Crying in Your Sleep
Nocturnal Crybabies: Why You've Been Crying in Your Sleep
It's natural for babies to cry in their sleep. That's because their neurological systems are still a bit raw and thus, they're still attempting to regulate their body systems. That includes the sleeping and waking cycle. What actually happens is that the infants get into these semi-conscious states that adults may find a bit bizarre. When in these states, the newborn's body has difficulty in deciding whether it's awake or asleep. That's why while the babies are sleeping, they end up doing stuff that they normally only do while they're awake. That includes crying. Parents usually observe an improvement as the infants reach the third to fourth month.
If you've recently been crying in your sleep then the explanation may not be too dissimilar. However, since you're already an adult who has presumably gained mastery over his/her body functions, then crying in your sleep may be suggestive of a more serious underlying condition.
Exploring the Reasons Why You're Crying in Your Sleep
Depression: One of the most common reasons why people cry in their sleep is that they're suffering from depression. Other symptoms associated with depression include chronic fatigue, a miserable mood during most of the day, and an evidently reduced interest in activities that the individual used to enjoy. The person may show problems with his/her appetite which may lead to either weight loss or weight gain. There are also feelings of low self-esteem, inability to concentrate, and possible suicidal ideations. What's more, the depressed person may manifest psychomotor agitation or restlessness. Depressed individuals usually have disturbed sleeping patterns. It's the combination of restlessness and confusion that causes them to wake up crying in the middle of the night.
There is a strong link between dreams and depression. Research reveals that depressed subjects report dreaming three to four times more than non-depressed subjects. The quality of REM in depressed persons also tend to be filled with emotions that are more intense and themes that are more unpleasant. As if adding salt to the wound, nightmares are combined with insomnia and less deep sleep. The latter is referred to as slow wave sleep that is necessary to make the person feel rested and reinvigorated upon waking. In other words, instead of feeling restored, the dreamer suffering from depression feels like he has been up fighting all night long. All these facts are closely related to the next possible reason why you're crying in your sleep a little too often.
Nightmares and Night Terrors: Night terrors commonly occur to kids and teens possibly due to their developing imaginations. With that said, they usually outgrow nocturnal terrors as they leave adolescence behind. When night terrors occur in adults, it can be suggestive of a grave underlying condition that may have psychological, emotional, and sometimes physical roots.
Sleep terror disorder, as those in the medical field would call it, is just one of the series of sleeping disorders known as parasomnias. Other types of parasomnias include somnambulism (sleepwalking), somniloquy (sleep talking), and nightmare disorder. At this point, it becomes necessary to emphasize the difference between nightmares and night terrors. When people have nightmares, they normally awake from the nightmare and may be comforted by the reality that everything was just a bad dream.
On the other hand, when someone arises in a middle of a night terror, he/she shows an inability to register and respond to words of comfort. In other words, it's harder to shake them awake from the dream. The person could get up crying and screaming believing he's still in the dream. To the observer, however, the dreamer is already awake. When the dreamer does come to his senses, he will have zero or only the faintest recollection of both the dream and the part where he awoke crying and screaming. He may remember the general feeling of being afraid but that's about it. It's for this reason why parents should not wake up their kids in the middle of a night terror.
If you're experiencing sleep terror disorder, you may become physically active in your sleep. You may end up crying in your sleep or falling out of bed. On the other hand, if you're suffering from a nightmare disorder, you may experience bad dreams frequently. You may get up crying since you're likely to remember vivid parts of the dream or even the whole dream. At least you are aware that you're awake. As you may notice the huge difference between sleep terror disorder and nightmare disorder is that in the latter, the dreamer is more likely to be able to remember the bad dreams.
There's also a condition called confusional arousal. The person sleeps and then he wakes up, cries for a few minutes or hours, and possibly even talk or move in an unnaturally slow pace. This is also known as sleep drunkenness. It would look as though the person is asleep and awake at the same time. As far as the dreamer is concerned, he is awake at that moment. However, when called out, he will not respond. At times, the person might respond but he will do so in an exaggeratedly slow manner. There are those who go back to sleep and there are those who wake up in the next ten to thirty minutes. Regardless, they'll have no remembrance of the moment where they woke up and cried or talked or screamed.
To understand the reason why some people cry, yell, or even jump out of bed while they're asleep, it's necessary to review the normal stages of sleep presented in the table below.
Stages of Sleep
entering the alpha and theta brain waves
may experience periods similar to daydreaming while drifting off to slumber
somewhere between being awake and falling asleep
similar to a meditative state
occurs for about five to ten minutes
brain creates sleep spindles which are brief periods of brain activity that can be described as rhythmic and rapid
body temperature lowers
cardiac rate slows down
occurs for approximately twenty minutes
delta waves (brain waves that are slow and deep) develop
marks the transition from light sleep to extremely deep sleep
also known as delta sleep
occurs for about half an hour
the phase where strange activities like sleepwalking and enuresis may occur
REM sleep (rapid eye movement)
respiratory rate rises
brain activity increases
also known as paradoxical sleep because as your muscles grow relaxed almost to the point of paralysis, the brain and other physiological systems manifest increased activity
where dreaming happens
While you're in REM, your brain is highly active. However, your muscles become inactive and your voluntary muscles, in particular, are rendered immobile. This is a protective mechanism. Imagine if you dream that you're running around, crying, and tearing your hair out. The paralysis prevents you from doing this and other things that may bring harm to yourself or others. This mechanism, however, is dysfunctional in people with REM sleep behavior disorder.
