10/21/2012 12:06 pm ET Updated Dec 21, 2012

Body Language: Not Just a Political Message

In the aftermath and post-mortem discussion of President Obama's performance during his first debate with Governor Romney, one television pundit opined that the president's body language exhibited the wrong non-verbal cues to the approximately 67 million television viewers. Just as body language may be an important source of information in a presidential campaign, body language -- or perhaps more precisely, body movements -- may be clues to a sleep disturbance.

Frequent changes in body position is associated with a number of sleep disturbances. Normally, a person changes position during sleep three to five times per hour. However, those with insomnia may move more often as they attempt to achieve sleep. Although generally one envisions obstructive sleep apnea as a condition characterized by breathing pauses during sleep, restless sleep frequently is reported. Many of those afflicted with obstructive sleep apnea are noted by their bed partners to move excessively at night and occasionally engage in violent or unusual behavior. Moreover, there are some conditions in which body movement is the defining characteristic of the disorder. Persons with restless legs syndrome have the irresistible urge to move their legs, and sometimes their arms as well, because of discomfort when they lay down and attempt to sleep. This results in great difficulty in achieving sleep. In periodic limb movement disorder, there is rhythmic movement of the legs, generally every 20 to 40 seconds during the night. Although now thought to be uncommon, it may be a cause of poor sleep. There also are some relatively obscure but benign conditions such as hypnagogic foot tremor and alternating leg movement activity, which also are defined by abnormal movement of the extremities.

Some sleep disorders are characterized by more dramatic body movements. Seizures may occur at night, and sleepwalking obviously is a nighttime event. In children, night terrors are a common occurrence. This is a disturbance where there is sudden, panicked awakening out of sleep, preceded frequently by a sudden scream. Observed primarily in older adults, REM sleep behavior disorder is a condition in which individuals appear to act out their dreams. It sometimes is a prelude to more serious neurologic conditions such as Parkinson's disease.

The state of sleep is not necessarily a quiescent one. Body movements can be a clue to a sleep disturbance. The moral of the story is body language is just not for politicians. When your bed partner complains that you are moving around too much in bed, you should heed the warning and consider whether there is an underlying sleep disorder.

For more by Stuart F. Quan, M.D., click here.

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