Waking up with numb hands isn’t uncommon. Many people have had the sensation of their hand being asleep at one time or another.

Sleeping in a position that puts pressure on your arm or hand is a common cause of numbness and a pins and needles sensation that soon resolves after waking and repositioning, but it isn’t the only possibility.

Numb hands can be a sign of an underlying medical condition, so it’s important to be aware of other symptoms.

Learn more about what causes this and what you can do about it.

The following are possible causes of waking up with numb hands.

Carpal tunnel syndrome

Carpal tunnel syndrome is caused by compression on the median nerve in the carpal tunnel, which is a narrow passageway on the front of your wrist. Tingling and numbness are the most common symptoms. Weakness in grip strength may also occur.

Repetitive hand motions, like typing on a keyboard or using machinery, may trigger it, as can obesity or wrist trauma.

Cervical (neck) spondylosis

Cervical spondylosis is commonly caused by everyday wear and tear to the spinal disks in your neck with age.

This can cause signs of osteoarthritis, such as bone spurs, and bulging disks. Both can narrow the space in your cervical spine and place pressure on a nerve root or spinal cord, causing numbness and tingling in your arms and hands.

Cervical spondylosis can also cause numbness in the legs and feet, as well as neck pain and stiffness.

Thoracic outlet syndrome (TOS)

TOS is a group of disorders that develop when nerves or blood vessels in the lower neck and upper chest area are irritated, injured, or compressed.

Numbness in the forearm, hand, and fingers are common symptoms of nerve compression, which can also cause pain in parts of your neck, shoulder, arm, or hand.

Peripheral neuropathy (nerve damage)

Peripheral neuropathy refers to several conditions that involve damage to your peripheral nervous system, which receives and sends signals between your central nervous system and the rest of your body.

There are more than 100 types of peripheral neuropathy and symptoms depend on the nerves affected. Symptoms can include:

  • tingling and numbness
  • sharp, stabbing pains
  • buzzing sensation

Diabetes mellitus

Diabetes mellitus is a chronic disease that causes high blood sugar. It happens when your body either doesn’t respond toinsulin effectively or doesn’t make enough.

Approximately half of all people with diabetes have some form of nerve damage, including peripheral neuropathy and carpal tunnel syndrome, which can cause pain, numbness, and weakness in your hands.

Sleeping posture

Pressure on your hands from your sleeping posture is a likely cause of waking up with numb hands. It can happen when you sleep on your arm or hand or in a position that puts pressure on a nerve. The temporary lack of blood flow can cause numbness or pins and needles.

Changing your position is typically enough to relieve your symptoms.

Chemotherapy and other medications

Chemotherapy and other medications can damage the peripheral nerves. Studies show that chemotherapy-induced peripheral neuropathy affects between 30 to 68 percent of people undergoing treatment.

Other medications known to cause peripheral neuropathy include anticonvulsants, certain heart and blood pressure-reducing medications, and some antibiotics, including metronidazole (Flagyl) and Fluoroquinolones (Cipro, Levaquin).

Vitamin B-12 deficiency

Vitamin B-12 is essential to the functioning of your brain and central nervous system and your DNA synthesis. It’s also needed to make red blood cells.

Vitamin B-12 deficiency can be caused by a number of factors, such as age, family history, and certain medical conditions, such as gastritis and autoimmune diseases.

Vitamin B-12 deficiency symptoms may include numbness and tingling in the feet, muscle weakness, and decreased appetite.

Alcohol abuse

Alcohol can damage nerve tissue when excessive amounts of alcohol are taken in. This is called alcoholic neuropathy.

People who drink too much may feel pain and tingling in their limbs. It isn’t uncommon to have deficient levels of certain vitamins and nutrients that the body needs for proper nerve function in the midst of alcoholism, as heavy alcohol use often coincides with a poor diet.

You may also notice:

Ganglion cyst

Ganglion cysts are noncancerous lumps that grow along the joints or tendons in the wrists or hands. If a cyst presses on a nerve, it can cause numbness in the hands. A cyst may also be painful when pressed or may interfere with joint movement.

