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Rhythmic Movement

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What is it?

Sleep related rhythmic movement disorder (RMD) involves repeated body movements. They occur while drowsy or asleep. It is typically seen in children. Rhythmic humming or other sounds are sometimes made along with the body motions. These sounds can be quite loud.

Following are the three types of RMD:

1. Body rocking

The child may rock his entire body while on hands and knees. It may also occur when he rocks his upper body while sitting up.

2. Head banging

This often occurs with the child lying face down. He lifts his head or entire upper body. Then he forcibly bangs the head back down into the pillow or mattress. This action is repeated over and over again. It may also occur when the child is sitting up. He will bang the back of his head against the wall or headboard one time after another.

Body rocking and head banging may also be combined. The child will rock on hands and knees. At the same time, he will bang the front of his head into the wall or headboard.

3. Head rolling

The head is rolled back and forth. The child is normally lying on his back.

Head banging is the most disturbing form of the problem. Typical cases in infants and toddlers pose little risk of serious injury. Strong motions can cause loud noises when the child hits the bed frame. The bed may also bang against the wall or scrape the floor.

The noises can greatly distress other family members. It is normal for a parent to be concerned. No cases of serious injury caused by RMD have been found. It is important for parents to discuss the child’s actions with other caretakers, family members, or baby sitters.

Less common rhythmic movement forms include the following:

  • Body rolling
  • Leg banging
  • Leg rolling

Episodes often occur when the child is almost asleep. They may also occur at any point in the night. At times, they may even happen during quiet activities when the child is awake. He or she may be listening to music or riding in a car.

The rate may vary, but the actions are rapid. One or two motions tend to occur every one or two seconds. An episode will often last up to 15 minutes. The motions may stop when a noise, movement or voice disturbs the child. Children who are old enough to talk will usually not recall the event in the morning.

These actions are common in normal infants and children. These motions alone do not qualify as a disorder. It is only a disorder if the actions severely injure the child or greatly disturb his or her sleep.

Who gets it?

It is very common in healthy infants and children. Body rocking begins at an average age of six months. Head banging begins at an average age of nine months. At nine months of age, 59% of all infants have been reported to have one of the following rhythmic movements:

  • Body rocking (43%)
  • Head banging (22%)
  • Head rolling (24%)

At 18 months of age, the overall rate drops to 33%. It commonly goes away by the second or third year of life. By five years of age, the rate is only 5%.

It seems to occur at the same rate in both boys and girls. It may be more likely to occur among family members. One study found that children with body rocking had a higher level of anxiety.

RMD has been rarely reported in teens and adults. The condition may appear at an older age due to an injury to the central nervous system. In older children or adults, these actions may be related to one of the following:

  • Mental retardation
  • Autism
  • Pervasive developmental disorder

In most of these cases, the motions are not sleep related. They tend to occur when the person is awake.

How do I know if I have it?

1. Does your child make repeated body motions, such as body rocking, head banging, or head rolling?

2. Do these motions tend to occur when your child is drowsy or asleep?

3. Do these actions cause one of the following problems?

  • They interfere with the child’s sleep.
  • They make the child sleepy or grumpy during the day.
  • The child suffers an injury that requires medical treatment.

If you answered yes to these questions, then your child may have RMD.

It is also important to know if there is something else that is causing your child’s sleep problems. They may be a result of one of the following:

  • Another sleep disorder
  • A medical condition
  • Medication use
  • A mental health disorder
  • Substance abuse

Do I need to see a sleep specialist?

Most children who display these actions do not need help. It is a common part of the way their sleep process develops. Talk about your concerns with your child’s doctor. You should see a sleep specialist if the motions injure your child or keep him or her from sleeping well.

What will the doctor need to know?

First, the doctor will need to know when the motions began. He or she will also want to know what else has been going on in your child’s life. You should complete a two-week sleep diary for your child. Make note of any times when the actions occur. This will give the doctor clues as to what might be causing your child’s problems. The doctor will need to know your child’s complete medical history. Be sure to inform him or her of any past or present medication use. Also tell your doctor if your child has ever had any other sleep disorder.

Will I need to take any tests?

No tests are needed to detect RMD in most children. Your doctor may have your child do an overnight sleep study if the motions are severe. This study is called a polysomnogram. It charts your child’s brain waves, heart beat, and breathing as he sleeps. It also records how his or her arms and legs move. This will also show if there are other disorders, such as sleep apnea, that are causing the sleep problems.

The best sleep study will also record your child’s sleep on video. This will help show if your child moves or does anything unusual during the night.

How is it treated?

Medications may be prescribed if the movements are disturbing the child, interfering with the child’s sleep or causing injuries.

By Donald R. Townsend, PhD
Updated May 16, 2006


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