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Sleep Disorders

Sleep Talking and Thrashing

12/08/2009

Question:

I have been sleep talking for 9 years I do not make sense but some of my family members have said i speak in different voices and it sounds like two people, often a child,I make rediculous noises and thrash about, it happens every night and has for 9 years I have been to a phsycologist and spent enormous amount of money and it made no difference at all what do you think?

Answer:

Sleep-talking or somniloquy is very common sleep behavior. While we don’t know exactly how common talking in sleep is, it is estimated to occur in about half of all children and in about 5% of adults. Thus it is present in all ages and can occur in any sleep stage. It appears to occur more often in females than males. It is possible that sleep talking is more common that is thought due to the fact that patients are not often aware of it and that it requires a bed partner to point it out. Individuals who do not have a regular bed or room partner may never become aware of the presence of occasional periods of sleep talking. Furthermore, sleep talking, due to its brief and self limited nature, may go unnoticed by the bed partner, who may not awaken to observe the behavior. Therefore, like other manifestations of sleep, normal or abnormal, sleep talking may have been present for a long time before it was brought to your attention.

Sleep talking can be related to dream content, though this is not always the case. Sometimes the affected person may report that the vocalization that they made corresponded with a dream that he or she was having. In some cases the vocalization may represent another character in the dream other that the patient. That is; if a person is dreaming of being chased they may vocalize their part of the dream or the part of the chaser. Therefore, these vocalizations may be disturbing to the bed partner. Oftentimes, the most serious consequences of sleep talking are disturbance of the bed partner’s sleep or the social embarrassment that accompanies the sleep talking.

Sleep talking can range from infrequent quite sounds to full spoken sentences to singing and shouting. Often, the speech cannot be understood and may sound like mutterings or gibberish. The cause of talking in sleep is not entirely known. Most of the time, the cause of this sleep behavior can not be linked to any identifiable underlying problem or disease. And in most cases, the problem is not serious and tends to resolve over time or with aging. However, in some cases, it has been found to be associated with other sleep-related disorders, such as sleep walking, REM behavior disorder (an unusual disorder in which individuals tend to act out their dreams while asleep), sleep-related epilepsy, post-traumatic stress disorder, sleep apnea, and the nighttime sleep eating syndrome. Certain situations, such as sleep deprivation, alcohol use and some medications, may precipitate sleep talking in some individuals. In adults who begin sleep talking during adulthood (in other words, they did not do this as a child), there may be a higher rate of psychiatric disorders. However, most adults who talk in their sleep do not have these problems.

The evaluation for your case should include a medical history and exam as well as a psychological evaluation. This evaluation may point to other underlying causes that could be treated. However, in the absence of these, you should be assured that sleep talking is usually not a serious problem.

Practicing good sleep hygiene may help to limit or reduce your sleep talking. You should try to maintain adequate sleep time (8-9 hours), keep a regular sleep schedule, and avoid caffeine and alcohol up to 4-5 hours bedtime. Also, if on medications, you could try to change the timing of your prescription medications to see if this makes a difference.

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Response by:

Rami N Khayat, MD Rami N Khayat, MD
Clinical Associate Professor of Pulmonary, Allergy, Critical Care & Sleep
College of Medicine
The Ohio State University