Most ganglion cysts go away without treatment.

Other diseases

A number of other diseases can cause numbness in the hands. Some of these include:

If you’re also experiencing numbness in other parts of your body, here’s a look at what could be causing it.

Waking up with numb hands and arms

Carpal tunnel syndrome and your sleeping position can cause you to wake up with numbness in one or both hands and arms.

Other causes of numb hands and arms are cervical spondylosis, peripheral neuropathy, and TOS. Alcohol abuse can also cause it.

Waking up with numb hands and feet

Peripheral neuropathy caused by a medical condition, such as diabetes, or certain drugs, including chemotherapy, can cause numbness in your hands and feet. Alcohol abuse and vitamin B-12 deficiency can also cause it.

Waking up with numb hands and fingers

Carpal tunnel syndrome often affects the hands and all the fingers except for the pinkie finger. Cervical spondylosis, TOS, peripheral neuropathy, and sleeping posture can also cause numbness in your hands and fingers.

Waking up with one numb hand

If only one hand is numb, carpal tunnel syndrome and pressure on your hand during sleep are the most likely culprits. Peripheral nerve damage and ganglion cysts are other possibilities.

A doctor will first ask you about your symptoms and any medications you’re taking. They’ll then perform a physical exam. They’ll likely order imaging or other tests, such as:

A doctor may also refer you to a neurologist. They can perform a neurological exam to check for weakness.

Treatment for hand numbness depends on the cause. You may not need any treatment if your numbness is occasional and improves once you change sleeping positions.

Treatment may include a combination of medical treatments and home remedies.

Exercise

Exercises for carpal tunnel syndrome can help improve your symptoms and increase your strength if you also have muscle weakness.

Stretching, strengthening, and posture exercises can also help with symptoms of cervical spondylosis.

Over-the-counter pain medications

Nonsteroidal anti-inflammatory drugs, such as ibuprofen or aspirin, can help with mild pain and inflammation affecting your hands, neck, and other areas.

Splints or wrist guards

Wearing a wrist guard or splint keeps your wrists straight to relieve pressure on your median nerve. You can wear them when performing repetitive tasks or in the evenings to help prevent symptoms of carpal tunnel syndrome.

Topical treatments

Lidocaine patches and capsaicin cream applied to the skin may provide relief of mild pain and peripheral neuropathy. Topical menthol, such as Biofreeze, can also help relieve carpal tunnel pain, according to a 2014 study.

Vitamin B-12

A vitamin B-12 deficiency can be treated with oral vitamin B-12 supplements. If the deficiency is severe or if you can’t absorb vitamin B-12 from your diet, you may need vitamin B-12 injections.

Eating foods high in vitamin B-12, such as salmon, eggs, and liver may also help.

Antidepressants

Some types of antidepressants treat neuropathic pain by interfering with the processes responsible for sending pain signals. They can be helpful in treating nerve pain caused by diabetes and other conditions.

Antiseizure medications

Drugs developed to treat epilepsy may relieve nerve pain. These include gabapentin (Gralise, Neurontin) and pregabalin (Lyrica).

Surgery

Surgery may be an option for certain conditions if nonsurgical treatments don’t work. This can include surgery to release compressed nerves or blood vessels caused by carpal tunnel, bulging disks, TOS, or ganglion cysts.

See a doctor if you continue to experience numbness or your numbness doesn’t improve when you change positions. Also see a doctor if you’re experiencing numbness in other areas or have other concerning symptoms.

Call 911 for numbness that begins suddenly, especially when accompanied by weakness or paralysis, difficulty speaking, or a sudden severe headache as these are potential signs of a medical emergency like a stroke.

Waking up with numb hands is likely nothing to be alarmed about if it happens occasionally and improves once your hands wake up.

If the numbness persists or you experience other symptoms, see your doctor. They can check for nerve damage and other underlying causes of numbness.