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Monday, May 20, 2013
Numb left arm
Occasionally over the past couple of years, my left arm feels numb when I sleep on my right side. No tingling, just a general numbness from armpit to fingertips. There is a particular tightness in the armpit, as if a thick shirt fold was causing the problem. The numbness begins immediately when I roll to my right side. I goes away quickly when I roll to my left side, back, or front. I`m 48 years old, in good general health, 15-20 pounds overweight, regulary run 5 miles/day, and spend a lot of time on a computer keyboard.
Assuming that the quality of your sleep, and your energy level during the day are satisfactory, your problem is not likely secondary to a primary sleep disorder. Your symptoms sound most consistent with a neurological or musculoskeletal problem.
When you fall asleep on you right side, it is possible that you are compressing nerve fibers in your neck (in an area known as the cervical spine), resulting in the shooting numbness you feel in your arm. The speed with which this abnormality appears and resolves coupled with the shooting nature of the sensations suggests this type of nerve compression. This type of problem can arise from arthritis or other bone abnormalities (such as degenerative disk disease or joint disease).
These conditions can occur for a number of reasons with one of the more common settings being in people who work on computers for extended periods. Other possible explanations for your symptoms may be inflammation in the shoulder joint or an enlarged or accessory first rib on the left side causing compression of nerves or blood vessels. Based on the information you provided, the possibility that this is related to your heart is low, but your doctor should help you determine your risk factors. Typically pains related to the heart are worse with activity and not as quick to resolve.
I recommend that you get a physical exam by your regular doctor, a Rheumatologist, or a Neurologist. In addition to obtaining more history and performing a physical examination, your doctor may order further evaluation, that may include X-rays, nerve conduction studies, or MRI. For temporary relief you can consider trying a soft neck collar (you can buy over the counter) or adjusting the type or height of your pillow.
If you have excessive sleepiness, snoring, or disrupted sleep, then you should also consider seeing a Sleep Specialist.
If you would like further information about sleep disorders or sleep itself, I recommend the American Academy of Sleep Medicine. In addition to information about sleep medicine, the website also contains a list of accredited Sleep Centers and may help you to locate one nearest you if need be
Rami N Khayat, MD
Clinical Assistant Professor of Pulmonary, Allergy, Critical Care & Sleep
College of Medicine
The Ohio State University