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Sleep Disorders

Pins and Needles and Nightmares

10/19/2009

Question:

I have noticed that when I wake up from a nightmare that I have pins and needles...or numbness in my legs. Why is it only after a nightmare? Is the poor circulation causing the nightmares?

Answer:

Thank you for visiting NetWellness. On this site, we try to answer general questions about sleep disorders but cannot diagnose or recommend specific treatment. You appear to have a very specific question that can only be answered properly by a physician who performs a full history and physical exam during an office visit. In addition, laboratory tests and possibly sleep studies may need to be performed to accurately diagnose your condition. Having said that, I will try to answer you question as best I can with the information provided.

The symptoms describe may be nothing more than some of the phenomenon associated with nightmares. However, there are multiple other conditions that can cause the symptoms you describe and these include the following (though these lists are not exhaustive):

- Nightmares: nightmare disorder, other primary sleep disorders causing nightmares [sleep deprivation, narcolepsy (sleep attacks), night terrors (usually only in young children), sleep apnea], various medications [some antidepressants and antibiotics, beta-blockers (heart/blood pressure medication), montelukast (an asthma/allergy medication)], substance abuse and psychiatric disorders [PTSD (post traumatic stress disorder), anxiety]. Of note, we would not expect poor circulation to cause nightmares.

- Pins and needles (P&N) or paresthesias: temporary P&N could be due to prolonged immobility such as one would see during long periods of REM sleep (dream sleep or rapid eye movement sleep - the part of sleep where one is unable to move and when one typically dreams) or during sleep paralysis spells if narcolepsy was the underlying disorder; neuropathy (nerve damage - the symptoms would likely be present throughout the day), various metabolic problems (such as anemia, abnormal thyroid or parathyroid function) or fibromyalgia - just to name a few

- Numbness: determining the cause of this symptom really depends on the clinical history, and the duration and persistence of the symptom - causes include arthritis, nerve disease, multiple sclerosis, peripheral vascular disease, and kidney failure to name a few. Again, poor circulation does not usually present with numbness in the extremities at night. Usually, with vascular disease, the symptoms first appear with exertion, and are not associated with sleep.

So as you can see there are a number of causes for each symptom and perhaps in your situation there may be a single diagnosis to explain all the symptoms. I encourage you to discuss your symptoms with your primary care physician. A referral to a sleep specialist in your area may be needed to help clarify the cause of the problem.

I hope this helps and thanks again for using NetWellness.

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Response by:

Steven  Kadiev, MBBCh Steven Kadiev, MBBCh
Formerly:
Assistant Professor
College of Medicine
The Ohio State University