night, and discuss when you should consult with your doctor – especially if this feeling persists and is accompanied by other symptoms.

That Tingling Sensation: Paresthesia

The sensation of pins and needles or “tingling” in your limb is technically known as paresthesia. Paresthesia refers to a burning or prickling sensation that usually occurs in the hands, arms, legs, or feet. The feeling is usually painless, but it can be noticeable enough to wake you from your sleep. Temporary paresthesia is also fairly common. A recent study showed that 33% of people experienced paresthesia at least once a week.  You may have experienced periods of paresthesia if you’ve sat uncomfortably with sustained pressure for too long, crossed your legs for too long, or (most commonly) when you’ve fallen asleep with a crooked arm or hand over your head. In these cases, paresthesia is thought to be caused by poor positioning that compresses and squishes the nerves – blocking nerve signals from readily flowing between the limb and the brain.

Long-term nerve compression can actually damage nerves, so waking up to reposition the limb is yet another fascinating example of the body protecting itself. In general, that’s all it takes: reposition and relieve the pressure from the affected limb, “shake it out”, and refrain from falling asleep in that same position. However, there are other potential ways for you to prevent paresthesia and, importantly, determine whether the symptoms should be assessed by a doctor.

Why Do My Arms and Hands Fall Asleep at Night?

Most of the time, temporary paresthesia is simply caused by a poor sleeping position and is no cause for concern. However, chronic paresthesia that happens regularly and is unrelated to temporary nerve compression may be a sign of an underlying medical condition that should be assessed by a physician.

Possible conditions that may cause paresthesia or associated numbness may include:

  • Carpel tunnel syndrome
  • Vitamin B deficiency
  • Peripheral neuropathy (chronic nerve damage)
  • Diabetes mellitus
  • Cervical (neck) spondylosis
  • Thoracic outlet syndrome
  • Ganglion cysts
  • Central nervous system disorders like stroke or multiple sclerosis

This list is not exhaustive, and there are several other possible conditions that may be causing chronic paresthesia. Speak with your doctor if the sensation persists, or if you’re experiencing any significant discomfort or pain.

How to Prevent Your Arms and Hands From Falling Asleep at Night                

Sleep Positions

Sleep experts agree that the best sleeping position is the one that feels most comfortable for you. According to the Better Sleep Council, nearly half of all Americans sleep in the fetal position. In general, sleeping on your back and side is often recommended. When it comes to paresthesia, there’s surprisingly very little scientific research examining the most optimal sleep position to prevent your arms and hands from falling asleep at night.

In one study, researchers from the University of Washington surveyed 396 people about their sleep preferences and overnight paresthesia. Participants who reported sleeping on their sides experienced the least amount of paresthesia, whereas those sleeping with flexed wrists reported a higher frequency. If sleeping on your side, keep your wrists and fingers flat in a neutral position and avoid placing your head on your hand or forearm. You may also want to sleep on your back with your arms lying flat on your sides or on a pillow.

Pre-Sleep Relaxation and Stretches

Certain relaxation techniques like guided meditation, mindfulness, and gently stretching may help relax both your mind and body before sleep. Although these particular practices may be most helpful for those struggling to fall asleep, they may help slow breathing and relieve muscle tension and stiffness to keep you from waking up during the night. Start with focusing on your breath or choosing a pleasant word to ruminate on. Slowly breathe in, enjoying how the air feels as it passes through your body, and exhale the tension out. Try to focus on relaxing and releasing tension in your shoulders, down to your arms, and fingers.

Remember to relax without drinking alcohol or consuming caffeine too close to bedtime. Both can block important dream sleep, worsen snoring and other symptoms of sleep apnea, and even increase the time spent awake during the night.

When to See a Doctor

Remember, infrequent paresthesia is not a cause for concern. Simply repositioning yourself and releasing the pressure on the nerve will usually relieve the sensation of pins and needles. However, you should consult with a doctor if symptoms of paresthesia persist even after changing positions and gently stretching out the affected limb.

Medical attention is required if you notice the sensation of pins and needles on a recurring basis, or the symptoms are accompanied by any difficulty speaking, seeing, coordinating, facial numbness, or unexplained weakness. Paresthesia coupled with other underlying medical conditions, medications or alcohol use disorders also warrants speaking with a medical professional.

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