Sleeping problems can have a big impact on energy levels, mood and ability to concentrate. They can also be a symptom of other medical or mental health conditions, such as pain, heart disease, anxiety or depression.
It’s normal to wake up during the night, but if your sleeping problems last for weeks or months, you should talk to your doctor. You can often improve your sleeping problems by making simple changes to your daily routine.
Sleeping on your stomach puts your spine in a natural misalignment that can lead to discomfort, back pain, and stiffness. Stomach sleeping also forces you to twist your neck, which strains the muscles and can cause a painful herniated disk.
Sleep experts agree that sleeping on your stomach is generally a bad idea. Some people are able to sleep comfortably on their stomach, but this position is more likely to cause problems with your joints and spine than other positions.
You’re more likely to develop neck and back pain as you get older if you sleep on your stomach, as well as other health problems such as acid reflux and heartburn. You’re also more likely to suffer from breathing difficulties in this position, which may contribute to snoring and milder forms of sleep apnea.
Stomach sleeping also tends to compress the bones of your pelvic girdle, which can be uncomfortable and painful. The position also pushes your arms down, which can put pressure on the shoulder joint and can eventually cause rotator cuff issues.
While it’s possible to adapt to a stomach-sleeping habit, you should try to sleep in other positions if you can. For example, by putting a pillow under your head while you’re on your stomach, you can keep your spine in alignment and avoid the painful twisting of your neck.
You can also try using a body pillow for stomach sleepers, which may help prevent hip sinkage, keep your upper airways open, and alleviate neck strain. This type of pillow also helps reduce your lower back pain by supporting the curve of your lumbar region. By adjusting your mattress, pillows, and other sleeping habits, you can minimize or even eliminate sleep problems such as acid reflux, snoring, and neck and back pain. While some of these sleeping problems may require medical attention, it’s important to remember that many are easily fixable. By sticking to a healthy sleep schedule, exercising regularly, avoiding heavy meals and beverages late at night, reducing stress, and practicing good bedtime habits, you can improve the quality of your sleep and boost your overall health.
The most classic of all sleep positions, sleeping on your back can be the best position for your spine. This sleep position distributes your weight evenly, which can help minimize lower back pain. Additionally, sleeping on your back can help reduce acid reflux for people who struggle with this condition.
It can also alleviate neck pain by taking pressure off of your neck. If you’re struggling with tension headaches, this sleep position can help with that as well. By sleeping flat on your back, you can also take pressure off of your shoulders and hips.
Sleeping on your back can prevent wrinkles. This is because your face isn’t pressed up against a pillow for hours at a time like when you sleep on your side or stomach. It can also help prevent snoring, which can be problematic for those around you, especially your partner.
For those who want to start sleeping on their back, it can be a bit of a challenge at first. But the good news is that you can train yourself to do it. Sleep experts recommend placing a pillow underneath your head, and you can also use pillows under your knees and calves to help with the lower back.
You can also use a body pillow to help you fall asleep on your back and keep you in that position throughout the night. This helps you avoid rolling over on your side or stomach, which can cause neck and back pain. It can also help with preventing snoring, as you’re able to support your back properly.
Snoring isn’t just annoying for the person in your bed, but it can also be a sign of thickening of the carotid arteries. It can also indicate that you are having trouble breathing properly, which isn’t ideal for anyone. Snoring can be prevented by avoiding sleeping on your belly and instead opting for a back-sleeping position, which can also help with reducing lower back pain and acid reflux. To ensure you are able to stay in this position, you can try using a body pillow or a pillow under your arms or knees to help maintain the neutral spine.
If you’re a side sleeper, it’s likely because that’s your most comfortable position. Unfortunately, your side sleep habit can also be the cause of aches and pains in your shoulder, hip, or back. And it might contribute to your snoring or exacerbate your sleep apnea symptoms.
