It's All Terrible: Dealing with Challenging Sleep Behaviors

September 21, 2018

It's All Terrible: Dealing with Challenging Sleep Behaviors

At Sleep365, we know that a luxurious mattress goes a long way toward getting good, healthy sleep. But we know that sometimes it’s not just your mattress that gets in the way of a good night. So we wanted to explore some of the most challenging sleep behaviors out there, and what you can do about them.


Comedian Mike Birbiglia made it funny, but also exposed how scary sleepwalking can be, too. Some sleepwalkers cook and eat food, while others get dressed or undressed. Some even drive, send text messages, or shop online – all while in a state of semi-wakefulness.

Sleepwalking typically occurs during periods of non-REM (NREM) sleep. NREM sleep (also known as “delta” or “deep” sleep) tends to occur early in the night, so sleepwalking usually happens within an hour or two of going to bed. A sleepwalking episode typically lasts less than 10 minutes , but may last up to half an hour. People of any age can sleepwalk, but children tend to sleepwalk more than any other group. Around 20 percent of all children sleepwalk at least once.

If your loved one is up and moving around in an apparently cognizant state, it can be hard to tell if they’re sleepwalking. But if, after going to bed, they’re up doing something strange and don’t respond to your voice, they’re probably sleepwalking. Other signs of sleepwalking include blank facial expressions and verbal responses that makes no sense.

What can you do if you encounter someone who’s sleepwalking? First, keep this in mind: the idea that it’s dangerous to confront them is a myth. Your main goals should be: 1) do not shout or startle the sleepwalker, and don’t try to physically restrain them unless they’re on the verge of doing something dangerous; and 2) ensure they’re safe, and gently guide them back to bed. Once they’re asleep again, wake them briefly and let them know what happened. This may prevent them from sleepwalking again during the same deep-sleep cycle.

The exact cause of sleepwalking isn’t totally understood, but researchers believe it’s a result of the brain having trouble modulating the sleep and wake cycles.

In most cases, sleepwalking goes away before adulthood. Sleepwalking that begins later in life or lasts into adulthood may be caused by underlying issues like stress, sleep deprivation, or a noisy sleeping environment. In some cases, excessive alcohol consumption, illicit drug use, or prescription sleep medication can also cause sleepwalking. You may have a higher chance of sleepwalking if you also suffer from other sleep disorders like restless leg syndrome or sleep apnea.

What to do about sleepwalking.

If you suffer from sleepwalking, try to stick to a regular sleep schedule and get the recommended six to eight hours of sleep each night. Avoid other potential triggers like sleep medications, drugs, and alcohol, and ensure your sleeping environment is cool, quiet, and dark. If sleepwalking continues, see your doctor. They may recommend hypnosis or antidepressants.

To prevent injury due to sleepwalking, you should put your car keys away, lock all doors and windows, keep firearms and other weapons out of reach, and remove breakable objects from the bedroom. If you have a sleepwalking child, make sure they don’t sleep on the top bunk. Finally, ensure that everyone in your home knows that you or your loved one sleepwalks.

What to do about sleep talking.

In most cases, sleep talking isn’t problematic. But if your chronic sleep talking is irritating your bed partner, talk to a doctor. You may also want to speak with a doctor if your sleep talking begins after the age of 25, since it could indicate some other medical issue.

Sleep talking.

Sleep talking – technically known as somniloquy – is simply the act of talking while sleeping. Sleep talking might include mumbling, nonsensical speech, or entire dialogues. The speech – if it’s at all coherent – might refer to past or present events. Like dealing with a cranky old Australian, understanding a sleep talker’s speech can be difficult or impossible. But don’t worry — most incidents last just a few seconds and are harmless.

Sleep talkers are typically not aware of their behavior. Sleep talking can occur spontaneously but it can also be induced by speaking to a sleeping person.
Unlike sleepwalking, sleep talking poses no physical danger, though it can irritate your bed-sharing partner or roommate. Sleep talkers are often afraid to sleep away from home to avoid annoying others or embarrassing themselves.

Sleep talking can be genetic, and seems to occur more in males and children. It might be caused by alcohol and drugs, stress, fever, anxiety, and depression. Eliminating or accurately diagnosing these conditions could enable you to tackle your sleep talking.


