Advertisement

Current Sleep Medicine Reports

, Volume 4, Issue 1, pp 19–27 | Cite as

Sleep-Related Movement Disorders: Hypnic Jerks

  • Robyn Whitney
  • Shelly K. Weiss
Sleep Movement Disorders (A Avidan, Section Editor)
  • 81 Downloads
Part of the following topical collections:
  1. Topical Collection on Sleep Movement Disorders

Abstract

Purpose of Review

Hypnic jerks represent a benign physiological phenomenon of sleep, which must be differentiated from other sleep-related movement disorders and epilepsy. A comprehensive review of hypnic jerks is presented with emphasis on recognition, physiology, evaluation, and treatment.

Recent Findings

The recent edition of the International Classification of Sleep Disorders (ICSD-3) has classified hypnic jerks as a sleep-related movement disorder under the subheading isolated symptoms and normal variants. Although generally benign, there have been increasing reports of excessive hypnic jerks in neurological disorders such as Parkinsonism, migraine, and brainstem lesions and children with neurologic disorders. Recent research identifying changes in the polysomnogram has led to a better understanding of the physiology of hypnic jerks. A variety of different motor patterns have been described; however, the origin and physiology of hypnic jerks remain enigmatic.

Summary

Hypnic jerks represent a fascinating phenomenon of sleep; however, additional studies are needed to clarify their physiology and origin.

Keywords

Hypnic jerks Sleep starts Hypnagogic jerks Sleep-related movement disorders Myoclonus Physiology 

