Sleep-related movement disorders

Sleep-related movement disorders involve repeated body movements, uncomfortable sensations, muscle contractions, or jaw grinding that occur during sleep or interfere with the ability to settle for sleep. These unconscious or unwanted movements can cause shorter sleep duration or fragmented sleep, and may lead to sleepiness, brain fog, pain, or other problems during the day. This page explains common signs, the conditions in this category, and when to seek support.

Nighttime symptoms

• Repeated kicking, jerking, or flexing during sleep
• Sudden painful cramps in the calf, foot, or thigh
• Tooth grinding, jaw clenching, or grinding sounds during sleep
• Difficulty falling asleep, repeated waking, or unrefreshing sleep
• Sleep disruption for a bed partner or caregiver

Daytime Symptoms

• An urge to move the legs during rest, evening, or bedtime
• Uncomfortable crawling, pulling, tingling, aching, or burning sensations in the limbs
• Morning jaw pain, headache, muscle soreness, or tooth sensitivity
• Daytime fatigue, sleepiness, poor concentration, irritability, or reduced function

Symptoms may begin in the evening or during sleep, but their effects can continue into the next day. Repeated awakenings, pain, jaw tension, or an urge to move can affect sleep quantity and quality, which can flow onto having an impact on daytime energy, concentration, mood, relationships, school, work, driving, and physical activity.

The relationship can also move in the other direction. Sleep loss, long periods of sitting, stress, activity patterns, medications, caffeine, alcohol, and health conditions may influence symptoms for some people. A whole-24-hours approach looks for patterns and aims to identify opportunities for treatment and lifestyle optimization.

A person does not need to know the name or cause of a condition before asking for help. Arrange an appointment when symptoms are persistent, worsening, painful, distressing, or affecting sleep or daytime life.

Red flag: Seek prompt medical or dental care for:

• Falling asleep while driving or during safety-sensitive activities
• New weakness, numbness, swelling, redness, injury, or severe pain
• Jaw locking, major tooth damage, or difficulty eating
• Movements associated with falls, injury, or violent dream enactment
• Symptoms or sleepiness that causes severe distress or thoughts of self-harm
• Symptoms beginning after a medication change
• Major changes in mood, behavior, school performance, or daytime alertness

Assessment begins with thorough history with a clinician who may review symptom timing, pain, the effect of movements, medications, substances, iron status, medical conditions, stress, sleep schedule, and observations from another person.

RLS and typical nighttime cramps are usually identified from the symptom history. Dental examination is important for bruxism (tooth grinding). PLMD requires an overnight sleep study to measure limb movements and determine whether they are linked with sleep disruption. Testing should be matched to the person and suspected condition. Discover more details about assessment and diagnosis for each sleep-related movement disorder on the relevant topic page.