Most side sleepers sleep curled up, which can cause neck and shoulder pain. It can also put pressure on your spine and lead to misalignment. To avoid these problems, try alternating which side you sleep on each night. Sleep on your left side one night, then switch to your right, and so on. This can help keep your spine aligned throughout the night and prevent aches in different areas of your body.
Another drawback to this sleeping position is that it can cause heartburn or acid reflux. To combat this, sleep with a pillow behind your head or between your legs to keep your stomach elevated. Sleeping with a pillow between your knees can also alleviate pain in your lower back. For pregnant women, a pillow placed under the bump can relieve some of the pressure on their abdomen.
People who prefer the log position tend to be easy-going, and they often have open, trusting relationships with others. They’re observant, and they often carefully consider the pros and cons of an issue before making a decision. They may have a logical mind, but they’re also creative and imaginative.
Although the fetal or “couch potato” sleeper is commonly associated with a lack of good nutrition, they do enjoy a variety of health benefits. They’re prone to indigestion and bloating, but they tend to have less trouble with heartburn than other sleepers. Sleeping in this position can also help reduce aortic regurgitation, which is common in pregnancy. However, this position is not recommended for those with heart disease or chronic acid reflux because it can increase the pressure on the left side of the heart. It can also lead to a more rapid heartbeat, which is not ideal for those with heart failure. These people should avoid sleeping in this position and instead opt for the supine or back positions.
While experts generally agree that sleeping on your stomach is bad for your back and can cause neck pain, some people insist that it’s the only way they can sleep. If you are a stomach sleeper, try modifying your position by placing a thin pillow under your pelvis or putting a body pillow between you and your bed. These long cylindrical pillows may help shift the weight of your torso to other areas, and can also provide extra comfort, especially if you roll around at night.
Getting good quality sleep is important for your health and wellbeing. If you’re struggling to get a good night’s rest, it’s worth talking to your doctor or physical therapist about what might be causing it. They can share tips and advice for getting better sleep and recommend treatment if necessary.
It’s also a good idea to see a doctor if your trouble with sleeping is accompanied by other symptoms, such as fatigue or problems breathing. Allergies, colds and other upper respiratory infections can contribute to breathing difficulty at night, while nocturia (frequent urination) can be caused by a variety of things, including hormone imbalances, kidney disorders or urinary tract problems. Other common causes of sleeping difficulties include stress, anxiety and chronic pain conditions such as fibromyalgia.
If you’re sleeping poorly at night and feel dead-tired throughout the day, see your doctor. You might have a sleep disorder that can have serious consequences for your health, energy and quality of life.
A doctor will recommend treatment based on your symptoms. Short-term use of sleeping tablets may help, but they can have troublesome side effects.
There are many possible symptoms of insomnia, including difficulty falling or staying asleep, waking up too early and feeling tired during the day. Insomnia can also make you irritable and moody. If you have these symptoms, talk to your doctor.
Your doctor will ask you about your sleep habits, including whether you take naps and when you go to bed and wake up. Your doctor will also want to know what medications you take and how much caffeine and alcohol you consume. Your doctor may also test for a number of other conditions, such as anxiety, depression, narcolepsy, or sleep apnea.
People with anxiety, stress, or other mental health problems have a higher risk of having insomnia. The same goes for people who have a physical illness, such as heart disease, acid reflux, chronic pain, or cancer. The good news is that treating these conditions can help to improve insomnia.
It’s normal to have occasional trouble sleeping, but if you’re having trouble at least 3 nights per week for more than three months, you have a sleep disorder. You should also see a doctor if your insomnia causes impairments or distress in social, occupational, or academic functioning, or if it interferes with your quality of life.
The most common cause of insomnia is emotional or psychological factors. These include anger, anxiety, or depression, as well as grief or trauma. Insomnia can also be caused by medical issues or diseases, such as asthma, hyperthyroidism, fibromyalgia, or Parkinson’s disease.
Sometimes, sleep problems are due to lifestyle factors or environmental issues. These can include having a sleep routine, keeping a regular schedule of bed and wake times, and avoiding stimulants like caffeine or nicotine. You should also be sure to get enough exercise and spend some time in natural light during the day.
