You are describing 2 behaviors in your sleep that are probably related - sleep talking, also known as somniloquy, and holding up your hands, which may represent a parasomnia. Parasomnias are a group of disorders characterized by undesirable physical events or experiences that occur during entry into sleep, within sleep or during arousal from sleep. Sleep talking and parasomnias often overlap with each other (i.e. are the same manifestation of an underlying problem). I'll address the sleep talking first and then the issue of a possible parasomnia.
Sleep talking is not an uncommon problem, especially in children. While we don't know exactly how common talking in sleep is, it is estimated to occur in about half of all children and in about 5% of adults. It is more common in women than in men.
Sleep talking can range from infrequent quite sounds to full spoken sentences to singing and shouting. Often, the speech cannot be understood and may sound like mutterings or gibberish. The cause of talking in sleep is not entirely known. Most of the time, the cause of this sleep behavior can not be linked to any identifiable underlying problem or disease. And in most cases, the problem is not serious and tends to resolve over time or with aging. However, in some cases, it has been found to be associated with other sleep-related disorders, such as sleep walking, REM behavior disorder (an unusual disorder in which individuals tend to act out their dreams while asleep), sleep-related epilepsy, post-traumatic stress disorder, sleep apnea, and the nighttime sleep eating syndrome. A number of these conditions are parasomnias. Other factors that may be associated with adult-onset sleep talking (in other words, they did not do this as a child) include a change in or new medications, sleep deprivation, depression, stress, medical illness, or pain. In addition, in adult-onset sleep talking, there may be a higher rate of psychiatric disorders. However, most adults who talk in their sleep do not have these problems.
Often times, the most serious consequence of sleep talking is social embarrassment from unintentionally verbalizing subconscious thoughts or dream content. What exactly this means and how this relates to your awake experiences is unclear. Sometimes, sleep talking can lead to disrupted sleep or the sleep of a bed partner (as in your case). In this situation, further evaluation should be considered.
Now, on to the issue of a possible parasomnia. There are a number of different parasomnias, ranging from sleepwalking and sleep terrors to behaviors associated with dreams to a number of other sleep-related behaviors (such as eating during sleep, bedwetting, etc). The behavior you describe, sleep talking and holding your hands up while asleep, could suggest a possible parasomnia. Most parasomnias occur during either slow wave sleep or REM (dream) sleep. Slow wave sleep (or deep sleep) disorders often occur early in the night (when most slow wave takes place). It is very difficult to awaken individuals from slow wave sleep and they often have little recall of their behaviors. On the hand, REM behavior disorder is an uncommon condition in which individuals lose the muscle paralysis that usually accompanies REM sleep and thus may act out their dreams. This tends to occur later in the night and most individuals have some recall of what they were doing. Depending on the nature of the dream state, this can often lead to injurious behavior from falling out of bed, running into walls or furniture or hitting objects. It is more commonly seen in middle to older aged men, but can occur in women as well.
The causes of these parasomnias are not entirely known. In some cases, a change in medication, new medications, sleep deprivation, stress, or medical illness may bring on a parasomnia. However, in many cases, these conditions are idiopathic, meaning we don't know for sure what causes these behaviors. It's also possible that the symptoms you describe may be the result of another primary sleep disorder that is mimicking a slow wave sleep parasomnia or REM behavior disorder. Other primary sleep conditions that may present with the behaviors you describe include obstructive sleep apnea, sleep-related epilepsy (seizures), and sleep-related dissociated disorders.
As you can see, there are a number of factors to consider for the symptoms you describe. In order to determine if there is an identifiable cause for your symptoms, a thorough history and physical examination are needed. This should ideally be performed by someone trained in sleep medicine and obtaining a referral to a Sleep Specialist from your primary care physician is reasonable. Once a history and physical examination have been performed, you may require further evaluation with a sleep study to examine the nature of your sleep and evaluate for some of the possible conditions mentioned above. Specific treatments are available for most all of the conditions described and will depend upon the results of your evaluation.
If you would like additional information regarding sleep and sleep disorders, you can obtain it on the American Academy of Sleep Medicine website. This website also contains a list of Sleep Centers across the country so you can locate one near you if need be. Good luck and here's to better sleep!
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