Ashwin Lewis
It is not uncommon for newborns to shake or twitch in their sleep. This phenomenon is known as sleep myoclonus, which translates to muscle twitching in Greek. While it can be alarming for parents to witness, it is considered a normal part of a baby's development. Sleep myoclonus is characterised by myoclonic jerks or twitches that occur multiple times during sleep and are typically harmless. However, it may be challenging to distinguish between benign sleep myoclonus and epilepsy without measuring brain waves. In some cases, pronounced sleep twitches may warrant medical attention to rule out more serious conditions such as infantile spasms or seizures.
Why is my newborn shaking in her sleep?
| Characteristics | Values |
|---|---|
| Condition | Benign neonatal sleep myoclonus |
| Cause | Unknown, but may be related to sensorimotor development |
| Occurrence | Rare |
| Symptoms | Repetitive twitches or jerks during sleep |
| Diagnosis | Brain wave measurement to rule out epilepsy |
| Treatment | None, considered harmless |
| Prevention | N/A |
| Prognosis | N/A |
| Similar Conditions | Epilepsy, infantile spasms, benign familial neonatal convulsions, febrile seizures |
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What You'll Learn
Benign neonatal sleep myoclonus
The condition is generally considered harmless and resolves without treatment by 3 months of age. However, it can be difficult to distinguish benign neonatal sleep myoclonus from epilepsy without measuring brain waves. While benign neonatal sleep myoclonus is associated with normal brain waves, epilepsy is characterised by abnormal brain waves.
The cause of benign neonatal sleep myoclonus is not yet fully understood. One hypothesis suggests that it may occur when the protective sheath around a baby's spinal cord has not yet fully developed, allowing impulses to be carried out that would typically be impeded. It is also believed that the condition may have a genetic component, as it has been reported to occur in multiple family members and is more common in infants born to mothers with opioid dependency.
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Infantile spasms
If your newborn is shaking in her sleep, it could be benign neonatal sleep myoclonus, a harmless condition that causes repetitive twitches during sleep. This condition is believed to be the result of sudden muscle contractions or muscle relaxation. However, it is important to distinguish this from other more serious conditions, such as infantile spasms, a severe form of epilepsy that can cause developmental problems.
The diagnosis of infantile spasms involves observing the child's movements and performing an electroencephalogram (EEG) to evaluate their brain waves. Prenatal factors, perinatal causes such as hypoxic-ischemic encephalopathy and neonatal hypoglycemia, and postnatal insults like traumatic injuries or tumours are all associated with infantile spasms. The presence of other neurocutaneous disorders, such as tuberous sclerosis complex (TSC), or chromosome abnormalities like Down syndrome, may also contribute to this condition.
Treating infantile spasms is urgent to prevent permanent harm to the child's development. Hormonal therapy and vigabatrin, an anti-seizure medication, are the main treatments. While the long-term outcome varies, early diagnosis and treatment are crucial for optimising the child's development and mitigating potential complications.
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Febrile seizures
Simple febrile seizures are the most common type. They last a few seconds up to 15 minutes and happen only once in 24 hours. Complex febrile seizures either last longer than 15 minutes, happen more than once in 24 hours, or happen only on one part of a child's body. They may also be a combination of these.
Most febrile seizures occur in children between 6 months and 5 years of age, with the greatest risk between 12 and 18 months of age. Children who were in a neonatal intensive care unit in a hospital for more than 28 days, have developmental delays, infections, or a family history of seizures are also at greater risk.
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Epilepsy
If your newborn is shaking in her sleep, it could be benign neonatal sleep myoclonus, a normal sleep phenomenon that can be very frequent in some babies. It involves brief shaking of one or more arms or legs and occurs only during sleep. If the baby is woken, the movement stops. This condition is considered harmless, and babies will ultimately outgrow it, developing normally. However, without measuring brain waves, it may be difficult to tell whether an infant has benign neonatal sleep myoclonus or epilepsy.
- Benign Rolandic Epilepsy (BRE), also known as benign focal epilepsy of childhood, is one of the most common types of epilepsy, accounting for more than one-third of all cases. BRE usually starts between the ages of 3 and 5 and causes night seizures, sleepwalking, and night terrors.
- Infantile spasms, also called epileptic spasms, are a form of epilepsy that occurs in babies typically under 12 months old. They look like brief tensing or jerking spells involving the baby's abdomen, head, neck, arms, and/or legs. These spasms last for one to two seconds and usually happen in a series or cluster every five to ten seconds. Infantile spasms often occur after the baby awakes from sleep, and they can lead to developmental delays or regression.
- Febrile seizures are the most common type of childhood seizure, affecting up to 5% of American children before the age of 5. They are triggered by a fever and cause young children to lose consciousness and have rigid limbs that shake uncontrollably. While febrile seizures typically last a few minutes and are relatively harmless, they can increase the child's chance of developing epilepsy.
If you are concerned that your newborn's shaking may be due to epilepsy or another medical condition, it is important to consult with a healthcare professional for a proper diagnosis and treatment plan.
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Normal reflexes and development
It is common for newborns to exhibit shaking or twitching during sleep, and this is usually a normal part of their development. Lyndsey Garbi, M.D., a New York City-based pediatrician, affirms that "babies twitching in their sleep is relatively common, completely normal, and an expected part of their development." This phenomenon is known as benign neonatal sleep myoclonus or benign sleep myoclonus of infancy, characterised by myoclonic jerks or twitches that occur multiple times during sleep. While the exact cause is unknown, researchers suspect that these twitches are related to sensorimotor development, helping babies transform their rudimentary movements into coordinated movements and understand what they can do with their bodies.
Babies are born with immature yet rapidly developing neurological systems, which can cause them to twitch or move a lot during sleep. Additionally, their immature respiratory systems can result in periodic breathing, where they may appear to stop breathing momentarily, which is typically harmless. Newborns also exhibit various reflexes that can contribute to shaking or twitching during sleep, such as the rooting reflex, where they turn their head and open their mouth when the side of the mouth or cheek is touched, and the sucking reflex, where they will suck on anything placed in their mouth. These reflexes are normal and typically fade within the first year of life.
It is important to distinguish between normal developmental twitches and more serious movements that may indicate a seizure or other medical condition. If your baby is experiencing twitching movements or stiffening when awake, it could be a sign of infantile spasms, benign familial neonatal convulsions, febrile seizures, or epilepsy. Abnormal eye movements along with body movements are indicative of a true seizure. Other concerning symptoms include trouble breathing, changes in skin colour (blue, purple, or gray), or a seizure lasting longer than five minutes, which require immediate medical attention.
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Frequently asked questions
Newborns often shake or twitch in their sleep due to benign neonatal sleep myoclonus, a sleep-related movement disorder that occurs in very young infants. It is considered harmless, and researchers believe it is a normal part of their development.
If the twitching stops immediately upon waking, it is likely harmless myoclonic twitches. However, if the twitching continues when the baby is awake, or is accompanied by abnormal eye movements, trouble breathing, or a change in skin colour, it may be a seizure, and you should seek immediate medical attention.
Doctors are uncertain why benign sleep myoclonus occurs, but studies have shown that these movements are harmless. Researchers believe that twitching is part of a baby's development, helping them understand their limbs and what they can do with their bodies.
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