Notes

Compliance with Ethical Standards

Conflict of Interest

Robyn Whitney and Shelly K. Weiss declare no conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. 1.
    Derry CP, Duncan JS, Berkovic SF. Paroxysmal motor disorders of sleep: the clinical spectrum and differentiation from epilepsy. Epilepsia. 2006;47(11):1775–91.  https://doi.org/10.1111/j.1528-1167.2006.00631.x.CrossRefPubMedGoogle Scholar
  2. 2.
    •• American Academy of Sleep Medicine. International Classification of Sleep Disorders. 3rd ed. Darien: American Academy of Sleep Medicine; 2014. The most recent edition of the ICSD provides a comprehensive overview of all sleep disorders. Google Scholar
  3. 3.
    •• Weiss S. Sleep starts and sleep talking. In: Kothare SV, Ivanenko A, editors. Parasomnias. New York: Springer Science + Business Media; 2013. p. 139–54. This article provides a comprehensive review of hypnic jerks including their recognition, proposed physiology, diagnosis, and treatment. CrossRefGoogle Scholar
  4. 4.
    • Cuellar NG, Whisenant D, Stanton MP. Hypnic jerks: a scoping literature review. Sleep Med Clin. 2015;10(3):393–401. A recent review of hypnic jerks focusing on their clinical features, diagnosis, and treatment and also provides a scoping review that identifies the extent and range of the literature on hypnic jerks.  https://doi.org/10.1016/j.jsmc.2015.05.010.CrossRefPubMedGoogle Scholar
  5. 5.
    Walters AS. Clinical identification of the simple sleep-related movement disorders. Chest. 2007;131(4):1260–6.  https://doi.org/10.1378/chest.06-1602.CrossRefPubMedGoogle Scholar
  6. 6.
    Vetrugno R, Montagna P. Sleep-to-wake transition movement disorders. Sleep Med. 2011;12(Suppl 2):S11–6.  https://doi.org/10.1016/j.sleep.2011.10.005.CrossRefPubMedGoogle Scholar
  7. 7.
    Vendrame M, Kothare SV. Epileptic and nonepileptic paroxysmal events out of sleep in children. J Clin Neurophysiol. 2011;28(2):111–9.  https://doi.org/10.1097/WNP.0b013e3182120fdc.CrossRefPubMedGoogle Scholar
  8. 8.
    Montagna P. Sleep-related non epileptic motor disorders. J Neurol. 2004;251(7):781–94.  https://doi.org/10.1007/s00415-004-0478-0.CrossRefPubMedGoogle Scholar
  9. 9.
    Merlino G, Gigli GL. Sleep-related movement disorders. Neurol Sci. 2012;33(3):491–513.  https://doi.org/10.1007/s10072-011-0905-9.CrossRefPubMedGoogle Scholar
  10. 10.
    Zucconi M, Ferri R. Assessment of sleep disorders and diagnostic procedures. In: Bassetti C, Dogas Z, Peigneux P, editors. Sleep Medicine Textbook. Regensburg: European Sleep Research Society (ESRS); 2014. p. 95–109.Google Scholar
  11. 11.
    Fusco L, Specchio N. Non-epileptic paroxysmal manifestations during sleep in infancy and childhood. Neurol Sci. 2005;26(Suppl 3):s205–9.  https://doi.org/10.1007/s10072-005-0488-4.CrossRefPubMedGoogle Scholar
  12. 12.
    Avidan AY. Parasomnias and movement disorders of sleep. Semin Neurol. 2009;29(4):372–92.  https://doi.org/10.1055/s-0029-1237126.CrossRefPubMedGoogle Scholar
  13. 13.
    •• Chiaro G, Calandra-Buonaura G, Sambati L, Cecere A, Ferri C, Caletti MT, et al. Hypnic jerks are an underestimated sleep motor phenomenon in patients with parkinsonism. A video-polysomnographic and neurophysiological study. Sleep Med. 2016;26:37–44. Evaluates the occurrence and characteristics of hypnic jerks in individuals with Parkinsonism and highlights that they are a frequent and underestimated phenomenon in this group.  https://doi.org/10.1016/j.sleep.2016.07.011.CrossRefPubMedGoogle Scholar
  14. 14.
    Bruni O, Galli F, Guidetti V. Sleep hygiene and migraine in children and adolescents. Cephalalgia. 1999;19(Suppl 25):57–9.  https://doi.org/10.1177/0333102499019S2516.CrossRefPubMedGoogle Scholar
  15. 15.
    Fusco L, Pachatz C, Cusmai R, Vigevano F. Repetitive sleep starts in neurologically impaired children: an unusual non-epileptic manifestation in otherwise epileptic subjects. Epileptic Disord. 1999;1(1):63–7.PubMedGoogle Scholar
