Is your Bed Partner Kicking You While Sleeping?

One of my recent sleep coaching clients reported that their partner frequently keeps them awake with their extremely restless sleeping.  My suggestions were to consider using the guest room more often and asking their partner to speak with their physician.

There are medications and conditions that can cause this behavior, and severe sleep problems by themselves can cause or increase it.  When it is chronic and increasing in severity, it has to be addressed or you could get socked in the eye or worse.  Really. 

What I did NOT say is that there is a sleeping disorder characterized by very aggressive physical behaviors only while sleeping that has a high degree of accuracy in predicting a future diagnosis of a degenerative neurological disorder.  It is called REM Sleep Behavior Disorder.  It can begin with a preliminary diagnosis of Periodic Limb Movements of Sleep.  Both are much more common in people over 65, and both require medical treatment, not a bigger mattress or a pair of boxing gloves.

This degree of physical activity while asleep is NOT the same as someone who rolls back and forth while sleepless, or someone who gets up to use the bathroom 4x/night and collapses back into bed( both annoying!).  

This sleep disorder is characterized by an extreme degree of movement.  Bed partners use the words “violent”,  “aggressive”, and “dangerous”.   It has to be persistent over time, and it has be be unrelated to domestic violence, mental illness, and severe alcohol use.  It can be related to a current infection or taking a new medication, but REM Sleep Behavior Disorder doesn’t go away when the medication is stopped or the illness resolves.  

It isn’t Restless Leg syndrome, even though people with this disorder move about quite a lot.  Those patients have this behavior while awake in bed as well as while sleeping, unlike people with Periodic Limb Movements of Sleep, who display this only while sleeping.  But the level of activity, including the aggressive actions while asleep, make REM Sleep Behavior Disorder far more concerning.  

What should you do if you think your bed partner has Periodic Limb Movements of Sleep or REM Sleep Behavior Disorder?

1. Consider sleeping in the guest room.  You need good sleep, and if your bed partner does receive a diagnosis of a neurodevelopmental disorder in the future, you will need to be well-rested to deal with it.  If you are concerned that physical intimacy or emotional closeness will suffer, get in front of that during the daytime hours.  Make plenty of time for sex and warmth then.
2. Consider recommending that they get in front of a neurologist and a sleep doctor.  This isn’t something that is going to change with better sleep hygiene or even with CBT-i.  The medications used for these disorders are often those for nerve/seizure disorders and possibly those for Parkinson’s disease, and they can help.  They have to be carefully prescribed to avoid creating other problems.  And they have to be monitored.   There is a chance that your bed partner is having another medical issue or experiencing serious side effects from a combination of medications, so this means you need to speak with your provider(s).  Getting results means getting professional help.
3. Getting your partner out into early morning light and becoming slightly more physically active might help, and neither of these actions should be harmful for them.  Age weakens the circadian rhythm in all of us, so making the signals stronger are easy ways to improve everyone’s sleep.
4. Encourage your bed partner to avoid alcohol and explore any OTC medications that could be contributing to Serotonin syndrome.  This syndrome occurs most often when SSRI medication dosages are increased or start out too high, or when an OTC medication like cough syrup is taken at the same time as an SSRI.  Both alcohol and SSRI medications can act on REM sleep stages to contribute to more intense, frightening, and active dreaming.

Want more information on sleep coaching for yourself, so you are able to optimize your own sleep while your bed partner gets checked out?  Get in touch with me!  Our initial conversation is free!  You will learn more about my approach and about how to improve your sleep.