Gina Johnson
Involuntary muscle twitching or jerking while falling asleep or during sleep is known as sleep myoclonus. It is characterised by brief, unpredictable, and involuntary muscle jerks or spasms that may affect a single muscle or multiple muscle groups. Sleep myoclonus is not a disease but a symptom of several different conditions and can occur without a known cause. It is widely considered a benign condition with no short- or long-term effects on health or well-being. However, in some cases, it may be an indicator of an underlying medical condition.
| Characteristics | Values |
|---|---|
| Scientific Name | Sleep myoclonus, hypnic jerks, sleep starts |
| Description | Brief, involuntary twitching or jerking of a muscle or group of muscles |
| Occurrence | As a person falls asleep or during sleep |
| Severity | Mild to intense |
| Age Group | Occurs at any age, more common in children and adults |
| Causes | Overtiredness, caffeine consumption, elevated stress levels, anxiety, neurological disorder, spinal cord issue, sleep disorders, epilepsy, restless leg syndrome, medication, old age, diabetes-related neuropathy, family history of restless legs syndrome, physical inactivity, smoking, etc. |
| Treatment | No treatment required unless it causes distress or other symptoms like incontinence, injury, pain, or confusion |
| Prevention | Avoiding caffeine, managing stress and anxiety, reducing blue light exposure, meditation, breathing exercises, etc. |
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What You'll Learn
Sleep myoclonus, or involuntary muscle twitching
The symptoms of sleep myoclonus are difficult to miss and can be referred to as shakes, spasms, or contractions. They can happen in various ways: once or many times in a row, a single episode or multiple times a night, in a pattern or not. Sleep myoclonus occurs during the early stages of sleep, especially when a person is about to fall asleep. It can be strong enough to wake a person up and disrupt the process of falling asleep. However, sometimes, they may be so mild that the affected person does not notice them, although their sleep partner might.
The exact cause of sleep myoclonus is unknown, but it is believed to be associated with problems affecting the nervous system. It can occur by itself or alongside other symptoms of nervous system disorders. In children, sleep myoclonus may be caused by sleep disorders or other conditions such as pediatric periodic limb movement disorder (PLMD), which causes brief muscle spasms in the legs or arms during sleep. It is also commonly observed in infants and newborns, where it is considered benign and harmless.
While sleep myoclonus is generally harmless, it can sometimes indicate an underlying neurological disorder, especially if it is frequent or widespread. Certain lifestyle changes may help reduce the occurrence of sleep myoclonus. These include avoiding excessive tiredness, reducing caffeine consumption, managing stress and anxiety, and limiting exposure to blue light before bed. If sleep myoclonus is disrupting sleep or occurring while awake, it is recommended to consult a healthcare provider for an evaluation.
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Hypnic jerks, or sleep starts
A person shaking while sleeping could be due to hypnic jerks, also known as sleep starts, hypnagogic jerks, sleep twitches, myoclonic jerks, or night starts. They are characterised by brief and sudden involuntary contractions of the body's muscles, which occur when a person is about to fall asleep, often causing them to jump and wake up suddenly. These jerks can be mild and hardly noticeable, or intense enough to wake the person up. They are usually benign and occur in people of all ages, with 60-70% of individuals experiencing them. However, they can be intensified in certain situations, such as stress, fatigue, stimulants like caffeine, nicotine, alcohol, or certain medications, and can interfere with sleep onset, leading to insomnia.
Hypnic jerks are a type of sleep myoclonus, which is the scientific name for the jerking movements the body makes during sleep or while falling asleep. Sleep myoclonus can occur on its own or as a symptom of various conditions, such as sleep disorders, pediatric periodic limb movement disorder (PLMD), or epilepsy. PLMD causes brief muscle spasms in the legs or arms during sleep and is often associated with other disorders such as ADHD, autism spectrum disorders, and Tourette's syndrome. While hypnic jerks are typically not dangerous, they can be a cause for concern if they lead to insomnia or are accompanied by other symptoms such as incontinence, injury, pain, or confusion.
The exact cause of hypnic jerks is not fully understood, but they are believed to be associated with the transition from a wakeful state to sleep. One theory suggests that they are a reflex initiated in response to normal bodily events during the lead-up to the first stages of sleep, such as a decrease in blood pressure and muscle relaxation. Another theory proposes that the body mistakes the sense of relaxation that comes with falling asleep as a sign of physical falling, causing a jerk to wake the sleeper up. While there is no definitive way to prevent hypnic jerks, certain lifestyle changes, such as reducing stimulants, avoiding physical exertion before sleep, and consuming magnesium, may help reduce their frequency.
In some cases, hypnic jerks can be mistaken for other sleep-related conditions, such as restless leg syndrome, periodic limb movement disorder, hypnagogic foot tremor, rhythmic movement disorder, or hereditary essential startle syndrome. However, hypnic jerks are distinguished by their occurrence only at sleep onset and the lack of rhythmicity or periodicity in the movements. Additionally, unlike seizures, hypnic jerks are not accompanied by tongue biting, urinary incontinence, or postictal confusion. While they can be disruptive, hypnic jerks are generally not a cause for concern unless they are causing distress or impacting an individual's ability to fall asleep consistently.
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Restless leg syndrome
There are several reasons why a person may shake while sleeping. One of the most common reasons is hypnic jerks, also known as sleep starts, which are involuntary muscle contractions that occur as a person falls asleep. These jerks are typically mild and harmless, and they can happen to anyone.
