There are a few possible reasons for numbness, tingling, or "pins and needles" during sleep, but the most common reason is carpal tunnel syndrome. The median nerve and nine tendons that bend your fingers run through the palmar side of the wrist; they travel through a canal formed by the wrist bones. That canal has a thick ligament over it, much like a bridge over the canal. Sometimes, the ligament either gets too thick or too tight or the tendons and nerve in the carpal tunnel get too big for the canal, and the nerve gets compressed. This cuts off blood supply to the nerve, which causes numbness and tingling in the thumb, index, and long fingers and the ring finger. When we sleep, we tend to flex our wrists, which puts even more pressure on the nerve. This can cause you to wake up with tingling or even a feeling of burning in the hand. One thing to try is to wear a wrist splint at night to keep your wrist from flexing while you sleep. If this seems to help, the numbness likely is from carpal tunnel syndrome, in which case I would recommend that you see a hand specialist to talk about your options for treatment.