Q: My husband and I have nearly conquered his snoring habit only to have a new problem crop up. Around 4 to 5 every morning, his whole body begins to jerk, which does not wake him up, but sends me into a panic. Any ideas why this happens, and more important, how we can get it to stop?
A:There are several sleep disorders that could be causing the symptoms you describe.
First, some people have a condition associated with snoring called obstructive sleep apnea. A person’s throat closes off and blocks the flow of air. Lack of air causes the person to wake briefly. Obstructive sleep apnea may happen at various times during the night but it often occurs in a stage of sleep called rapid eye movement (REM) sleep, which commonly occurs in the early morning hours. So, it’s possible your husband is experiencing obstructive sleep apnea during that stage of sleep and at that time of night. His struggle to breathe and overcome the air blockage in his throat may be leading to the jerking movements you’re noticing.
The second possibility is a less common condition called REM sleep behavior disorder (RBD). Normally when you dream, your body is paralyzed. Your eyes can move — hence the rapid eye movements of this stage of sleep — as can your diaphragm, the main muscle for breathing, but the rest of your body can’t.
People who have REM sleep behavior disorder lose their sleep paralysis, and they start to act out their dreams. It can be as subtle as shaking or twitching. Or, it could be much more dramatic. Some people actually act out what’s happening in the dream, such as a punch, a swing or a kick.
Third, your husband’s movements could be associated with a condition known as periodic limb movement disorder. It’s the nighttime equivalent of restless legs syndrome. About 80 percent of people who have restlessness in their legs while they’re awake also twitch at night.
A fourth possible explanation for your husband’s movements during sleep is a seizure disorder. Sleep may facilitate seizure activity in some people.
I recommend that you and your husband meet with a sleep specialist. This specialist could evaluate the situation, ask some specific questions to get a better sense of what’s happening and perform a careful physical exam.
Your husband should also undergo a sleep study. Results of the sleep specialist evaluation and the sleep study findings should provide a diagnosis and point you in the right direction regarding treatment.
Dr. Eric Olson, Center for Sleep Medicine, Mayo Clinic, Rochester, Minn.
