What is Rhythmic Movement Disorder?
Does your child rock their head or body as they fall asleep? Or does your partner or sibling bang their head against the wall while snoozing? Or maybe you’ve been told you’re the one showing any of these symptoms.
These motions may be referred to as rhythmic movement disorder. This kind of disorder can disrupt your sleep. In some cases, it can lead to injury. And the effects can start to snowball if they persist. For example, sleep deprivation can impair cognitive functions, which can then affect your daytime performance.
It sounds serious, right? But don’t worry. Based on our research, RMD is not scary. Knowing what it is and what it does can be a good place to start. Finding a way out of it may not be easy — or necessary. Find out why in the section called Treatments for RMD. Read on.
Table of Contents
What is Rhythmic Movement Disorder (RMD)?
Rhythmic movement disorder (RMD) is a neurological disorder typically characterized by repetitive, involuntary movements while a person is asleep or about to sleep.
Yet, not everyone who rocks or rolls before or during they doze off is considered an RMD patient. The RMD term is limited to individuals who are affected by a biological consequence of the repetitive motions. According to this ScienceDirect article, they should be experiencing any of the following:
- Sleep interference
- Significant daytime function impairment
- Self-inflicted physical injury that requires medical treatment
On the other hand, the manifestations of the disorder could be symptoms, indications, or causes of another condition, such as Sleep Apnea, Autism, Tourette syndrome, Rett syndrome, or ADHD (attention-deficit/hyperactivity disorder).
Symptoms of RMD
Rocking themselves to sleep is a common move among patients with RMD. It includes rocking the whole body from side to side while lying down or sitting. Once tired, people can fall asleep in as fast as 10 minutes. Some do it automatically in their sleep, though, and are not aware of it.
Likewise, when individuals with RMD are exhausted during the day, they can also experience body rocking.
While not as common as body rocking, head rolling still happens in child and adult patients alike. Usually, they are lying on their backs when the head begins to rock back and forth. The rocking can be strong. But so far, there have been no reports of serious injury. This movement poses little risk to infants and toddlers.
However, head rolling can create loud sounds that may disturb family members or roommates of the patient. The motion can also cause the person to hit the bed frame. It can then produce banging and creaking noises.
This case is the least common among the three. It happens when the patient is lying on their tummy. They will then bang their head against the pillow. If they are sitting up, they will strike the headboard or wall with the back of their head. This movement can disrupt other sleepers if it’s done at night.
Also, head banging can occur with body rocking. A child or adult can rock on their hands and knees while hitting their head against the headboard or wall.
Standalone or combined with body rocking, head banging is done over and over by the patient until they fall asleep.
Aside from head and upper torso motions, some individuals may manifest leg rolling and leg banging. A humming sound can accompany these primary and secondary movements. Parents need to inform other family members and guests, if they’re hosting a few, about these activities and noises.
RMD can happen at sleep onset or during NREM (non-Rapid Eye Movement) sleep. NREM is the first sleep state in which a person gradually goes into a deep sleep. An attack seldom occurs in the REM sleep. And when it does, it may be treated as a symptom of REM sleep disorder.
An episode can usually last up to 15 minutes. But in rare cases, it will go on for hours. It may only stop when the patient is woken up or disturbed by a movement or sound.
Rhythmic Movement Disorder in Children
Rhythmic movement disorder is likely to start in infancy and then subsides when the child is in pre-school or around five years old. But the situation can also persist beyond childhood.
It’s considered RMD if it’s intense enough to cause injury and other clinical conditions, as cited above. Apart from the injury or the condition associated with it, the disorder is not life-threatening. It can, however, make the person grumpy or sleepy in the day.
Until now, researchers haven’t fully understood what triggers RMD. It could be brain dysfunction. It could be genetic, which means some patients have parents or other family members who had RMD when they were younger.
There is no test to determine RMD in a child. Instead, specialists perform a sleep study on patients to assess each case. If you suspect that your child has this disorder, bring them to their primary care physician for advice and checkup.
Rhythmic Movement Disorder in Adults
While RMD is rare in teens and adults, it can persist or start when the central nervous system suffers an injury. It can be associated with autism, developmental disability, or mental disability. In adults, this disorder is not as common as sleep talking or sleepwalking. But it comes with its own set of noises.
RMD in an otherwise healthy adult can look like this:
However, the Neurology Journal says that the person in the video has had RMD since childhood.
Head rocking, headbanging, or body rocking in adults also happens at sleep onset or during sleep, which you may not be aware of. Somebody else, like a partner or sibling, can tell you it happened. You can ask your doctor for evaluation when you are sure it’s happening. Treatments are available to taper the effects.
Treatments for RMD
Vestibular Stimulation Therapy (VBT)
A 2018 study looked at introducing vestibular stimulation through a device called Somnomat B. The participants were provided with gentle rocking movements for the first 60 minutes and for 10 minutes after symptoms were detected.
However, the results of this study did not say if VBT was effective in treating RMD symptoms. In patients with other conditions, though, VBT has a soothing and calming effect.
More researchers need to continue pursuing a path to help RMD patients sleep with vestibular stimulation. The use of a device similar to Somnomat to determine movements can also help in detecting symptoms during studies. So this must be made available to them.
For controlling the symptoms of rhythmic movement disorder, dopamine antagonists can be prescribed to patients with “intractable RMD without response to drugs.” Dopamine antagonists include haloperidol and pimozide. These are known to alleviate symptoms, while dopamine agonists may aggravate them. Dopamine agonists or levodopa may not be used.
Other forms of medication that show promise in aiding RMD patients are the following:
- Benzodiazepine such as clonazepam
- Tricyclic antidepressants.
Sometimes, the best response is no treatment at all. According to the National Center for Biotechnology Information (NCBI), treatment is usually not necessary. The primary care provider should do their best to reassure parents who are worried about their child. If the kid shows violent symptoms, such as head banging, the use of headgear may help prevent injury.
Treating RMD is usually not necessary. But there are steps you can take if you want to be reassured about your condition. You can take medication and/or therapy to help you sleep better at night. As it is, body rocking in adults may otherwise help put them to sleep. It seems a soothing and calming movement, anyway.
Whatever action you take, make sure to get advice from your primary care doctor first. Sleep specialists may also assist in this kind of situation. One thing must be stressed: RMD is not scary. You just need to beat the parts that prevent you from snoozing restfully at night and waking up feeling refreshed the next morning.
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