Body Twitches and Sleep Issues: A Neurology Perspective

Body twitching and inability to sleep?

Hello, doctor.
I apologize for bothering you with a question.
My mother (48 years old) has been experiencing some health issues.
About a week ago, she started feeling her body twitching while she was conscious before falling asleep.
Initially, it was her limbs that would occasionally twitch, but now it has progressed to twitching of the skin surface, with her limbs twitching approximately every 10 minutes.
These sensations only occur when she is relaxing before sleep, which has made it difficult for her to fall asleep.
My mother has had kidney issues for a long time; could this be related? Or could it be due to lifting heavy objects? However, it has already been two weeks, and she is still experiencing these symptoms.
She has seen a doctor, but they couldn't determine the cause and only prescribed muscle relaxants.
I would appreciate your response.
Thank you.

Ph, 20~29 year old female. Ask Date: 2019/07/08

Dr. Cai Zongzhang reply Neurology

Hello, the twitching you are referring to likely involves involuntary and rhythmic movements of a certain part of our body, most commonly seen as shaking of the hands or limbs.
However, it can also occur in other areas such as the head, neck, and extremities.
There are many causes of twitching, and a neurologist will diagnose based on the location, frequency, timing, and other related symptoms of the tremors.
In simple terms, the causes of twitching can be categorized into physiological, psychological, and pathological.
In fact, every person's muscles experience subtle twitches that are often difficult to notice.
Sometimes, twitching can occur under stress or tension.
Conditions such as metabolic abnormalities (like hypoglycemia or hyperthyroidism), certain medications, and even beverages like coffee, tea, and cola can also lead to twitching.
It is advisable to observe the symptoms closely or consult a physician for further examination.

Reply Date: 2019/07/08

More Info

Understanding body twitches and sleep issues can be quite complex, especially when considering the various physiological and psychological factors involved. In your mother's case, the symptoms she is experiencing—specifically, the twitching or jerking movements of her limbs and skin before falling asleep—could be indicative of several conditions, including myoclonus, restless leg syndrome, or even anxiety-related disorders.

Myoclonus refers to sudden, involuntary muscle jerks that can occur in various parts of the body. These movements can be benign, such as those experienced during the transition from wakefulness to sleep, often referred to as hypnic jerks. However, if these movements are persistent and disruptive, they may warrant further investigation.
Restless leg syndrome (RLS) is another possibility, characterized by an uncontrollable urge to move the legs, often accompanied by uncomfortable sensations. This condition typically worsens during periods of inactivity, such as when lying down to sleep, and can significantly impact sleep quality.

Given your mother's history of kidney issues, it is essential to consider that certain metabolic imbalances or electrolyte disturbances related to renal function could contribute to muscle twitching or spasms. For instance, low levels of magnesium or potassium, which can occur in individuals with kidney problems, may lead to muscle cramps or twitching.
Additionally, the physical strain from lifting heavy objects could also play a role in her symptoms. Muscle fatigue or strain can lead to spasms or twitching, particularly if the muscles are overworked or not adequately rested.
It's also worth noting that anxiety and stress can exacerbate physical symptoms, including muscle tension and twitching. If your mother has been under significant stress, this could contribute to her sleep disturbances and the twitching sensations she is experiencing.

Since she has already consulted a physician who prescribed muscle relaxants, it may be beneficial for her to follow up with a neurologist or a sleep specialist. These specialists can conduct a more thorough evaluation, which may include a sleep study (polysomnography) to monitor her sleep patterns and movements throughout the night. This could help identify any underlying sleep disorders or neurological conditions that may be contributing to her symptoms.

In the meantime, encouraging your mother to practice good sleep hygiene can be beneficial. This includes maintaining a regular sleep schedule, creating a relaxing bedtime routine, and ensuring her sleep environment is comfortable and conducive to rest. Additionally, gentle stretching exercises before bed may help alleviate muscle tension and promote relaxation.

In summary, while your mother's symptoms could be related to various factors, including her kidney health, physical strain, or anxiety, a comprehensive evaluation by a specialist is crucial for accurate diagnosis and effective treatment. It’s essential to address both the physical and psychological aspects of her condition to improve her overall well-being and sleep quality.

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