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Wednesday, May 22, 2013
Almost every night I wake up (usually, it seems, in the last hour or two before morning) with my arms lifted in the air. I gently graze the surface of each arm with my opposite hand, alternating between sets. It seems that I continue to do it as I drift in and out of consciousness.
Is there a neurological explanation for this, as it seems to be related to stimulation? Or is it just a kind of habit?
I apologize for the delay in answering this question. It’s interesting how you describe the movement that you noticed during sleep. It seems that this movement partly occurs during wakefulness and partly during sleep; therefore, you are able to remember it and to describe it. The other assumptions I have are that you are not terribly distressed about this movement and that you have not gotten out of bed or have injured yourself or a bed partner. But I am not clear on the word “stimulation”. I will try to answer as specifically as I can. You should, however, discuss this issue with your primary care provider or a sleep specialist if any of my assumptions above are incorrect.
Several types of movements occur during sleep and during the transition between wake and sleep. Sleep-related movement disorders may be secondary to an underlying condition, where the movement is not the problem, but a manifestation of a hidden problem. Some of these problems include:
- an underlying medical illness (such as seizures),
- another sleep disorder (such as sleep apnea),
- an environmental stimulus (such as an uncomfortable bed),
- the use of certain substances and medications (such as sleep walking after taking Ambien)
Primary sleep-related movement disorders, on the other hand, have no clear underlying cause. There disorders can be divided into several categories. Some of which are:
- Sleep walking
- Confusional arousals
- Dream-related movements
- Rhythmic movement disorder
- Periodic limb movements
Sleep walking (seen in all ages) and confusional arousals (mostly seen in kids) occur during the first half of the night, and people don’t remember them. They are usually reported by bed partners. Dream-related movements occur during the second half of the night, but are usually related to dream content. Rhythmic movement disorder can occur any time of the night, but are usually childhood behaviors that are self-soothing and help the waking person go back to sleep. These are rare in adulthood. Periodic lib movements afflict the lower extremities more often than the upper, and present as muscle jerks rather than organized complex sequence of behaviors.
You can see that are several possible explanations your behaviors, but none fits well. I’m afraid that it will be quite difficult to answer your question accurately without a personal discussion and probably a sleep study. An evaluation by a sleep specialist would be helpful. Please visit the American Academy of Sleep Medicine for a list of sleep specialists in your area.
Best of luck and sleep well.
Ziad Shaman, MD
Assistant Professor of Medicine
School of Medicine
Case Western Reserve University