Saturday, April 11, 2009

Sleeping Disorders - A startle or jolt before sleep - The Hypnic Jerk

One of the most common sleeping disorders, and one of the milder ones, is an involuntary muscle spasm or jolt which occurs just as we are falling asleep – a sleep start. This condition is known as a hypnic jerk or hypnagogic jerk. It is a reaction very like the “startle” response and can be accompanied by a falling sensation. It can feel like an electric shock just before dropping off.

Something around 10% of the population will experience hypnic jerks on a regular basis and 60% to 70% at some point in their lives. They often happen if we fall asleep in an uncomfortable position, are sleep deprived or over tired or are having a stressful or anxious time. A hypnic jerk is a type of myoclonic twitch and is similar to a hiccup. It’s considered to be a benign condition.

Not enough research has been done on the subject to give a definitive answer on why they occur but there are a number of theories.

One is that it is just a part of falling asleep in some people. As part of a number of stages from changing brain waves, slowing heartbeat and breathing, the bodies muscular systems transition into their “sleep” state accompanied by the jerk.

Another theory is that as the muscles relax our brain is tricked into thinking that it is falling, drowning or somehow in danger. The jerk is an attempt to turn oneself upright or catch something leading to safety.

Most people experience the hypnic jerk once or twice a night and often don’t even know they are undergoing the reaction. A more severe case can severely affect the sufferers or a bed partners sleep inviolves the twitching every 30 seconds throughout the night. This sleeping disorder is known as periodic limb movements (nocturnal myoclonus).

Generally hypnic jerk requires no treatment and is a normal part of sleep every so often. No “cure” has been developed. A return to normal sleeping patterns, retiring to bed before overtiredness or treatment for the underlying stress and anxiety will often reduce the occurrences another suggestion is to avoid caffeine and spend some time before attempting to fall asleep engaged in relaxation.

If the jolt is causing you more than a mild surpise or is preventing you from getting regular sleep than see you doctor.

34 comments:

  1. Amazing to read this! I experience a single hypnic jerk every night without fail. The effect is a welcome instant 'dumping' of concerns of the day, allowing true relaxation ready for sleep.
    My wife, for many months demonstrated nocturnal myoclonus EXACTLY as described, other than it included a contraction and painful (for me)scraping of the toenail every 30 seconds. Not 27. Not 33, but oddly a regular 30! The unerring regularity made it difficult to accept as an involuntary act! -We remain married. Adequate rest and reduced anxiety have lessened severity of my hypnic jerk and my wife's nocturnal myoclonus has indeed ceased.

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  2. I to jerk every 30 seconds but my son whose 3 does to I don't really get why is it genetic?

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  3. This is happening to me more than a few times a night, and at least 4-5 nights a week. Ive gone to bed at 9pm and find myself still awake at 6am, finally so exhausted i fall asleep with an hour or two of rest before having to work a full work day. Two to four hours a night is not enough to properly function. This is one of the most frustrating things ive ever dealt with. Does anyone have any advice or tips on specifically what they did to help this problem?

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  4. I believe that my hypnic jerk is caused by my efforts in the past to stay awake at night even though I had been very sleepy. This habit is picked up by my brain, so that it always wakes me up whenever I'm falling asleep. I think the cure is to force myself to sleep regularly, and lose the anxiety over being unable to sleep. A little sedative might help to start regular sleep schedule. Just be careful in choosing the right,non-addictive sedative.

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  5. I fell asleep in the arms of my boyfriend and he told me I jerked in my sleep. He was quite worried. When he fell asleep and I was awake, it happened to him. I am very confused about it, but it may of been because we were in an uncomfortable position.

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  6. I thought, and still think to some extent that I am experiencing nocturnal seizures. Usually I have between 60-100 a month. In May this year I was put on tegretol 800mg which took my 'fits' down to 15/20 a month. This month my neurologist thought they might be sleep starts and I have been put on Clonazepam along side the tegretol. This month I have had just 3 'fits'. I am not sure if I am experiencing seizures or sleep starts.

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    1. yours mirror mine exactly - up to 100 a month, then on 800 tegretol and fits down to 15/20, then clonazepam 4mg at night and 0.5 am. noon and tea time - fits down to two a month!

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  7. I have spent 3 months of hell. My hypnic jolts/jerks were down to a diazepam withdrawal I did too quickly (after 16 years on the drug). At one time I was having hundreds a night and was unable to fall into unconsciousness at all. Had to have sleeping pills. I am now back on the drug to try to stop the jolts then I will reduce very slowly.

