Jerking Sleep

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Brandon Peters, MD, is a board-certified neurologist and sleep medicine specialist.
Medically reviewed by Rochelle Collins, DO on May 22, 2020
Rochelle Collins, DO, is a board-certified family medicine doctor currently practicing in Bloomfield, Connecticut.
If you have ever seen your infant suddenly jerk during sleep, it may give you a start or causes you to worry. What you are seeing is likely a benign condition known as sleep myoclonus, also known as nocturnal myoclonus.
While myoclonus tends to resolve spontaneously over time in babies, it can suddenly develop in adults for any number of reasons.
Sleep myoclonus is a condition in which there is a sudden jerking or twitching movement that affects a muscle and occurs during sleep. It is involuntary, meaning that it is not under conscious control and not done on purpose.
It may affect smaller muscles or even cause movements of the arms or legs. It may appear like a sudden twitching in an infant or baby, and this may lead to confusion about the possibility of a seizure.
Sleep myoclonus occurs during the early stages of sleep, especially at the moment of dropping off to sleep, and may either be incidental or provoked by external stimuli such as noise, movement, or light.
Nocturnal myoclonus, also known as periodic limb movement disorder (PLMD), involves repetitive movements of the legs during sleep or even wakefulness. It may occur multiple times per minute. It can affect extremities in an alternating pattern.
PLMD usually affects both sides equally and causes flexion of the wrists, elbows, and occasionally feet. It may occur repeatedly but also go away for extended periods during the night. 
Although the cause is not clear, sleep myoclonus may involve problems with a neurotransmitter called dopamine.1 This distinction alone differentiates it from seizures, which involve electrical changes in the brain.
Myoclonus also may be a side effect of some drugs, including levodopa, cyclic antidepressants, and bismuth salts. The condition often improves once the drug is stopped.
Other conditions with slightly different symptoms also may affect the legs and disrupt sleep. These include restless legs syndrome, periodic limb movements of sleep, night starts (hypnic jerks), and nocturnal leg cramps.
Myoclonus is a condition that may cause concern when it occurs in children as it may seem like a seizure or infantile spasms. The important difference is that sleep myoclonus only occurs in sleep.
Sleep myoclonus is common during the first week of a newborn's life and usually resolves within a year. Commonly referred to as benign neonatal sleep myoclonus, there are no inherent consequences to the condition or reasons for concern.
Infants who experience sleep myoclonus will have a normal neurologic examination and electroencephalogram (EEG). If these movements occur during wakefulness, further evaluation by your child's doctor may be needed to rule out seizures and other causes.
Sleep myoclonus is not considered serious or in need of treatment unless it is interfering with sleep and a person's quality of life.
If it is, the condition may be treated with Xenazine (tetrabenazine), a drug often used to treat movement disorders such as Huntington’s disease. In one study, Xenazine significantly improved symptoms of severe myoclonus over five years, with only drowsiness being a notable side effect.
In most cases, however, treatment is not necessary if sleep is relatively normal. It is believed to be a benign condition, meaning that it has no short-term or long-term impacts on health or well-being for the affected individual.
If you're suffering from sleep myoclonus or have a child or other family member who is, visit a healthcare provider for further evaluation.
Although the condition often resolves on its own, a doctor's visit might put your mind at ease and help you rule out other conditions that might be causing the problems you're experiencing, such as restless leg syndrome. As with any medical condition, the sooner you get treatment, the sooner you can begin taking control of your symptoms.
Tossing and turning night over night can have a big impact on your quality of life. Our free guide can help you get the rest you need. Sign up for our newsletter and get it free.
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Coulter, DL et al. "Benign neonatal sleep myoclonus." Arch Neurol 1982; 39:191.
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Myoclonus refers to a quick, involuntary muscle jerk. Hiccups are a form of myoclonus, as are the sudden jerks, or "sleep starts," you may feel just before falling asleep. These forms of myoclonus occur in healthy people and rarely present a problem.
Other forms of myoclonus may occur because of a nervous system (neurological) disorder, such as epilepsy, a metabolic condition, or a reaction to a medication.
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Ideally, treating the underlying cause will help control your myoclonus symptoms. If the cause of myoclonus is unknown or can't be specifically treated, then treatment focuses on reducing the effects of myoclonus on your quality of life.
People with myoclonus often describe their signs and symptoms as jerks, shakes or spasms that are:
If your myoclonus symptoms become frequent and persistent, talk to your doctor for further evaluation and proper diagnosis and treatment.
Myoclonus may be caused by a variety of underlying problems. Doctors often separate the types of myoclonus based on their causes, which helps determine treatment. Types of myoclonus include the following categories.
This type of myoclonus occurs in normal, healthy people and rarely needs treatment. Examples include:
Essential myoclonus occurs on its own, usually without other symptoms and without being related to any underlying illness. The cause of essential myoclonus is often unexplained (idiopathic) or, in some cases, hereditary.
This type of myoclonus occurs as part of an epileptic disorder.
Symptomatic myoclonus occurs as a result of an underlying medical condition. Examples include:
Nervous system conditions that result in secondary myoclonus include:
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Mills K, et al. An update and review on the treatment of myoclonus. Current Neurology and Neuroscience Report. 2015;15:512.
Ferri FF. Myoclonus. In: Ferri's Clinical Advisor 2019. Philadelphia, Pa.: Elsevier; 2019. https://www.clinicalkey.com. Accessed Nov. 15, 2018.
Myoclonus fact sheet. National Institute of Neurological Disorders and Stroke. https://www.ninds.nih.gov/disorders/myoclonus/detail_myoclonus.htm?c. Accessed Nov. 15, 2018.
Caviness JN. Classification and evaluation of myoclonus. https://www.uptodate.com/contents/search. Accessed Nov. 15, 2018.
Sutter R, et al. Myoclonus in the critically ill: Diagnosis, management, and clinical impact. Clinical Neurophysiology. 2016;127:67.
Caviness JN. Treatment of myoclonus. https://www.uptodate.com/contents/search. Accessed Nov. 15, 2018.
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Rabano-Suarez P, et al. Generalized myoclonus in COVID-19. American Academy of Neurology. 2020; doi:10.1212/WNL.0000000000009829.
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Jerking Sleep