Will this lead to Gangrene?

March 18, 2005 1:17 PM

Every single morning when I wake up, my left hand and forearm are 'asleep'. Am I doing any long-term damage to the flesh/nerves of that hand by letting this continue to happen?

I've been to a hand doc (multiple problems with my right hand) who can't find a cause for it -- says its probably just caused by the position I sleep in, and then the appointment ended before I could fit this question in.

The numbness is in the four fingers and the side of my hand and and forearm that are farthest from my thumb. It doesn't extend all the way up to my elbow. It doesn't bother me, except for being slightly inconvient for a few minutes after I get up. But is the ongoing reduced bloodloss risking some long-term damage to the hand?

posted by anastasiav to Health & Fitness (14 answers total)

Excellent question! For me, it isn't every morning, but more often than not; I'm eager to hear responses.
posted by AllesKlar at 1:32 PM on March 18, 2005

Try sleeping with an elbow pad, like a skateboard pad, (not too tight) on various parts of that arm, to break the pattern, and see if it stops.
posted by weapons-grade pandemonium at 1:59 PM on March 18, 2005

IANAD but I'd say I strongly doubt it, at least not any more damage than just continuing to be alive. I base this on the fact that a limb that is "asleep" isn't entirely cut off from blood flow, it's just reduced. If you tourniquet your arm to reproduce the effect you'll see a big difference in color (which I have never noticed in a sleeping limb) and pain when you return blood flow.

Probably contributing to the phenomena is something I turned up called "nocturnal hypotension." Perhaps I'm too optimistic but I presume we'd be evolved/created/imagined (you pick your preference) in such a way that would avoid injuring ourselves as a result of our daily activities.

That said, a google for 'gangrene sleep' does turn up this link, http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2203138&dopt=Abstract with some indication that people with other medical problems could potentially have damage from this kind of event.
posted by phearlez at 1:59 PM on March 18, 2005

I'd guess that rather than the blood supply being reduced, it's more likely that you're pressing on a nerve -- happens to me quite often, and has for years. I'm pretty skinny, maybe that makes a difference? I2ANAD.
posted by anadem at 2:22 PM on March 18, 2005

I3ANAD, and I get these sleep-weaknesses in my arms (elbows especially). I keep a glass of water by my bed to ward off middle-of-the-night thirst. Sometimes I will reach for it as I wake up at 3 or 4am, and nearly drop it on the floor or in the bed because I have no strength in my right arm.

I too wonder whether it's from the way that I sleep (corpse position, eg lying on my back with my arms on either side). Or perhaps it's the Pulldowns that I do three times a week with my trainer - and I am developing a mild form of tendonitis in that elbow? Could that be?
posted by seawallrunner at 2:28 PM on March 18, 2005

I sometimes sleep with the same wrist braces I had when I was wearing them for RSI, usually that helps keep me from holding my hands in tingle-inducing fetal crouch positions.
posted by matildaben at 2:29 PM on March 18, 2005

i also am far from being a doctor, however, about 15 years ago my diabetic uncle passed out due to an insulin insufficiency and the position he fell in cut the blood off from his legs for maybe a few hours. it damaged his nerves and he was a parapalegic until he died a couple years ago.
posted by quadrinary at 2:35 PM on March 18, 2005

I sleep on my right side with my arm under the pillow my head is on, hand loodely under my head, arm bent. Most mornings I wake up with my pinky, ring and middle fingers completely asleep and my forearm down to my elbow numb. When I don't sleep this way, it doesn't happen. There was a simlar question asked here a few months ago.
posted by jessamyn at 2:39 PM on March 18, 2005

Sounds like ulnar nerve compression. Did your doc suggest an EMG? Do you rest your arm on a rest during driving/working where it may be compressing the nerve? You can feel it where it runs through the "funny bone" groove in your elbow. It's pretty easy to compress.
posted by docpops at 3:07 PM on March 18, 2005

There was also this question.
posted by CunningLinguist at 3:38 PM on March 18, 2005

I've been to a hand doc

What is this doctor's specific medical specialty? (i.e. what was the residency in? what is s/he board certified for?) Because if s/he specializes in bone injuries, for instance, they don't necessarily have the background to recognize the difference between benign and serious symptoms of, say, neuro or circulatory disorders...

Talk to your PCP (primary care physician) about your symptoms. Part of a PCP's job is to determine when specialty care is warranted, and which types of specialists are most likely relevant to your symptoms; ideally the PCP also keep tabs on your follow-up to make sure that you've received a useful diagnosis and (if necessary) treatment.

Eh, maybe it's a big nothing, but I'd still want the PCP to know what's up. Even it doesn't warrant intervention now, the PCP may want you to watch out for certain other developments that would suggest it's a problem after all.
posted by nakedcodemonkey at 4:14 PM on March 18, 2005

I'm pretty skinny, maybe that makes a difference?

Maybe a coincidence, but I'm skin and bones, and this happens to me too.

Derail: I also have very little (a thin layer of skin) between my shinbone and the scary world; lately I've cultivated a fear that something will slice my shin open and cut through my bone, as I've no protective layer of fat to protect my marrow.

With that and the new fear of gangrene, I'll have a bit more trouble sleeping nights.
posted by NickDouglas at 9:59 PM on March 18, 2005

Sounds like a C8 radiculopathy. The problem's probably in the neck or brachial plexus.

See a neurologist.
posted by ikkyu2 at 2:32 AM on March 19, 2005

I knew a junkie who nodded off with her left arm in a position to lose blood. Had to get it amputated, so it is possible.
posted by cmonkey at 4:30 PM on March 19, 2005