for Arnold Chiari Malformation? An MRI of the upper neck will reveal this. Sometimes it is a mild presentation, and has to be looked for.

Hands that tingle and go numb at night might be due to carpal tunnel. Have you tried wearing braces on your wrists to hold them so they don't pinch the tunnel?

Often carpal tunnel starts at night like you are having it.

Do you have puffiness in the hands? Swelling? Do you consume alot of salt?

Are you a male? You didn't say in your post. If you are male, do you use vibrating tools?

Do you drink alcohol?

Another thing to try is the gluten free diet. Some people present with neuropathy when gluten intolerant. Keep a food diary and see if your spells at night follow a rhythm ... worse with certain types of food. Some foods release histamine-- and this causes alot of tingling for some people.
If you suspect a food trigger... do an elimination diet. Remove that food for
at least 2 weeks.

Also you can try Thiamine to see if you have problems with low thiamine. This can be genetic or induced by heavy alcohol consumption. 200mg -300mg of this daily may improve nerve functions. If you suspect a food trigger/histamine release, you can try the AlkaSeltzer treatment. Use regular with aspirin AlkaSeltzer before going to bed. That is if you can tolerate aspirin and don't have other drugs that will add or interact (Coumadin, Plavix, Pletal, etc)

The fact that you only have symptoms at night is telling you something.
Position, food for dinner, alcohol at night, etc. Do you have allergies? It might help to get a new pillow, in case you are allergic to bed mites. (things like that) Some people are allergic to feathers and don't know it, for example.

A sleep study may help. It will show if you are having problems in the brain stem..for example. However, sleep paralysis does not typically have pain associated with it.