Sleep-Wake Transition Disorders

Sleep-wake transition disorders cause difficulties during the transition from waking to slumber, or from one sleep stage to another. The best-known transition disorder is so common that most people don't even think of it as a disorder at all: sleep talking.

Somniloquy or Sleep Talking

Sleep talking, or somniloquy, can occur at any point in the sleep cycle. The lighter the sleep, the more intelligible the speech. During the early stages of the sleep cycle, people may have entire conversations while asleep. In deeper slumber, somniloquy may consist of moans and gibberish.

Popular myth associates sleep talking with dreams. While talking while dreaming is possible, somniloquy can occur during other stages of sleeping. Sleep talking is a relatively common condition. About 50 percent of children and 5 percent of adults talk in their sleep, according to the American Academy of Sleep Medicine (2007).

People who sleep talk typically have no awareness that they're talking, and often speak in an emotionless tone. Anxiety disorders, stress and fevers can cause sleep talking. Somniloquy is not generally considered a serious problem unless it's severe or long lasting. If your sleep talking disturbs your partner or others in the household, or if your sleep talking is particularly loud or violent, you should see a sleep specialist.

Reducing Sleep Talking Symptoms

Somniloquy can be very bothersome to other family members. Here are a few tips to help reduce nighttime chatter:

Avoid heavy meals and caffeine before bedtime.Get enough rest as sleep deprivation increases somniloquy.Practice proper sleep hygiene by developing the habits and rituals conducive to sleeping well.Reduce stress levels as much as possible, especially right before going to bed.

Other Sleep-Wake Transition Disorders

Sleep talking is the most common of the sleep-wake transition disorders, but it's not the only one. Others are:

• Rhythmic movement disorder: Rhythmic movement disorder is a common sleep-wake transition problem seen in infants and young children. The child may engage in head-banging, head-rolling, body-rolling or body-rocking just before falling asleep. According to the American Academy of Sleep Medicine (2006), 59 percent of nine-month-old infants experience it to some degree. The Academy also notes that by age five, only five percent of children still have bedtime rhythmic movements. Rhythmic movement disorder may be alarming to parents, but it generally doesn't require treatment.
• Nocturnal leg cramps: Nocturnal leg cramps are sudden cramps in the leg that wake people up. Nocturnal leg cramps occur most often in the calf, but can also occur in the soles of the feet. The condition becomes more common after age 50. Nocturnal leg cramps may last mere seconds to as many as 10 minutes, and the soreness can linger even longer. Heavy exercise before bedtime appears to increase the chances of leg cramps. Nocturnal leg cramps are not to be confused with restless leg syndrome or periodic limb movement disorder.
• Myoclonus and sleep-wake transitions: Myoclonus, also known as sleep starts, are brief involuntary muscle twitches that often occur during the sleep-wake transition. The sudden twitch startles many people out of sleep and may be disruptive to their bed partners. Most people experience myoclonus at one time or another. Hiccups are another type of myoclonus.

Resources

Cleveland Clinic. (2008). Nocturnal leg cramps. Retrieved August 19, 2010, from http://my.clevelandclinic.org/disorders/nocturnal_leg_cramps/hic_nocturnal_leg_cramps.aspx.

Kuhlman, D. (2007). Sleep talking. Retrieved August 25, 2010, from http://www.sleepeducation.com/Disorder.aspx?id=16.

National Institute of Neurological Disorders and Stroke. (2010). Myoclonus fact sheet. Retrieved August 19, 2010, from http://www.ninds.nih.gov/disorders/myoclonus/detail_myoclonus.htm.

National Sleep Foundation. (n.d.). Sleep talking. Retrieved August 19, 2010, from http://www.sleepfoundation.org/article/sleep-related-problems/sleep-talking.

Townsend, D. (2006). Rhythmic movement. Retrieved August 19, 2010, from http://www.sleepeducation.com/Disorder.aspx?id=18.