Restless legs syndrome (RLS) is a neurological disorder that causes uncomfortable or painful sensations in the legs and an irresistible urge to move them. It is often worse at night when people are at rest and can interfere with sleep. These unpleasant feelings may occur in any part of the legs but are most common in the lower calf area. Some people experience them in the thighs and feet as well. RLS can be a temporary problem or a chronic, long-term issue. It can be triggered by many things, including certain medications or pregnancy. Stress and emotional upset can also exacerbate symptoms.
Symptoms of RLS are felt in both men and women but are more prevalent in older adults. Approximately 40% of pregnant women experience RLS, and it can be much more severe during the third trimester. It is thought that some people have a genetic component to their RLS, but the cause is still unknown.
Itching and pain, especially in the calf area, are some of the most common symptoms of RLS. These sensations are usually uncomfortable, sometimes painful, and may feel like they are “pulling” or “searing.” Some people describe it as a “creeping” or “antsy” feeling that’s hard to explain. Others say that the sensations are similar to pins and needles, electrical shocks, buzzing, or being stuck in quicksand. These sensations are most intense at night when the person is at rest or lying down and are relieved with movement.
RLS can have a significant impact on daily activities and quality of life. People who suffer from it find it difficult to concentrate, focus, or complete everyday tasks. They are more likely to be tired and irritable. In some cases, it can lead to depression or substance abuse. It can also cause problems with relationships and work.
Taking steps to manage RLS and a good night’s sleep can help people live more comfortable lives. Some of the most helpful things to do include getting regular exercise, avoiding caffeine and alcohol, and keeping a sleep schedule. Sleep diaries can be helpful, too, because they help people track their habits and identify patterns that might affect how they sleep at night.
Some people with narcolepsy experience episodes of falling asleep while they are awake during the day, called excessive daytime sleepiness (EDS). The symptoms can make it difficult to concentrate and perform daily tasks, such as driving or working at a job. These episodes often occur during a monotonous activity, such as a meeting or long period of highway driving, but can also happen while eating or speaking. When the episodes occur, it may take a while to wake up, and it’s common for people with narcolepsy to forget what they were doing right before they fell asleep.
In about 10 percent of cases, the first symptom of narcolepsy is cataplexy, a sudden temporary loss of muscle tone that doesn’t cause a loss of consciousness. It can be triggered by strong emotions, such as anger, fear, surprise, or happiness. Symptoms of cataplexy can vary in severity, from drooping eyelids to total body collapse. Typically, these episodes happen several times a day and are accompanied by the feeling of losing control.
Other symptoms of narcolepsy include vivid hallucinations while asleep or awake, especially when people are tired. These visions are mainly visual, but can also involve other senses. They can be a frightening or frighteningly real experience. Some patients with narcolepsy have hallucinations while they are falling asleep or waking up, which can result in a brief loss of ability to move when they are trying to fall asleep or wake up (sleep paralysis).
Treatment for narcolepsy includes taking medication to help with the sleepiness and making lifestyle changes. Keeping to a regular sleep schedule and taking short naps throughout the day can help manage symptoms. Avoiding caffeine and alcohol, exercising regularly, and avoiding large meals in the hours before bedtime can also improve sleep quality. People with narcolepsy should let their employers and teachers know about the condition, so they can discuss possible accommodations for work or school that could help ease symptoms.
A diagnosis of narcolepsy depends on a physical exam and detailed medical history, including a family history of the disease. Doctors may ask for a polysomnogram, or PSG, which is an overnight test that monitors brain and heart activity, breathing, eye movements, and other body functions. They may also order blood and urine tests to rule out other conditions that can cause similar symptoms.