Another reason for shaking while sleeping could be a condition called sleep myoclonus, which is characterised by involuntary, non-rhythmic muscle twitching during sleep. Sleep myoclonus is not a disease but rather a symptom of several different conditions, and it can also occur without any known cause.
In some cases, shaking while sleeping could be a sign of a sleep movement disorder such as Periodic Limb Movements of Sleep (PLMS). PLMS involves repetitive leg and/or arm movements during sleep that can disrupt sleep patterns. This condition is often associated with high blood pressure and an increased risk of stroke and heart attack.
Now, let's focus specifically on Restless Leg Syndrome (RLS), a common condition of the nervous system that affects sleep. RLS causes an overwhelming and irresistible urge to move the legs due to uncomfortable sensations. These sensations can include itching, crawling, throbbing, or aching feelings in the legs, and they are usually relieved by movement. RLS typically occurs in the evening or at night when a person is sitting or lying down. It can severely interrupt sleep, making it difficult to fall asleep or return to sleep after waking up.
The exact cause of RLS is unknown, but it often runs in families, and specific gene variants are associated with the condition. It may also be related to low levels of iron in the brain or dysfunction in the basal ganglia, a part of the brain that controls movement using the chemical dopamine. RLS is more common in women and typically begins in middle age, although it can develop at any age and even in childhood.
If RLS is disrupting your sleep, healthcare professionals may recommend sleep tests to understand your sleep patterns better. Treatment for RLS can vary depending on the severity of the symptoms. For mild cases, lifestyle changes such as improving sleep hygiene and establishing a bedtime routine can help. For more severe cases, medications may be prescribed to manage the symptoms.
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Periodic limb movements during sleep (PLMS)
Shaking while sleeping could be caused by hypnic jerks, also known as sleep starts, which are involuntary muscle contractions that some people experience as they fall asleep. These are common and harmless, and usually mild and unnoticeable. However, if they are intense, they may prevent a person from falling asleep, leading to insomnia.
Another cause of shaking while sleeping could be periodic limb movements during sleep (PLMS). PLMS is a movement disorder that involves repetitive leg and/or arm movements during sleep, which can disrupt sleep. These movements are involuntary and occur at periodic intervals anywhere from 4 to 90 seconds apart, or 20 to 40 seconds apart, according to some sources. They usually only last the first half of the night during non-REM sleep stages and do not occur during REM sleep due to muscle atonia. PLMS can be unilateral or bilateral and are not symmetrical or simultaneous. They are often observed in the lower extremities, including the toes, ankles, knees, and hips, but can also be seen in the upper extremities.
PLMS is diagnosed based on medical history and the results of an overnight sleep study (polysomnogram), which tracks and records how multiple body systems work while a person is asleep. The polysomnogram will record the periodic limb movement index (PLMI), which corresponds to the number of periodic limb movements per hour. For adults, a PLMI of more than 15 movements per hour is required for a diagnosis of PLMS, while for children, it is more than five movements per hour.
The exact cause of PLMS is unknown, but it is often associated with other disorders such as restless leg syndrome (RLS), obstructive sleep apnea, narcolepsy, and neurological disorders such as Parkinson's disease. Certain medications, such as antidepressants and antihistamines, can also make PLMS worse. People with PLMS may experience frequent awakenings and problems falling asleep due to these movements.
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Pathologic myoclonus, or muscle contractions that spread
Shaking while sleeping is known as sleep myoclonus, which is characterised by involuntary, nonrhythmic muscle twitching that occurs either as a person falls asleep or during sleep. Sleep myoclonus is not a disease but a symptom of several conditions, and it can also occur without a known cause.
Pathologic myoclonus is a form of myoclonus that involves muscle contractions that begin in one part of the body and spread to other muscles in other areas. It can be caused by drug toxicity, hypoxia, metabolic disturbances, degenerative disorders of the basal ganglia, and some dementias. It can also be caused by an injury to the peripheral nerves, which are the nerves outside the central nervous system that connect to sensory organs and muscles and relay information to and from the CNS.
Pathologic myoclonus is often more severe than physiologic myoclonus and can affect a person's movement, severely limiting their ability to eat, talk, or walk. It can also interfere with sleep, causing insomnia. In some cases, pathologic myoclonus may be a sign of an underlying neurological disorder or medical condition.
The severity of pathologic myoclonus can range from mild to severe, and it can begin in childhood or adulthood. It is typically diagnosed based on a person's medical history and the results of an overnight sleep study, which tracks and records how multiple body systems work while the person is asleep.
While the exact cause of pathologic myoclonus is unknown, research suggests that it may be related to abnormalities in neurotransmitters and receptors. Identifying the role of these abnormalities may help develop drug treatments and diagnostic tests for the condition.
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Frequently asked questions
Shaking while sleeping can be caused by hypnic jerks, also known as sleep starts, which are involuntary muscle contractions that occur as a person falls asleep. They can be strong enough to wake a person but can also be so mild that they go unnoticed.
The exact cause of hypnic jerks is unknown, but they are believed to be linked to factors such as overtiredness, caffeine consumption, and elevated stress levels.
Hypnic jerks are generally harmless and are not indicative of any underlying health conditions. However, in rare cases, a strong hypnic jerk may cause a minor bump, muscle spasm, or cramp.
Sleep myoclonus refers to brief, involuntary twitching or jerking of a muscle or group of muscles during sleep. Unlike hypnic jerks, sleep myoclonus may be more frequent and can affect different parts of the body. Sleep myoclonus is not a disease but a symptom of various conditions, and it can also occur without a known cause.
