Sleep Tremors and Migraines: When to Seek Medical Advice

Muscle twitching, migraine?

Hello doctor, I would like to ask if the following symptoms my friend experiences while sleeping are normal and if she needs to go to the hospital for an examination.
She is 20 years old, does not smoke or drink alcohol, has a family history of diabetes (her father), and has no personal medical history except for occasional migraines.

1.
She experiences continuous shaking while sleeping (her hands shake, then her feet, and sometimes her shoulders and fingers), and when she wakes up, she does not feel the shaking.
2.
She falls asleep easily but has very light sleep.
3.
She loves to sleep and often feels unrested.
4.
She grinds her teeth while sleeping, constantly clenching her jaw.
Regarding her migraines, besides reducing chocolate and cheese intake (as found online), what other methods can help reduce the frequency of her headaches? Are they periodic headaches or can they be prevented? Thank you, doctor.

Yu, 10~19 year old female. Ask Date: 2018/10/12

Dr. Cai Zongzhang reply Neurology

Hello, regarding your friend's issue, it is uncertain if he is simply too fatigued.
Especially considering the sleep conditions you described, this phenomenon may occur due to excessive fatigue or long-term irregular sleep patterns.
It is recommended that he maintains a regular daily routine, engages in moderate exercise, and follows a balanced diet.
If the symptoms do not improve, it is advisable for him to visit a hospital for further evaluation.

Reply Date: 2018/10/12

More Info

Dear Concerned Friend,
Thank you for reaching out with your questions regarding your friend's sleep disturbances and migraines. It’s important to address these symptoms, as they can significantly impact overall health and quality of life. Let’s break down the symptoms your friend is experiencing and discuss when it might be appropriate to seek medical advice.

Sleep Tremors
1. Tremors During Sleep: The continuous shaking or tremors your friend experiences while sleeping could be indicative of several conditions. One possibility is periodic limb movement disorder (PLMD), which involves involuntary movements of the limbs during sleep. Another consideration could be restless legs syndrome (RLS), which often leads to uncomfortable sensations in the legs and an urge to move them, typically worsening at night. Since your friend is unaware of these movements upon waking, it might be less likely to be a conscious action but rather an involuntary response during sleep.

2. Shallow Sleep: The fact that your friend falls asleep easily but experiences shallow sleep could suggest a disruption in the sleep cycle. This can be caused by various factors, including stress, anxiety, or even sleep disorders. Shallow sleep may prevent her from reaching the deeper stages of sleep, which are crucial for restorative rest.

3. Frequent Sleepiness: Feeling excessively sleepy during the day can be a sign of inadequate sleep quality or quantity. If your friend is getting enough hours of sleep but still feels tired, it may be worth investigating her sleep patterns further.

4. Teeth Grinding (Bruxism): Grinding teeth during sleep, known as bruxism, is another common issue that can lead to dental problems and headaches. It can be caused by stress, anxiety, or misaligned teeth. This condition can also contribute to sleep disturbances and may require intervention from a dentist or a sleep specialist.

Migraines
Regarding your friend's migraines, it’s essential to understand that migraines can be triggered by various factors, including dietary choices, stress, hormonal changes, and sleep patterns. Here are some strategies that may help manage her migraines:
- Dietary Modifications: In addition to avoiding chocolate and cheese, your friend might consider keeping a food diary to identify other potential triggers. Common migraine triggers include caffeine, alcohol, processed foods, and foods containing MSG.

- Regular Sleep Schedule: Maintaining a consistent sleep schedule can help regulate sleep patterns and potentially reduce the frequency of migraines. Encouraging your friend to establish a calming bedtime routine may also improve her sleep quality.

- Hydration: Dehydration can trigger migraines, so it’s crucial for her to drink enough water throughout the day.

- Stress Management: Techniques such as mindfulness, yoga, and regular physical activity can help reduce stress levels, which may, in turn, decrease the frequency of migraines.

When to Seek Medical Advice
Given the symptoms your friend is experiencing, it would be advisable for her to consult a healthcare professional, particularly a sleep specialist or a neurologist. Here are some signs that indicate she should seek medical attention:
- If the tremors during sleep worsen or become more frequent.

- If she experiences excessive daytime sleepiness that interferes with her daily activities.

- If she has frequent migraines that are not responding to over-the-counter treatments or lifestyle changes.

- If she notices any other concerning symptoms, such as changes in mood, cognitive function, or overall health.

In conclusion, while some sleep disturbances can be benign, the combination of symptoms your friend is experiencing warrants further investigation. A healthcare professional can provide a thorough evaluation, possibly including a sleep study, to determine the underlying causes and recommend appropriate treatment options.
Best wishes to your friend for improved sleep and health!
Sincerely,
Doctor Q&A Teams

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