The line between simply bizarre and truly worrisome sleep habits usually comes down to how frequent and disruptive the behavior is and whether it's explainable by something else.
Carlos had been a snorer his whole life. All the men in his family snored, too. Even after his wife began retiring to the family’s guest bedroom so she could sleep in peace, Carlos, 57, didn’t think much of his nighttime quirk; after all, he had bigger problems — including high blood pressure, diabetes, heart disease, heartburn and erectile dysfunction — to worry about.
It wasn’t until Carlos, whose story is featured in the American Psychiatric Association’s guide to its latest diagnostic manual, complained to his doctor about daytime sleepiness and a lack of focus — despite being in bed for eight to 10 hours each night — that he learned his snoring was a symptom of a very real, albeit common, disorder: sleep apnea, which repeatedly causes breathing to stop throughout the night.
“Years ago, we thought snoring was weird and funny, but we now know it’s a potentially negative symptom,” says Dr. Karl Doghramji, a psychiatrist who serves as medical director of the Jefferson Sleep Disorders Center in Philadelphia.
And while most snoring is harmless, it may be cause for concern if it involves a pause in breathing followed by a gasp — a typical pattern in sleep apnea, says Dr. Neil Kline, a sleep physician, internist and spokesman for the American Sleep Association in Lititz, Pennsylvania.
In the case of many other nighttime habits, the line between simply bizarre and truly worrisome usually comes down to how frequent and disruptive the behavior is and whether it’s explainable by something else, like poor sleeping habits. “There are people who are following all of the rules and sleeping at the right time and not taking medications, and it happens on a constant basis,” Doghramji says. “Then we try to find out what’s causing the condition.”
When in doubt, seek an evaluation from a sleep specialist, who can help diagnose or dismiss your (or your partner’s) concerns. If it is a sleep disorder, effective treatments are available and important to pursue since untreated conditions can impair daily life and, at least in the case of sleep apnea, can raise risk of heart attack, stroke and deadly accidents. “Don’t dismiss these,” Doghramji says.
Here’s how to evaluate whether six other nighttime behaviors might be red flags:
1. Drooling
If you wake up with a puddle on your pillow or spot a wet patch on your shoulder after nodding off on a plane, rest easy: While sometimes embarrassing, drooling in and of itself is usually completely normal, Kline says. “Our mouth is always making saliva, and sometimes we sleep with our mouth open, so the saliva comes out and that’s what drooling is,” he says.
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Thinkstock
2. Sleepwalking
What if you could log some of your 10,000 steps each day without even realizing it? For some people, mostly kids, it happens and is usually not cause for alarm, Kline says. Still, it’s worth taking precautions to keep your loved ones safe if they’re prone to sleepwalking by keeping them protected from dangerous items like knives or areas like windows that could be mistaken for doors. “There are reports of people doing very complex actions during sleep, including leaving the home and driving somewhere and then awakening and having no recollection of what’s happening,” Kline says.
Never try to wake a sleepwalker, warns Michael Grandner, a psychologist who directs the Sleep & Health Research Program at the University of Arizona College of Medicine. “When someone is woken up from sleep walking, not only are they already disoriented, but [their negative reaction] seems to be exaggerated,” he says. “They don’t know who they are and where they are; they just lash out.” To avoid catching the brunt of it, try to guide sleep walkers back to bed.
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3. Sleep talking
When Adam Lennard started saying uncharacteristically confident phrases like “hold me, I want you to feel greatness” in his sleep, his now-wife decided to share the hilarity with the world by recording his habit in a blog called “Sleep Talkin’ Man.” Kline, too, says sleep talking usually is merely a laughing matter and “not necessarily a symptom of a disorder.” That said, it can also be associated with fragmented sleep, so if you’re a sleep talker who doesn’t seem well-rested even after being in bed for the recommended seven to nine hours, talk to your doctor or visit a sleep specialist.
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4. Screaming
Waking up to the uncontrollable screams of a seemingly terrified child is a parent’s nightmare, but if the sounds are night terrors — common episodes in childhood that the screamer has no recollection of — parents can at least take comfort in knowing their children are probably just fine. “Your kid is not in pain; your kid is not in danger — they actually don’t know it’s going on,” Grandner says, since the screams don’t occur during the same state of sleep as dreaming and are different from nightmares. “One way to make a night terror worse is to hug them and calm them down and make them stop crying. The best thing to do is ignore it, and then it will go away.”
(Thinkstock)
Thinkstock
5. Twitching
Do you keep twitching yourself or your partner awake? While a jerk or two while falling asleep is normal as your brain and body imperfectly shift into different phases of sleep, leg twitches in a limb like the leg that are rhythmic, happening every 25 seconds or so, may be linked to sleep apnea. Treating the apnea often eliminates these so-called “periodic limb movements,” Grandner says. If the twitches or discomfort in your legs happen while you’re still awake — and subside when you stand up — it may be restless legs syndrome, which is typically treated by adding iron to the diet or taking a very low dose of a Parkinson’s medication, which can help promote better muscle-brain coordination, Grandner says.
(Thinkstock)
Thinkstock
6. Kicking
First you kissed your spouse goodnight, but later in the night, you reportedly kicked her. What gives? It may be REM behavior disorder, a sleep disorder most common in older adults that can cause them to punch, hit and kick while sound asleep. “They’re essentially acting out their dreams,” Kline says. “It is not uncommon for the bed partners to get injured by this thrashing.” If this behavior sounds like you, talk to your doctor since the condition is also linked to Parkinson’s disease. And, while there are medications that may help treat this and other odd behaviors during sleep, “the focus should be on preventing injury to the patient and the bed partner,” Kline says.
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