I wake up and my finger tips and toes are numb. what causes this?

Numbness on waking: When you are sleeping, there is reduced movements. Sometimes, one may lie in a position that compresses some nerves for hours, or compresses blood vessels that supply these nerves. These nerves then do not function properly, and there can be a sensation of numbness or tingling, even pain. With movement after you wake up, the pressure is released, and function rapidly returns to normal.

Peripheral neuropath: These symptoms are indicative of a peripheral neuropathy. Diabetes and a variety of nutritional and vitamin deficiencies can cause it. You should see your doc.