
Here’s a message for the violent sleepers and the non-sleepers:
If you have difficulty sleeping or keeping your hands/feet to yourself while sleeping, you may be living with a sleep disorder. Have you woken up to complaints from your partner stating that you’re a violent sleeper? How about finding yourself up in the wee hours of the night unable to fall asleep? These signs are associated with movement disorders (limb movements during sleep) and insomnia (the inability to fall asleep). Movement disorders and insomnia are among the many sleep disorders that are affecting people today.
Sleep disorders can be defined as conditions that cause uncontrollable changes in sleep patterns.
What are Movement Disorders?
Movement disorders during sleep include:
- Periodic limb movement disorder (PLMD) is the repetitive movement of the limbs during sleep. These movements can be described as twitching, jerking, or flexing which typically occurs every 20-40 seconds. PLMD is often associated with restless legs while awake.
- Sleepwalking or somnambulism is a disorder that causes people, mostly children, to walk and perform other activities while they are sleeping.
- Rapid eye movement (REM) sleep behavior disorder or RBD is characterized by the vocalization and violent limb movements associated with dream imagery or “acting out” dreams. This may cause injury to the patient or bed partner.
History from the patient, a bed partner, and/or family member can often make the diagnosis, but a sleep study may be needed especially for RBD. These disorders are treatable, often with medication, but must be differentiated from seizures or other problems.
What is Insomnia? Do I have it?
Chronic difficulty falling asleep or staying asleep is the most frequent sleep-related complaint. Severity varies widely. There are many contributing factors, including anxiety, depression, chronic pain, medications, circadian rhythm disorders, and other medical disorders. Research has shown that treatment of insomnia, whether this is the primary or secondary problem, can improve daytime function and quality of life.
How are Movement Disorders and Insomnia Treated?
Chronic insomnia and movement disorders are often treated with medication, but the best long-term results are reached with purposeful changes in sleep behavior. Changing longstanding sleep habits can be challenging, and guidance and support may be needed. The first step in this process is sleep hygiene. This series of healthy sleep habits includes:
- Keeping a consistent sleep schedule, allowing enough time in bed for sleep.
- Establishing a relaxing bedtime routine.
- Avoiding TV/computer/phone screens 30 minutes before bedtime.
- Allowing at least two hours after a heavy meal before bedtime.
- Having a bedtime environment that is dark, cool, and quiet.
- Avoiding alcohol and caffeine during the evening.
- Limiting daytime naps to 30 minutes or less.
- Using the bed only for sleep and sex.
- Exercising regularly and keeping a healthy diet.
A message for the violent sleepers and the non-sleepers: If you think that you may be living with a sleep-related disorder, contact your primary care physician or a sleep medicine specialist for more information. Until then, try to rest well.

About Richard A. Parisi, MD
Richard A. Parisi, MD, is a fellowship trained, board certified physician with over 30 years of experience in Internal Medicine, Pulmonary Diseases, and Sleep Medicine. Dr. Parisi provides treatment and care for a variety of sleep disorders and conditions. He has a special interest in sleep apnea, narcolepsy, and other sleep-related disorders. Dr. Parisi joined TPMG Lung and Sleep Specialists at Williamsburg in 2019.