  16. 16.
    Tinuper P, Provini F, Bisulli F, Vignatelli L, Plazzi G, Vetrugno R, et al. Movement disorders in sleep: guidelines for differentiating epileptic from non-epileptic motor phenomena arising from sleep. Sleep Med Rev. 2007;11(4):255–67.  https://doi.org/10.1016/j.smrv.2007.01.001.CrossRefPubMedGoogle Scholar
  17. 17.
    Hogl B, Zucconi M, Provini F. RLS, PLM, and their differential diagnosis--a video guide. Mov Disord. 2007;22(Suppl 18):S414–9.  https://doi.org/10.1002/mds.21591.CrossRefPubMedGoogle Scholar
  18. 18.
    Sander HW, Geisse H, Quinto C, Sachdeo R, Chokroverty S. Sensory sleep starts. J Neurol Neurosurg Psychiatry. 1998;64(5):690.  https://doi.org/10.1136/jnnp.64.5.690.CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Frenette E, Guilleminault C. Nonepileptic paroxysmal sleep disorders. Handb Clin Neurol. 2013;112:857–60.  https://doi.org/10.1016/B978-0-444-52910-7.00006-4.CrossRefPubMedGoogle Scholar
  20. 20.
    • Sathe H, Karia S, Desousa A, Shah N. Hypnic jerks possibly induced by escitalopram. J Neurosci Rural Pract. 2015;6(3):423–4. Highlights a unique case report of hypnic jerks being triggered by an SSRI and expands our knowledge on the potential triggers of hypnic jerks.  https://doi.org/10.4103/0976-3147.158797.CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    • Sharpless BA. Exploding head syndrome. Sleep Med Rev. 2014;18(6):489–93. Provides a comprehensive literature review of exploding head syndrome and adds to our knowledge about this intriguing disorder.  https://doi.org/10.1016/j.smrv.2014.03.001.CrossRefPubMedGoogle Scholar
  22. 22.
    Green MW. The exploding head syndrome. Curr Pain Headache Rep. 2001;5(3):279–80.  https://doi.org/10.1007/s11916-001-0043-9.CrossRefPubMedGoogle Scholar
  23. 23.
    Oswald I. Sudden bodily jerks on falling asleep. Brain. 1959;82(1):92–103.  https://doi.org/10.1093/brain/82.1.92.CrossRefPubMedGoogle Scholar
  24. 24.
    Bruno RL. Abnormal movements in sleep as a post-polio sequelae. Am J Phys Med Rehabil. 1998;77(4):339–43.  https://doi.org/10.1097/00002060-199807000-00015.CrossRefPubMedGoogle Scholar
  25. 25.
    Salih F, Klingebiel R, Zschenderlein R, Grosse P. Acoustic sleep starts with sleep-onset insomnia related to a brainstem lesion. Neurology. 2008;70(20):1935–7.  https://doi.org/10.1212/01.wnl.0000312336.92028.9b.CrossRefPubMedGoogle Scholar
  26. 26.
    • Serino D, Fusco L. Epileptic hypnagogic jerks mimicking repetitive sleep starts. Sleep Med. 2015;16(8):1014–6. This article importantly highlights that epileptic seizures may mimic sleep starts.  https://doi.org/10.1016/j.sleep.2015.04.015.CrossRefPubMedGoogle Scholar
  27. 27.
    •• Chokroverty S, Bhat S, Gupta D. Intensified hypnic jerks: a polysomnographic and polymyographic analysis. J Clin Neurophysiol. 2013;30(4):403–10. This article importantly highlights the polysomnogram findings seen in hypnic jerks and describes four unique motor patterns. The article adds to our understanding on the possible origin and physiology of hypnic jerks.  https://doi.org/10.1097/WNP.0b013e31829dde98.CrossRefPubMedGoogle Scholar
  28. 28.
    •• Calandra-Buonaura G, Alessandria M, Liguori R, Lugaresi E, Provini F. Hypnic jerks: neurophysiological characterization of a new motor pattern. Sleep Med. 2014;15(6):725–7. This article also adds to our understanding of the physiology and origin of hypnic jerks and describes a unique motor pattern seen on polysomnogram.  https://doi.org/10.1016/j.sleep.2014.01.024.CrossRefPubMedGoogle Scholar
  29. 29.
    American Academy of Sleep Medicine. International Classification of Sleep Disorders. 2nd ed. Westchester: American Academy of Sleep Medicine; 2005.Google Scholar
  30. 30.
    Lozsadi D. Myoclonus: a pragmatic approach. Pract Neurol. 2012;12(4):215–24.  https://doi.org/10.1136/practneurol-2011-000107.CrossRefPubMedGoogle Scholar