Nightmares and night terrors.

Nightmares and night terrors are similar and different — just like Democrats and Republicans. Both primarily affect children of similar ages. In the case of nightmares, children three to six years old are most at risk, while night terrors typically affect children who are three to eight years old. Nightmares and night terrors also have similar causes: stress, sleep deprivation, and anxiety. And in most cases, children eventually grow out of nightmares and night terrors without any lasting psychological effects.

But nightmares and night terrors are also different. Nightmares tend to occur later in the night, during REM sleep. Night terrors, on the other hand, take place early in the night, usually in the first two hours of going to bed.

Plus: while nightmares typically include no physical behavior, children experiencing night terrors might sweat, scream, lash out, and/or appear anxious.

And finally, nightmares are often vivid and can be recalled in detail upon waking or the next day. Children who experience night terrors, however, often won’t recall them upon waking.


What to do about nightmares and night terrors.

It’s almost impossible to wake someone having a night terror, so many authorities discourage parents from even trying. Instead, just wait for the incident to pass or – if you feel obligated to do something – stand by making soothing comments, and hold your child if it seems to help.

Nightmares often occur spontaneously, but you might be able to prevent them by preventing your child from viewing scary films, games, or television shows.

Periodic Limb Movement in Sleep

About 80 percent of people with RLS also experience periodic limb movement in sleep (PLMS). PLMS causes people to twitch or jerk their legs (or, in rare cases, their upper limbs) in repetitive motions every 20 to 40 seconds while sleeping. One or (more commonly) both legs may be affected. A PLMS episode can last anywhere from a few minutes up to an hour. Motions might include a repetitive extension of a single toe, or a bending at the knee or ankle.


Restless Leg Syndrome and Periodic Limb Movement in Sleep

It sounds funny, but it’s a pain: Restless leg syndrome (RLS) is causes aching, itching, throbbing, crawling, or pulling feelings within your legs. Kicking or flexing your legs will relieve the symptoms, at least temporarily. The severity of the symptoms varies from person to person, but they tend to increase in the evening and at night, often right when you’re falling asleep. The symptoms may also manifest while you’re sleeping, causing you to wake up or move your legs. As a result, people with serious RLS report getting less than five hours of sleep each night. But even a mild case of RLS can negatively affect the quality of your sleep.

RLS is typically seen in older adults, with the onset beginning after 45 years of age. Women are roughly twice as likely as men to develop RLS, and an estimated seven to 10 percent of the U.S. population has the disorder.

Medical experts believe RLS has three primary causes: iron deficiencies, dopamine deficiencies, and certain genetic conditions. Anemia, pregnancy, and some medications can also trigger RLS.  

What To Do

If you’re experiencing RLS, talk to your doctor. The condition can often be managed by changing your sleep habits or increasing the amount of exercise you get. You should also limit your intake of caffeine, alcohol, and tobacco, all of which might exacerbate your symptoms. If all else fails, you might also be able to treat your condition with medication.

REM sleep behavior disorder.

During REM sleep, the brain “locks” your limbs in place to prevent you from acting out your dreams. But in some people, this locking mechanism doesn’t work. The resulting condition, known as REM sleep behavior disorder (RBD), causes you to move your limbs just as you do in your dream.

RBD is serious because it can be not only disruptive to you and your partner, but downright dangerous. People with RBD have been known to scream, hit, and punch during REM sleep.

Anyone can develop RBD, but men over 50 years of age are at increased risk. Having certain kinds of dementia, Parkinson’s disease, or other neurodegenerative disorders also increases your risk for RBD. Antidepressants have also been known to cause RBD.

What to do about RBD.

If you experience RBD, see a doctor. The condition may be associated with an undiagnosed neurodegenerative condition or brain tumor. Treatment will typically require medication or altering the dosage of any medication you’re currently taking. Your doctor might also recommend placing barriers on your side of the bed and removing dangerous or fragile objects from your bedside. If your episodes occur frequently, your bed partner may also want to sleep in a separate bed.


That's a lot of information. Are you tired yet?

Unfortunately, we could go on. But with so many challenges to your sleep, let’s not get too stressed out. The good news is a healthy lifestyle, a good bed, supportive family, and proper medical attention can provide relief for most of these conditions.