Sleep-Related Muscle Twitches and Anxiety Disorders

Q: Sleep-Related Muscle Twitches and Anxiety Disorders

Hello Ms. <br>Cocoa： You mentioned that "the eyelid nerves and even the facial nerves at the corners of the mouth are twitching involuntarily... <br>the teeth are clenching involuntarily, and after clenching, the facial muscles (near the cheekbones) also start to twitch significa

Teeth clenching and facial muscle twitching upon falling asleep?

Hello Dr.
Jiang: I have been experiencing anxiety and autonomic nervous system dysregulation for the past six years.
During severe episodes, I take half a Xanax for relief.
In recent years, I have noticed that sometimes when I wake up, the nerves in my eyelids and even the corners of my mouth can twitch involuntarily.
This condition can last for many days, and sometimes while lying in bed, I feel certain parts of my body twitching as well.
Last night, my partner noticed that as I was falling asleep, my teeth were clenching involuntarily, and after that, the muscles in my face (around the cheekbone area) began to twitch significantly.
They also felt that my body seemed to twitch a bit.
Later, they tried to massage my head, which seemed to help me relax.
However, I am starting to worry that if my partner is asleep and doesn't notice, could this lead to epilepsy? I would appreciate your help in addressing my concerns.
Thank you.

Kekou, 30~39 year old female. Ask Date: 2023/10/18

Dr. Jiang Junyi reply Neurology

Hello Ms.
Cocoa: You mentioned that "the eyelid nerves and even the facial nerves at the corners of the mouth are twitching involuntarily...
the teeth are clenching involuntarily, and after clenching, the facial muscles (near the cheekbones) also start to twitch significantly." Generally speaking, muscle twitches that occur before falling asleep are referred to as hypnic jerks.
Under conditions of excessive fatigue, mental stress, and psychological anxiety, involuntary body movements may occur when falling asleep, which can happen during napping or nighttime sleep.
Typically, muscle twitching while awake resembles peripheral muscle instability and may warrant consideration of certain metabolic disorders, such as hyperthyroidism or electrolyte imbalances.
Additionally, some nerve-stimulating substances like caffeine may exacerbate muscle twitching while awake.
The epilepsy you are concerned about is a symptom caused by abnormal electrical discharges in the brain and requires an electroencephalogram (EEG) for diagnosis.
If symptoms persist, it is advisable to consult a neurologist for further evaluation.
Thank you for your inquiry, and feel free to discuss further.
Wishing you good health, peace, and happiness.
Dr.
Jiang Junyi, Department of Neurology, Taoyuan Hospital, cares for you.

Reply Date: 2023/10/18

More Info

Dear Patient,
Thank you for reaching out with your concerns regarding sleep-related muscle twitches and anxiety disorders. It’s understandable to feel anxious about these symptoms, especially given your history of anxiety and autonomic nervous system dysregulation. Let’s delve into your situation and explore some potential explanations and recommendations.

Firstly, it’s important to recognize that muscle twitches, or myoclonus, can occur for a variety of reasons. In the context of anxiety disorders, these involuntary movements can be exacerbated by heightened stress levels. Anxiety can lead to increased muscle tension, which may manifest as twitching or jerking movements, particularly during the transition between wakefulness and sleep. This phenomenon is often referred to as "sleep starts" or hypnic jerks, which are sudden muscle contractions that can occur as one is falling asleep.

Your experience of eyelid and facial muscle twitching, as well as the involuntary jaw movements you described, could be related to several factors:
1. Anxiety and Stress: Chronic anxiety can lead to muscle tension and spasms. The body's fight-or-flight response can cause muscles to remain in a state of heightened readiness, leading to twitching or jerking movements.

2. Sleep Disorders: Conditions such as sleep apnea or periodic limb movement disorder can cause involuntary movements during sleep. These disorders can disrupt sleep quality and lead to daytime fatigue and anxiety.

3. Medication Side Effects: While Xanax (alprazolam) is commonly prescribed for anxiety, it can also have side effects, including muscle spasms or twitching in some individuals. If you suspect that your medication may be contributing to these symptoms, it’s crucial to discuss this with your prescribing physician.

4. Neurological Concerns: While it’s understandable to worry about conditions like epilepsy, the symptoms you describe do not necessarily indicate a seizure disorder. However, if you experience persistent or worsening symptoms, it would be prudent to consult a neurologist for a thorough evaluation.

To address your concerns and improve your sleep quality, consider the following strategies:
- Sleep Hygiene: Establish a calming bedtime routine to signal to your body that it’s time to wind down. This could include activities such as reading, gentle stretching, or practicing relaxation techniques like deep breathing or meditation.

- Limit Stimulants: Reduce or eliminate caffeine and nicotine intake, especially in the hours leading up to bedtime, as these can exacerbate anxiety and disrupt sleep.

- Regular Exercise: Engaging in regular physical activity can help reduce anxiety and improve sleep quality. Aim for at least 30 minutes of moderate exercise most days, but avoid vigorous workouts close to bedtime.

- Mindfulness and Relaxation Techniques: Practices such as yoga, meditation, or progressive muscle relaxation can help alleviate anxiety and reduce muscle tension.

- Consult a Specialist: If your symptoms persist or worsen, consider seeking a consultation with a sleep specialist or a neurologist. They can conduct further assessments, such as a sleep study, to determine if there are underlying sleep disorders contributing to your symptoms.

- Medication Review: Discuss your current medication regimen with your healthcare provider. They may consider adjusting your dosage or exploring alternative medications that may have a lower risk of side effects related to muscle twitching.

In conclusion, while your symptoms may be concerning, there are several avenues to explore for relief and improvement. It’s essential to maintain open communication with your healthcare providers and seek their guidance as you navigate these challenges. Remember, you are not alone in this journey, and with the right support and strategies, you can work towards better sleep and reduced anxiety.

Wishing you all the best for your health and well-being.

Sincerely,
Doctor Q&A Teams
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