  31. 31.
    • van der Salm SM, Erro R, Cordivari C, Edwards MJ, Koelman JH, van den Ende T, et al. Propriospinal myoclonus: clinical reappraisal and review of literature. Neurology. 2014;83(20):1862–70. A comprehensive literature review and analysis of all cases of propriospinal myoclonus that have been published in the literature since 1991, highlighting the clinical features, etiology, diagnostic findings, and treatment.  https://doi.org/10.1212/WNL.0000000000000982.CrossRefPubMedPubMedCentralGoogle Scholar
  32. 32.
    Antelmi E, Provini F. Propriospinal myoclonus: the spectrum of clinical and neurophysiological phenotypes. Sleep Med Rev. 2015;22:54–63.  https://doi.org/10.1016/j.smrv.2014.10.007.CrossRefPubMedGoogle Scholar
  33. 33.
    • Brown TM. Sleep-related leg cramps: a review and suggestions for future research. Sleep Med Clin. 2015;10(3):385–92. A comprehensive and recent review of sleep-related leg cramps focusing on what is currently known and what research is still needed.  https://doi.org/10.1016/j.jsmc.2015.05.002.CrossRefPubMedGoogle Scholar
  34. 34.
    Monderer RS, Wu WP, Thorpy MJ. Nocturnal leg cramps. Curr Neurol Neurosci Rep. 2010;10(1):53–9.  https://doi.org/10.1007/s11910-009-0079-5.CrossRefPubMedGoogle Scholar
  35. 35.
    Maurer VO, Rizzi M, Bianchetti MG, Ramelli GP. Benign neonatal sleep myoclonus: a review of the literature. Pediatrics. 2010;125(4):e919–24.  https://doi.org/10.1542/peds.2009-1839.CrossRefPubMedGoogle Scholar
  36. 36.
    Marx C, Masruha MR, Garzon E, Vilanova LC. Benign neonatal sleep myoclonus. Epileptic Disord. 2008;10(2):177–80.  https://doi.org/10.1684/epd.2008.0196.PubMedGoogle Scholar
  37. 37.
    Vetrugno R, Plazzi G, Provini F, Liguori R, Lugaresi E, Montagna P. Excessive fragmentary hypnic myoclonus: clinical and neurophysiological findings. Sleep Med. 2002;3(1):73–6.  https://doi.org/10.1016/S1389-9457(01)00123-X.CrossRefPubMedGoogle Scholar
  38. 38.
    Nepozitek J, Sonka K. Excessive fragmentary myoclonus: what do we know? Prague Med Rep. 2017;118(1):5–13.  https://doi.org/10.14712/23362936.2017.1.CrossRefPubMedGoogle Scholar
  39. 39.
    Mine J, Taketani T, Yoshida K, Yokochi F, Kobayashi J, Maruyama K, et al. Clinical and genetic investigation of 17 Japanese patients with hyperekplexia. Dev Med Child Neurol. 2015;57(4):372–7.  https://doi.org/10.1111/dmcn.12617.CrossRefPubMedGoogle Scholar
  40. 40.
    Dreissen YE, Tijssen MA. The startle syndromes: physiology and treatment. Epilepsia. 2012;53(Suppl 7):3–11.  https://doi.org/10.1111/j.1528-1167.2012.03709.x.CrossRefPubMedGoogle Scholar
  41. 41.
    Thomas RH. Hyperekplexia: overexcitable and underdiagnosed. Dev Med Child Neurol. 2015;57(4):313.  https://doi.org/10.1111/dmcn.12638.CrossRefPubMedGoogle Scholar
  42. 42.
    Chokroverty S, Gupta D. Section 5: Sleep-related movement disorders and other variants: sleep starts. In: Thorpy M, Plazzi G, editors. . Cambridge: Cambridge University Press; 2010. p. 229–36.Google Scholar
  43. 43.
    • Thenganatt MA, Jankovic J. Psychogenic movement disorders. Neurol Clin. 2015;33(1):205–24. This article provides a comprehensive review of the psychogenic movement disorders and how they can be differentiated clinically.  https://doi.org/10.1016/j.ncl.2014.09.013.CrossRefPubMedGoogle Scholar
  44. 44.
    Hallett M. Functional (psychogenic) movement disorders—clinical presentations. Parkinsonism Relat Disord. 2016;22(Suppl 1):S149–52.  https://doi.org/10.1016/j.parkreldis.2015.08.036.CrossRefPubMedGoogle Scholar
  45. 45.
    Pal P. Electrophysiological evaluation of psychogenic movement disorders. J Mov Disord. 2011;4(1):21–32.  https://doi.org/10.14802/jmd.11004.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Division of NeurologyThe Hospital for Sick ChildrenTorontoCanada

Personalised recommendations