People with sleep apnea stop breathing several times in the night, which interrupts their natural sleep cycle. This prevents them from getting the deep, restorative sleep they need to stay healthy and alert. These breathing pauses can last for up to a minute and occur hundreds of times a night. The lack of oxygen during these episodes jolts people awake, although they may not remember what happened. This can cause them to feel tired and groggy in the morning, and it can lead to problems at work and home.
Breathing pauses happen when the throat muscles relax during sleep and close off the airway. This is the most common type of sleep apnea, known as obstructive sleep apnea (OSA). People who have OSA tend to snore loudly, but not everyone who snores has this condition.
There is also another form of sleep apnea called central sleep apnea (CSA). This happens when the brain temporarily stops sending signals to the body to breathe. CSA can happen in any stage of sleep, but it is more common in Stage 1 and Stage 2 sleep than in REM. People who have CSA don’t snore as often, but they do wake up frequently during the night with feelings of gasping or choking.
If you have these symptoms, ask your doctor for advice. They will examine you and may refer you to a specialist. Depending on the results of your test, your treatment may include weight loss, avoiding alcohol and other sedatives before sleeping, using a mouthpiece or surgery to help keep the throat open while you sleep, taking certain medications or wearing a mask that delivers positive air pressure to the nose and/or mouth during sleep.
If you have serious sleep apnoea, you will be told by the DVLA that you are not fit to drive until you have your symptoms under control. It is important to talk to your GP and discuss the problem as soon as possible because left untreated, it can lead to serious health problems, including heart disease.
If your sleep is disrupted by an underlying health condition or if you’re using over-the-counter sleeping tablets that are not suitable for you, talk to your GP. Keep a sleep diary to help them assess your symptoms and find the best treatment for you.
Cognitive behavioural therapy (CBT) can help you change your thinking and behaviour that affects your sleep. It is often recommended as the first treatment choice.
Cognitive behavioural therapy (CBT) is often recommended as the first treatment option for long-term sleep disorders such as insomnia. It works by changing actions or thoughts that can prevent you from sleeping well, and it promotes healthy habits for good sleep. CBT is usually delivered by a counsellor or psychologist, but it can also be accessed online. It can be conducted individually or in a group with other people experiencing sleep problems, and it can be customised to your specific needs.
It can be used to treat many different sleep problems, including narcolepsy, delayed sleep phase syndrome and nightmares. This treatment works by addressing the underlying anxiety or fears that are driving these behaviours, and it encourages patients to adopt more positive attitudes towards sleep. This may be achieved through a variety of techniques, such as mindfulness meditation or relaxation techniques. The therapist will be able to provide suggestions on how to implement these methods in your daily routine, which will aid your recovery.
CBT for insomnia involves a series of one-on-one sessions with a trained therapist. The number of sessions will vary, but they generally last around 30-60 minutes. These sessions will include a detailed history of your sleeping problems, and the therapist will discuss your goals for sleep recovery. These may include falling asleep more easily, waking up less often during the night and reducing daytime fatigue.
The therapist will then identify unhelpful beliefs and thoughts that contribute to your sleep disorder, and teach you techniques for challenging these negative ideas and promoting more helpful ones. It is also possible to develop sleep hygiene practices, such as limiting stimuli in the bedroom and using relaxing pre-sleep rituals.
It is important to remember that CBT for sleep disorders takes time, and you may not see immediate results. However, if you stick with the program and commit to it, you will reap the benefits over time.
If you’re interested in trying cognitive behavioural therapy, talk to your doctor or GP for more information. They will be able to advise on local providers who offer this treatment and help you find the right fit for your needs.
Sleeping pills are medicines designed to help you fall asleep or stay asleep. They can have serious side effects if taken for extended periods of time and should not be used as the sole treatment for a sleeping disorder.
If you have a short-term problem with insomnia, over-the-counter (OTC) sleep tablets may be an option. However, if your insomnia is long-term or if other treatments are not helping you get restful sleep, it’s a good idea to see a healthcare provider for more help.
