Why do my Hands Fall Asleep at Night?


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As a hand therapist, I am often asked the question “why do my hands fall asleep at night?” Waking up in the middle of the night with tingling or pain in the hands is incredibly common. There are many answers to this question, but most of the answers go back to the nerve. Nerves are like wires in our body that transmit signals from the brain or spinal cord to the tissues of the body and vice-versa. Nerves can control how our muscles work, they help control the function of our internal organs, and they also help with sensation. In order for our nerves to function properly, they need good nutrition (just like the rest of our body). The nutrition for the nerves comes from the blood flow, and good blood flow to the nerve allows the nerve to continue to send a strong signal.

One of the major nerves that supply the muscles and sensation of the hand is called the median nerve. The median nerve controls most of the muscles of the thumb and provides sensation for the thumb, index finger, long finger, and half of the ring finger. This nerve enters the palm of the hand through a tunnel on the front of the wrist called the carpal tunnel. The median nerve runs in the carpal tunnel with 9 other tendons of the hand, and the top of the tunnel is formed by a ligament.

When we sleep at night our body moves around in a lot of different ways, and often times we find that we bend our wrists while we sleep. If your wrists stay bent for a long period of time, this slows down the blood flow to the median nerve. As the blood flow slows down to the nerve, the function of the nerve also slows down. The first thing you will start to notice is numbness or tingling in your hand and fingers. This is the very start of Carpal Tunnel Syndrome. Typically, when you first start to feel the numbness and tingling, you can change the position of your wrist or shake your wrists out to help the nerve return to normal function. However, if you continually sleep in the position, or if you work in a job that requires you to bend your wrists this way (desk jobs, medical professional, laborers) the symptoms may start to become more severe. You may start to notice that the numbness or tingling doesn’t go away right away or even stays all day. You may even notice that you start to drop things easier or lose strength in your hand.

Why should I see a hand therapist?

The best thing you can do is early intervention. If you start to notice your hands falling asleep at night or during the day working on the computer, using a wrist brace that stops the wrists from bending can often be very helpful. If you are unable to help your symptoms this way, seeing a certified hand therapist is a good next step. Your hand therapist will first try to figure out what is causing your symptoms in the first place. If it is your work position, we will offer suggestions for improving ergonomics for your workspace to help improve the blood flow to the nerve. Hand therapists may also use massage or other treatments like ultrasound or heat to help improve the blood flow to your nerve. If you are having difficulty with hand strength or manipulating small objects, customized physical therapy exercise will help you return the function in your hand.

Carpal Tunnel Syndrome is something that many of us have heard of, and most know someone or is someone who has suffered from it, but with the proper early intervention, it can be treated quickly and successfully! Contact ProActive Physical Therapy today to schedule a FREE assessment and to learn more about our hand therapy services.


Alicia Koepsel Allie

PT, DPT, CHT | East