By Michael Huckabee, Ph.D., professor and director of the University of Nebraska Medical Center Division of Physician Assistant Education. Dr. Huckabee has more than 30 years’ experience as a physician assistant, mostly in rural Nebraska.
There are a variety of afflictions that can keep us from sleeping at night. Some have no clear explanation but many have solutions. Here are three for your consideration.
Night Cramps. The classic example is a sudden, intense pain in the calf, caused by a muscle spasm. While cramps can happen while awake, these grab your attention by jolting you awake from a dead sleep. They may occur once or year or less, but some people have several a night. One-third of the elderly have night cramps at least once every couple months.
Forty percent of pregnant women report leg cramps. Causes vary from dehydration, electrolyte imbalance, nerve or muscle disorders, medication side effects, or merely from working the muscles hard earlier in the day. Treatment usually is directed at the cause if it can be determined. It may be as simple as drinking plenty of water or stretching your legs before you go to bed. If your sleep is regularly interrupted, visit your clinician for help.
Restless legs. I wrestle this one myself. It’s hard to understand unless you’ve had it, but it’s an overwhelming urge to move your legs. Trying to stop it is like stifling a yawn, it doesn’t work. My legs will tingle and burn with the urge, though some don’t notice that. It only happens when I’m in bed, and pedaling my legs in the air helps most, to the dismay of my wife who would otherwise be asleep. The diagnosis is made when a person deals with these uncontrollable impulses, typically at night, and they improve with activity and worsen with rest.
Restless leg syndrome (RLS) varies from being mildly annoying for some to causing major sleep disruptions in others. While it’s known as a neurologic disorder, the cause is unclear but likely has genetic ties as it runs in families. There are effective medications for more severe cases and your clinician should be consulted. Most of us with RLS also suffer from periodic limb movement disorder, which is when my leg or arm jerks during sleep. Yeah, my wife loves that one, too.
Sleep Paralysis. This can be scary. While fading off to sleep or waking up a person will experience a complete paralysis, unable to move or speak. With it occurring at that sensitive period when our consciousness is drifting between sleep and waking, people will at the same time experience a vivid nightmare or hallucination. Often the person reports seeing an intruder, feeling like they are being choked, or otherwise being accosted. Individuals may have other out-of-body experiences, and some believe it explains those who report being abducted by aliens or experiencing demonic attacks.
The paralysis typically lasts from seconds to minutes, though rarely it may persist longer. About 6 out of 100 people suffer from this, and first occurrences are between the ages of 25-40. The cause is unknown but it may be related to an imbalance or overlapping of the stages of sleep.
Stress, erratic sleep schedules, and some medications may cause sleep paralysis, and there is likely a genetic component. Despite it being a frightening experience, there are no serious health problems. A variety of treatments, from simple home exercises to prescription medications, have been shown to be effective.
If you deal with any of these or other sleep disturbances frequently enough that it leaves you tired, missing work, or interfering with your relationships, you deserve a clinical evaluation. While there may not be easy answers to why, there are likely recommendations for how to get your sleep back in order.