Over-the-counter sleeping pills are available in tablet, gelcap, liquid, or chewable form and contain a variety of active ingredients. Many of these products contain an antihistamine known as diphenhydramine, which is also found in allergy medications such as Benadryl. Diphenhydramine helps you fall asleep but it can cause daytime drowsiness, dry mouth, and headache in some people. Long-term use of OTC sleep aids containing diphenhydramine can also lead to liver and kidney problems.
Other common OTC sleep aids include melatonin, a naturally occurring hormone that increases at night. Melatonin is not as effective as some other OTC sleep aids, but it can improve sleep problems caused by jet lag or shift work. However, it can interfere with some blood pressure and diabetes medications.
Some OTC sleep aids are sedating, and while they can help you sleep, they aren’t recommended for use by children. They can cause drowsiness, dizziness, or confusion the next day, and some have been linked to health issues including dementia and stroke.
If you decide to try a sleeping pill, always follow the package instructions. Never exceed the recommended dosage. If you find that the OTC sleep aid does not help you sleep or has unpleasant side effects, stop taking it and talk to your doctor. They can advise you on behaviour strategies to address your insomnia, so that you don’t have to rely on medication in the long term. These strategies can include eliminating naps during the day and limiting the amount of time you spend in bed.
When you’re struggling to get enough quality sleep, a visit to your GP is often the first step in getting it back on track. They will review your symptoms and examine you physically to find out what’s causing the problem. They may ask you to keep a sleep diary, which will help them identify how long and when you are sleeping, as well as the habits that can cause it (like going to bed too late or using too much caffeine).
They’ll also discuss any other medical conditions you have that can cause sleep problems such as acid reflux, heart disease or diabetes. They’ll ask you about your lifestyle too – such as whether you exercise, drink alcohol or take medication (both prescription and non-prescription).
Insomnia is a common sleep disorder that can affect people of all ages. It can range from difficulty falling asleep or staying awake to waking up too early and not being able to get back to sleep. Your GP may recommend cognitive behavioral therapy, which is a form of talking treatment designed to change the thoughts and behaviours that can cause insomnia. They may also suggest you try herbal treatments such as melatonin or benzodiazepines like clonazepam. They’re more likely to prescribe them if your symptoms persist and are associated with a health condition, such as high blood pressure or chronic pain.
If your GP isn’t sure what’s causing your sleeping difficulties, they might refer you to a specialist sleep clinic to have a sleep study done. This is a series of tests to measure your breathing, brain waves and body movements while you’re sleeping so they can diagnose a sleep disorder. They’ll then talk to you about the different treatments options.
For sleep apnea, your healthcare provider will prescribe a CPAP machine to open your airways and prevent you from snoring or gasping while you’re sleeping. Other treatments for sleep disorders include medications such as melatonin, zaleplon, eszopiclone, ramelteon or suvorexant for insomnia and stimulants for narcolepsy (like modafinil, armodafinil, solriamfetol). They might also recommend weight loss and lifestyle changes.
A good night’s sleep is essential to maintain good mental and physical health. Getting adequate amounts of sleep reduces the risk of depression, anxiety, high blood pressure and chronic diseases such as heart disease and diabetes. However, insomnia and other sleep disorders are a common problem for many people. These disorders can significantly affect quality of life and cause difficulties with thinking, memory and attention. If you suffer from a sleep disorder, it is important to seek treatment and follow your healthcare provider’s instructions to improve your quality of life.
Many sleep problems are a result of poor sleeping habits, which can be improved with simple changes in your daily routine. For example, you can try to get into the habit of going to bed and waking up around the same time each day, avoiding napping during the day, and not eating or drinking alcohol before bed. You should also make sure that your bedroom is dark, quiet and cool and remove distractions like televisions and computers. If you find that you cannot fall asleep, there are relaxation techniques such as progressive muscle relaxation, mindfulness meditation and biofeedback that can help to ease the tension that may be keeping you awake.
Sleep disorders can also be a sign of other medical or mental health conditions, so it’s important to see a doctor if you think you have a problem. Many times, these problems will disappear once you receive treatment for the underlying condition.