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  8. I am convinced Zantac has something to do with this as if changing the chemistry of the brain, I stopped taking it for a year and all is well.

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  9. Well not that this is a GOOD thing, but this is a refreshing forum to find. I have been suffering with these "jerks" for over a year now. They started one night out of nowhere. I had quit smoking 6 months before, but other than that, nothing else had changed. I still have them today. About a month into them, because I was not sleeping at all, my doctor finally, after going thru the sleeping pill list, prescribed me xanax, 1 mg for sleep. The first night I took it I slept for 9 hours straight, no jerks, no interruptions, great dreams! Unfortunately, now I have been taking the xanax for 14 months every night. If I don't take it, I don't sleep. Or if I try to cut my dose, I jerk and get maybe 2 or 3 hours of sleep at best. I worry I've created a monster with this drug. I only take .75 mg a night for sleep, but I've been doing it EVERY night for over a year. My naturepath told me, "Every prescription like that should have and EN DATE, otherwise its causing harm!" I don't know. Any suggestions??? Please feel free to email me any suggestions at Sunstrikn1@aol.com

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    1. You could try switching to clonazepam which is supposed to be less addictive, then weaning off that? But see a doctor to be sure.

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    2. I found just a anvil pm helps. Sometimes all night sometimes I'll get an hour or two before being herded awake

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  10. I had this over 3-4 years following a sustained time of stress at work and a house move. I believe there's a connection to MS in that sufferers can progress to MS later in some cases. Like most brain disorders, it's bound to be genetic, and also will be affected by any mind altering drug such as prozac, temazepan etc. The jerk experience is a wonderful experience like a massive high-and so I suggest it's a chemical release of endorphine? Or some other chemical. It seems to encompass the entire body and is sometimes like a flash of light. So very quick, not worried as it's the brain shutting down after a busy day. Try to marvel at the amazing complexity of the brain.

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  11. I have had this all my life and happens most nights, but only once. I fall asleep properly after the jolt. Annoys my husband as he gets disturbed by it.

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  12. I thought I was alone feeling those jolts. It happens to me usually when I am very tired and when something prevents me from going to sleep (such as my wife talking to me at the exact moment I am falling asleep). Then when my body relaxes to return to sleep, it is as if my brain is "starting me" to stay alert instead of disconnecting and drifting into sleep.

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  13. Every night I couldn't fall asleep due to "twitchy? Skin crawly?" type sensation and then whole body jolting/startle reflex several in a few minutes. I mentioned it to my sleep disorder docter. She said the doctors refer to this as "starting" and it is related to restless leg syndrome. She prescribed a small nightly dose of Requip. This immediately stopped these "twitchy, jumpy" nights of no sleep.

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  14. I have recently started getting these jolts as i fall asleep, i take an anti depressant mirtazaphine before bed. I tried not taking it and i dont sleep at all. I also get heartr paplataions sometimes. I wonder if this is a sleep disorder or something wrong with my heart. Very concerned

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  15. I'm concerned as I have had these jolts now for over a year. I am prescribed 2.0mg clonazepam every night for Myoclonic Dystonia which is a muscle spasm/movement disorder. I know clonazepam is addictive so I try to take only 0.5mg per night. I'm caught between the worry of addictive medicine and the fact that without the meds I get only 2-4hours sleep maximum. After the jolts I get a tight feeling around my chest which is a worry to me and this can linger for at least an hour. Does anyone else get this unpleasant after effect?

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    1. Yes what is the chest tightness?? I get like adrenaline rushes from what feels like in my esophagus area followed by a squeezing skin feeling, or just below the skin. Horrible PLEASE What is this????

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    2. I have had something like this and think it is hormonal. Started in menopause. Got better after that, though still happens occasionally. Scary.

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    3. Make yourself yawn and stretch go threw the motions of yawning each time you will get the feeling in your head that comes with a yawn after 6 or 7 times that stress tight feeling will subside and sometimes the July's will go away.

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    4. Make yourself yawn and stretch go threw the motions of yawning each time you will get the feeling in your head that comes with a yawn after 6 or 7 times that stress tight feeling will subside and sometimes the July's will go away.

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  16. what if my hypnic jerks are in the middle of class...and im always feeling like i might fall out of the seat without even knowing,

    and that my eyes are always in the back of my head before the jerk comes in...

    is this good or bad?

