I'm an "over-active" sleeper — Help!

Dear Active Sleeper,

Sleep talking and other parasomnias, or disorders that disrupt sleep, such as periodic limb movement disorder (PLMD) and restless leg syndrome (RLS), are pretty common. PLMD is defined as periodic movements or jerking of one's legs or arms for at least two seconds and can occur anywhere from five times per hour to every 20 to 40 seconds. RLS describes an irrepressible compulsion to move one's legs as a reflex to an uncontrollable and disagreeable sensation. While common, the exact causes of these sleep interruptions are unknown. Luckily, health care providers are able to treat sleep talking, restless leg syndrome, and other movements people make during sleep.

For sleep talkers, underlying psychological and physical factors, such as stress, lack of sleep, not eating enough, or heavy meals just before bedtime, may be the cause. The following are ways to address sleep talking:

• Getting a sufficient amount of sleep — lack of sleep causes stress in some people, which in turn, can lead to sleep talking.
• Avoiding heavy meals before bedtimes.
• Maintaining a regular sleep schedule.
• Cutting back on or eliminating caffeine and nicotine.
• Reducing alcohol consumption.
• Aiming to reduce overall stress — relaxation techniques, exercise, and speaking with friends or a counselor are all great ways to lower stress levels.

If you want to manage leg kicking and jerking of one's body suddenly during sleep, talk to a health care provider, who will most likely ask for a medical history. Lab tests may be ordered to check for vitamin or mineral deficiencies that could trigger sudden movements during sleep. Finally, to complete this comprehensive assessment, the s/he may suggest that you spend a night in a sleep lab, so that staff can chart and analyze body movements, air intake, brain and heart activity, and other bodily functions through a polysomnography. This tool tracks many physiological activities simultaneously. Using this information, the provider can determine if there are any other reasons that may be contributing to the PLMD and/or RLS. Examples of such disorders include sleep apnea, anemia, narcolepsy, and mineral deficiencies, such as potassium. Once a diagnosis has been made, the health care provider can then recommend treatment, which could include medications or supplements such as:

• Iron supplements to treat anemia
• Potassium supplements to treat cramping and spasms, especially in the legs
• Sleeping pills and sedatives to induce deep sleep and lessen the occurrence of sudden bodily jerks during sleep
• Dopaminergics, which are medications usually used for treating the uncontrollable shaking and tremors associated with Parkinson's Disease

Besides the moving around and talking in your sleep, you may want to address this situation with your fiancé. From your question, it appears as if you two may not have discussed his sleeping on the couch approach to dealing with your sleep issues; while you can't tell your fiancé what to talk about, as only he knows his true thoughts and feelings concerning your movements during sleep and the consequent disruption of his sleep cycle. However, you may want to tell him that you're going to deal with the situation by seeking medical advice. Having this conversation, and showing him this letter, might help get you on your way to sharing a bed in peaceful slumber.

In the meantime, with the help of your health care provider, or a referral to a sleep specialist, you can learn how to manage your sleep conditions, because even reducing the incidences of them can be of benefit to you both.

You can check out the following resources for more information:

• Willis-Ekbom Disease Foundation (Formerly the RLS Foundation)
• Helpguide: Restless Legs Syndrome (RLS)
• Cleveland Clinic: Periodic Limb Movement Disorder (PLMD)