Rhythmic Movement Disorder

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What Is Rhythmic Movement Disorder?

Sleep-related rhythmic movement disorder consists of broad, simple, and repeated movements before or during sleep. These movements are different from seizures Trusted Source National Library of Medicine, Biotech InformationThe National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information.View Source, jerks, or tremors. They can affect the head, the limbs, or the entire body. Children with rhythmic movement disorder may also make rhythmic noises such as loud humming.

For most children, sleep-related rhythmic movements are a normal part Trusted Source UpToDateMore than 2 million healthcare providers around the world choose UpToDate to help make appropriate care decisions and drive better health outcomes. UpToDate delivers evidence-based clinical decision support that is clear, actionable, and rich with real-world insights.View Source of early development. Rhythmic movements are quite common in infancy, with 59% of 9-month-old babies showing some type of this behavior. This percentage decreases dramatically with age: At 18 months, the percentage is cut almost in half to 33%, and by 5 years old only 5% of children are still affected.

Rhythmic movements by themselves aren’t abnormal and don’t necessarily constitute a disorder. To be considered a disorder, the movements must interfere with sleep, impair functioning during the day, or cause injury or increase its risk.

What Are the Symptoms of Rhythmic Movement Disorder?

People with rhythmic movement disorder may display one or more types of repeated movement. Adults with rhythmic movement disorder exhibit repetitive motions of the head and body Trusted Source National Library of Medicine, Biotech InformationThe National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information.View Source. In babies and children, the most common of these are head banging, head rolling, and body rocking.

• Head banging: The child forcefully and repeatedly strikes their head against the mattress, pillow, headboard, wall, or slats of the crib.
• Head rolling: The child rolls their head from side to side, generally while lying on their back.
• Body rocking: The child may rock their entire body forward and backward while on all fours, or they may move only the upper part of their body while sitting up.

Of these movements, head banging can be the most alarming for a parent to observe. However, even though head banging can cause loud noises, it usually doesn’t lead to significant injury. Other, less common movements include leg banging, body rolling, and leg rolling.

These actions may occur before sleep, when the child is drowsy, as well as during any stage of sleep. They may also occur when the child is quietly listening to music or when they are a passenger in a moving car. Each individual movement may last only a second or two, and an entire episode often lasts less than 15 minutes. The child may stop the movement if interrupted. Most of the time, if asked the next day, they don’t remember engaging in these behaviors.

However, the lack of sleep can contribute to problems with behavior, memory, and concentration Trusted Source National Library of Medicine, Biotech InformationThe National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information.View Source.

What Causes Rhythmic Movement Disorder?

The exact cause of rhythmic movement disorder isn’t well understood Trusted Source National Library of Medicine, Biotech InformationThe National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information.View Source, but researchers have offered several theories about why this condition occurs in children.

One possibility is that the movements are a self-soothing practice. Babies and children may rock their bodies or move their heads to help them return to sleep after waking or if they’re unable to fall asleep. These motions may be similar to those they had experienced in the womb, before being born, or to the feeling of being rocked to sleep by a parent.

Another theory suggests that these movements occur because the child’s nervous system hasn’t developed enough to control motor functions during sleep. This idea is supported by the tendency for these movements to decrease with age. The movements themselves may even stimulate the development of motor control.

Risk Factors

Researchers have identified and proposed several factors that may increase the risk of developing this disorder:

• Age: Babies one year old or younger are most likely to exhibit these behaviors. On average, body rocking appears at 6 months, head banging at 9 months, and head rolling at 12 months.
• Mental and emotional conditions:Anxiety and depression may occur at higher rates with rhythmic movement disorder in both children and adults. In people with learning disabilities or ADHD, rhythmic movement disorder may be less likely to go away as the person gets older.
• Family history: Rhythmic movement disorder may occur in some families more than in others. Researchers have observed the disorder in identical twins and triplets. It is unclear whether this points to a genetic link or whether rhythmic movements are behaviors that children learn.
• Developmental disabilities: Studies have linked both autism and Down syndrome to a higher instance of rhythmic movement disorder. However, people with these disabilities tend to make the movements throughout the day, not only around bedtime.
• Other sleep disorders: Rhythmic movement disorder may be associated with several other sleep disorders, such as sleep apnea, restless legs syndrome, and narcolepsy.

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How Is Rhythmic Movement Disorder Treated?

Many cases of rhythmic movement disorder in young children don’t require any type of treatment, aside from reassurance that the condition is normal and most often temporary.

Managing the disorder in babies and children largely involves protecting the child’s safety Trusted Source National Library of Medicine, Biotech InformationThe National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information.View Source. If there’s a risk of injury to an infant, talk with a doctor about whether taking steps, such as adding padding around the inside of the crib, may help protect the child. Take care when considering making changes to the crib, and follow the principles for reducing the risk of sudden infant death syndrome (SIDS). A pediatrician can give specific advice about safety improvements.

If another sleep disorder could be the cause of the rhythmic movements, treating the underlying disorder may offer relief. For example, research has shown that treating sleep apnea, for instance with a CPAP machine or weight loss, may clear up the rhythmic movement disorder Trusted Source National Library of Medicine, Biotech InformationThe National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information.View Source in people diagnosed with both conditions.

For serious cases of rhythmic movement disorder, doctors may prescribe medication.

When to Talk to a Doctor

Sleep-related rhythmic movements rarely require medical intervention. However, if the movements are interfering with sleep or could result in injury, connect with a physician for evaluation and advice.

To diagnose rhythmic movement disorder, doctors often perform a physical examination and collect a detailed medical history, including information about sleep habits. This can involve keeping a sleep diary, and making video recordings of the patient’s sleep. Doctors may also recommend a sleep study.

These diagnostic steps allow doctors to rule out other medical conditions, including epilepsy, that could cause abnormal movements. They also help doctors identify any underlying causes of the disorder.

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