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  17. Thanks for explaining this. I've had this problem for over a year now--it doesn't happen every night, but when it does, it can happen more than once. It's always in the early sleep stage, just as I'm about the fall completely asleep. I'll suddenly awake with a gasp. It usually is connected to my sleep position, anxiety, and sugar/caffeine intake for me. As long as I avoid sweets after dinner and am in a relaxed state when I go to bed, I'm okay.

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  18. i promised to come back and share my experience should i ever get better - and I did get better. And it was thanks to advice given on this site.

    My history: I started to develop persistent hypnic jerks after a bacterial infection. The infection itself was not serious but I had my first panic attack (heart jumping a beat) after taking a particularly aggressive antibiotic. The anxiety of which was so severe that my body went into ‘fight-or-flight’ mode. That same night - for six months - I had hypnic jerks.

    The jerks were so severe that I had to take zopiclone nightly to steal 5 hours’ sleep. And then they will start again early morning. Not knowing what was going on, I was plunged into a classic nervous breakdown. Doctors prescribed me antidepressant and anticonvulsants – both proved to be highly inappropriate and I suffered terrible side effects.

    At this time I couldn’t tell what was causation and what was effect. I was in pain and fear during the day and couldn’t sleep at night. I couldn’t work for a few months.

    Then I discovered this blog page and combed through every entry (seems to have been edited since two years ago). One drug, Klonopin (Clonazepam) kept being mentioned. Cut long story short, I asked my psychiatrist to put me on it and I weened myself off all the other drugs. And it worked.

    The side effect of Klonopin, being a powerful tranquilizer of particular long half life, is that it loosens your self-inhibition. Anger and laughter came particularly quick and there was a period where my usual shy personality changed into an extrovert one.

    I was diligent on reducing dosage - as most GPs would tell you the danger of these benzos – by cutting the pill every few months or so. I went from 3mg nightly to 0.5mg.

    Now, two years later, my jerks are all gone. I can take a nap in the afternoon without being knocked out of sleep at the point of drifting off. And in my case, I recognised that it’s mostly anxiety that caused it: the spiral of fear of sleep. Because I developed a fear of it happening, it in turns causes it to happen. Klonopin helped me break that self fulfilling cycle but I found that it takes time to switch your ‘flight-or-fight’ mode off.

    Obviously this is anecdotal and each case is different. With me, these days, if it does happen (and once in a while it still does), I acknowledge it and train my mind to think about something else. Two years ago I went through MRI, psychotherapy, hypnotherapy, acupuncture, sleep study to make sure it’s not something else like periodic limb movement disorder. After everything was ruled out the neuro doctor suggested that it’s anxiety, and I poo-pooed the idea. Turns out he was right after all, in my case.

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  19. Worth mentioning in addition to the above that the sleep study revealed that I have Sleep Apnea. To what extent the lack of oxygen, in combination with anxiety, caused the sleep jerk I will never know. I'm now sleeping with a CPAP machine nightly.

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  20. It takes just an hour to get started for this medication. It helps you to focus more keep the brain active. (Cheap Modalert Online)

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  21. My daughter who is 12 now hax ot since she was a baby. She has it every night. She sleeps a lot but every noght it happens. Actually for me it is a sign that she is falling asleep.

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  22. My daughter who is 12 now hax ot since she was a baby. She has it every night. She sleeps a lot but every noght it happens. Actually for me it is a sign that she is falling asleep.

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  23. When I am half asleep (not totally in a deep sleep yet), I had this dream that I was playing volleyball with my friends and when the ball was already heading towards me, my arms and legs suddenly moved without me doing it. I also had a dream when I was on a building rooftop and suddenly, I tripped and fell off the building, then I felt a movement with my body. What do you call those reflex?

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  24. My 3 year old grand son spasms in his sleep it almost looks like he's drowning gags at the mouth and lots of fluid comes out once i put him in a up rite position he neva use to do that can it be triggered by anything thats happen to him?

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  25. Possible Help for Hypnic Jerks From Personal Experience

    I started getting hypnic jerks over four years ago. Tried everything from western medicine to alternative treatments, including acupuncture, somatic experience, brain spotting, emotional freedom technique, massages, chiropractors, ericksonian hypnosis, neurological medicines.

    Recently the following three things together seems to be making a huge difference so far and very quickly.

    1)Drinking a lot of water everyday
    2)Taking electrolyte pills as well as also taking magnesium
    3)Using the Ondamed machine which is a biofeedback machine.

    Not sure if they are really helping me or just a good stretch for me but I feel fairly confident it is the above but not sure which of the three is the most important. But will keep you updated if I continue doing better.

    No harm in trying at least the first two.

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