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Thursday, May 23, 2013
Raising My Arms Above My Head During Sleep
I have found that during sleep I continue to raise my arms above my head, both arms. When I wake up in the morning my shoulders, upper back, neck shoulder blades are sore and achy because of this. What could be causing this?
This is an interesting question about why you appear to be moving about so much in your sleep. There are many possible explanations and the exact diagnosis would require further history and perhaps testing. As such, I don’t think I can provide you with a clear diagnosis, but hopefully can give you enough information to help guide you in the right direction.
Many types of movements that occur during sleep are normal. Large muscle contractions that occur during transition from wakefulness to sleep are common, and are known as “hypnic jerks” or “sleep starts”. This doesn’t sound like what you are describing though. There are a wide variety of movement disorders that are related to sleep or to the transition between sleep and wakefulness, and we’ll review some of these.
Movement disorders of sleep can affect only a certain part of the body and not other parts, and they can present as simple repetitive movements or complex elaborate behaviors. Examples of some of some movement disorders include:
- Wakefulness-related movement disorders include Parkinson’s disease and Essential Tremor.
- Simple movements that occur during childhood include Rhythmic movement disorders and Myoclonus of Infancy.
- Simple sleep-related disorders that affect the legs mainly include Periodic Limb Movement disorders and Hypnagogic Foot Tremor (both would be seen as repetitive leg jerks during sleep).
- Complex movements that occur during sleep may be an indication of disorder of Partial Arousal, disorder of dream sleep (REM sleep) or Epilepsy (a seizure disorder).
It’s also possible that the movements may be due to another factor interrupting your sleep, such as obstructive sleep apnea or heartburn.
The movements that you right about do not sound like they are typical for those disorders mentioned above, though additional history would be needed. Important factors to consider would include the exact nature of the movements, whether or not you are aware of them or if you are being told about them by a bed partner, the frequency with which they occur and whether or not you have ever injured yourself or others. It would also be helpful to know if you snore, have witnessed problems breathing in your sleep or feel sleepy during the daytime. Identifying any factors that may precipitate or bring on the issues would also be helpful.
As you can see, this requires a thorough evaluation and you probably best be served by seeing a Sleep Specialist to undergo an extensive history and, perhaps, a sleep study. With this evaluation, a diagnosis can likely be made and then appropriate treatment recommended.
Additional information regarding sleep can be obtained on the American Academy of Sleep Medicine website. This website contains a list of Sleep Centers across the country so you can find one if you need it. Good luck!
Dennis Auckley, MD
Associate Professor of Medicine
School of Medicine
Case Western Reserve University