Insomnia and other sleep disorders can have a significant impact on your everyday functioning, so it’s important to receive treatment right away if you are experiencing these symptoms. If you do not receive treatment, these problems can lead to serious consequences.
Many sleep disorders are caused by a combination of factors and can be treated with lifestyle changes, cognitive behavioral therapy or prescription medications. Talk to your doctor about the best way to manage your sleep problems and find a solution that works for you. In addition to a healthy diet and exercise, getting enough restful sleep is crucial for overall health and well-being.
People who don’t get enough sleep can experience a variety of problems. They can become irritable, depressed and have trouble concentrating.
If you’re having sleeping problems on a regular basis, talk to your doctor. They may suggest a sleep study or prescribe sleeping pills. The types of Sleeping problems include: Circadian rhythm sleep-wake disorders, insomnia, narcolepsy and parasomnias such as REM sleep behavior disorder (acting out dreams)..
Insomnia is the most common sleep disorder. It’s when you have trouble falling asleep, stay awake during the night or wake up too early in the morning. It can affect your quality of life and affect how well you work or think. It can also make it harder to cope with stress, and lead to depression and anxiety. There are different types of insomnia and it can be short-term or chronic.
The causes of insomnia vary but can include factors like stress, hormones, anxiety, medical conditions or other health problems, such as heart disease, diabetes, pain and cancer. There are also predisposing factors, which can make you more likely to develop insomnia, such as being a woman (it’s more common in women than men), having a stressful job or relationship, and having mental health conditions like anxiety and depression.
People with chronic insomnia can be classified as having short-term or long-term insomnia. Short-term insomnia is often the result of a specific event or situation, such as a breakup, job loss or illness. It usually gets better in a few nights or weeks. Long-term or chronic insomnia is not as easy to treat.
The most common treatments are changing your lifestyle, using medication and psychological therapies. Psychological therapies can help you to change unhelpful thinking and behaviours that may be keeping you awake. Medications can help you to fall asleep and stay asleep, but only when used as instructed. Talk to your doctor about the best treatment for you. You can help prevent insomnia by trying to go to bed and wake up at the same time each day, avoiding alcohol, caffeine and nicotine in the evening and getting regular exercise.
A person with narcolepsy often falls asleep in situations when they should be awake, like in class or during meetings. They may also fall asleep at unpredictable times, especially in response to strong emotions such as surprise or anger. This can lead to poor performance at work or school and problems with relationships.
The cause of narcolepsy is not known, but it likely results from a mismatch between the brain’s natural sleep-wake cycle and its ability to regulate alertness. People with narcolepsy tend to go straight into REM (rapid eye movement) sleep, the stage during which dreams happen. This can happen during the day or night, and can occur many times in a day. This disrupts the normal sleep-wake cycle and leads to poor quality sleep during the day and poorer sleep at night.
Other symptoms of narcolepsy include sudden loss of muscle strength triggered by emotions such as anger or laughter, which is called cataplexy. They also have hallucinations of vivid, frightening scenes that appear as they are falling asleep or waking up and last for only seconds or minutes. People with narcolepsy often have trouble staying awake during the day and may have to take frequent naps to avoid falling asleep at inappropriate times.
If you or someone you know is experiencing excessive daytime sleepiness, talk to your doctor. A doctor can give you advice on how to improve your sleeping habits and may want to refer you to a specialist or schedule a sleep study. People who experience these problems with their natural sleep-wake cycles are more likely to develop a health condition such as heart disease, high blood pressure or diabetes, so it is important to seek treatment if you think you may have a sleep disorder.
Millions of people in the United States work shifts. They include doctors, nurses, pilots, police officers, commercial drivers, and others who follow a schedule outside the typical 9 a.m. to 5 p.m. work day. Shift work can interfere with a person’s internal biological clock and cause sleep problems. The symptoms of shift work sleep disorder (SWSD) are persistent and affect daily functioning. It is diagnosed when symptoms occur in combination with a shift work schedule and they are not better explained by another medical or mental disorder, medication use, poor sleep hygiene, or substance abuse.
SWSD can make it difficult to fall and stay asleep, and it can also prevent a person from being awake during the times they are expected to be awake. It can lead to fatigue and problems with work performance and concentration. It can also increase the risk of injury at work and on the road.
Insomnia, drowsiness, and hypersomnia are the most common symptoms of SWSD. Symptoms vary depending on the type of shift worked. Night shift workers may experience insomnia, while daytime workers often have trouble staying awake. Insomnia can be made worse by caffeine and other stimulants, and drowsiness can be caused by medications or illness.
It takes time to adjust to a nontraditional sleep schedule, and many people find that their symptoms improve over time. However, if they continue to have sleep problems, they should talk to their doctor. The doctor may order a sleep study to help diagnose SWSD and determine the best treatment options. Bright light therapy can be used to adjust the circadian rhythm and promote a more normal sleep pattern. Some people also benefit from the use of melatonin, which is available over-the-counter and helps some people sleep.
Sleep is such a vital part of human life that modern medicine has an entire field dedicated to understanding it and the many conditions that affect it. If you find yourself tossing and turning at night, unable to fall asleep, waking up too early or having difficulty staying awake during the day, there could be an underlying cause. The good news is there are ways to help you get back on track and improve the quality of your sleep.
The most common cause of poor-quality sleep is insomnia. People with this condition have trouble falling or staying asleep, and they may experience an increased risk of health problems such as depression, weight gain, diabetes and heart disease. Insomnia can also lead to irritability, poor job performance and relationship difficulties.
Another common problem is circadian rhythm (body clock) disorders, which occur when your body’s natural sleep cycle gets disrupted. This can happen when you work the night shift, travel to different time zones or have a chronic sleep disorder like insomnia. Symptoms of these disorders include trouble falling or staying asleep, trouble with memory and attention span, irritability and decreased reaction times.
Involuntary movements in your arms or legs can interrupt your sleep and cause pain. These movements are called periodic limb movement disorder or PLMS, and they may occur during all stages of sleep. PLMS can be difficult to diagnose, and healthcare providers often pick it up as an incidental finding during a sleep study (polysomnogram). In some cases, PLMS may bleed into wakefulness in the form of hypnic jerks or myoclonic jerking. If this happens, it is referred to as restless leg syndrome or RLS.
RBD is a sleep behavior disorder that is characterized by reenactment of dream contents and motor behaviors during REM sleep. It is a type of parasomnia that is associated with neurodegenerative disorders, brain lesions, autoimmune conditions, and certain drugs1. RBD is also a common symptom of PD. In fact, it has been shown to be a predictive marker for progression of PD. Patients with PD and RBD experience faster cognitive decline, more psychiatric comorbidities, poorer treatment response, and more widespread brain atrophy compared to PD patients without RBD2.
The diagnosis of REM sleep behavior disorder is based on clinical history and in-laboratory video polysomnography. A history of repeated episodes of dream enactment behavior and a lack of other explanations for the behaviors are crucial in diagnosing the condition. In RBD, the defining feature is abnormal dream mentation that correlates with a wide range of complex and sometimes violent motor behaviors during REM sleep, such as punching, gesturing, and crying. Often, the behavior is preceded by excessive transient muscle activity in the chin and limb electromyography (EMG).
People with REM sleep behavior disorder are prone to injuries during their episodes of reenactment. They may kick, punch, scream, or pull their sleeping partner out of bed. They also may damage the home and its furniture, and they can even be injured by their own movements. They are at high risk of developing Alzheimer’s disease and other forms of dementia, and they may have an increased incidence of depression. Therapeutic management involves reducing injury risks and ensuring that the patient’s sleeping environment is safe and secure. This includes changing the patient’s bedding, padding the floor or sharp furniture surfaces, and limiting stimuli that can trigger the episodes.