REM Sleep Behavior Disorder
REM sleep behavior disorder is also referred to as dream-enacting behavior. It is a kind of sleeping disorder where the person ends up physically acting out his dreams. The dreams are very vivid and often bad. If you're suffering from this disorder, you may experience crying in your sleep or performing powerful movements with your arms and your legs. REM makes up 20% of your sleep and happens during the second half of your sleeping time. A lot can go on during that period. Individuals with REM sleep behavior disorder report that its onset is sudden with episodes that take place irregularly or during several times each night. When left unaddressed, the incidences tend to worsen overtime.
What are the symptoms of REM sleep behavior disorder?
- Arm flailing, leaping out of bed, kicking, punching, and other movements done in response to dreams filled with drama and action
- Making noises such as talking, crying, screaming, swearing, and laughing while sleeping
- An ability to recall the dream when aroused during an episode
In the last symptom mentioned, you'll see what makes REM sleep behavior disorder distinct from sleep terror disorder and confusional arousal. As previously mentioned, REM sleep behavior disorder is the result of the malfunction of the nerve pathways that hinder muscular activity during regular REM sleep. This sleep disorder is commonly seen in patients suffering from neurological disorders. These include Parkinson's disease and Lewy body dementia.
LBD and MSA: Lewy body dementia or LBD is a lot less well-known than Parkinson's. Even so, it's far from being a rare disease. In fact, next to Alzheimer's disease, LBD is one of the most progressive kind of dementia. LBD occurs when Lewy bodies (protein deposits) form in nerve cells in brain areas that govern thought, memory, and motor control. LBD leads to an advanced decline of the affected individual's mental capabilities. The person may imagine seeing things and there is a marked change in the level of consciousness and the ability to concentrate. Likewise, the person may also manifest symptoms that are similar to those of Parkinson's disease. These include muscular rigidity, tremors, and bradykinesia, which is a term for abnormally slow movement. REM sleep behavior disorder may also occur acutely in individuals suffering from drug or alcohol withdrawal especially those who have been taking sedative-hypnotics. So unless you actually have insomnia and have been given a prescription, do not take sedatives.
Another condition that can lead you to develop REM sleep behavior disorder and cause you to go crying in your sleep is multisystem atrophy. Unlike Parkinson's and LBD, MSA is a rare neurological condition. It causes impairment to your body's involuntary functions such as your cardiac rate, your digestive process, and your bladder control. Like LBD, Parkinsonian MSA is accompanied by Parkinson-like symptoms such as slow movement, abnormalities in balance and posture, and muscular rigidity. On the other hand, individuals who have the cerebellar type of MSA manifest lack of coordination, visual problems, trouble with chewing and swallowing, and speech slurring. In both cases of MSA, the person suffers from urinary and bowel incontinence, decreased secretion of tears and sweat and saliva, inability to regulate body temperature, irregular heartbeat, and incapability in controlling one's emotions. Among the sleeping disorders experienced by persons with MSA are abnormal breathing during sleeping and physically acting out one's dreams. If you are experiencing any of these symptoms along with crying in your sleep at night, be sure to inform your physician.
Parkinson's Disease: There are several reasons why people with Parkinson's disease are prone to experiencing REM sleep behavior disorder. First, restful sleep becomes difficult because the muscular rigidity prevents the person from assuming a comfortable sleeping position. Second, the depression and anxiety related to his present condition make a good night's sleep almost impossible for the affected person. When he/she does fall asleep, staying asleep could be difficult because of the pain, hot flashes, nocturnal sweating and other symptoms that occur as the medications start to wear off. The noises created by the tremors against the pillow also tend to disrupt normal sleep. Nighttime sleep is often disrupted by the fact that individuals with Parkinson's feel extremely sleepy during the day, causing them to take lengthy naps. Furthermore, it's not uncommon for Parkinson's patients to experience sleep apnea as well as heavy snoring. Additionally, the levodopa prescriptions taken by the patient has the potential to induce intense nightmares.
Restless Leg Syndrome: Individuals with Parkinson's disease suffer from restless leg syndrome. If you have RLS, you'll experience discomfort in your legs, which tend to worsen during bedtime. Such uncomfortable sensations include a pins-and-needles kind of feeling or an itchiness that can't be relieved by scratching. It can be a feeling that there's something creeping and crawling in your skin or that's something is tickling you. The discomfort can be severe enough to cause you to go crying in your sleep and make you not want to fall asleep at all. As a matter of fact, the symptoms only manifest themselves when your body is at rest. The exact cause of restless leg syndrome is still unknown. One thing is for sure, though, this condition is not exclusive to individuals with Parkinson's. Patients suffering from other chronic medical conditions such as diabetes, kidney failure, and peripheral neuropathy experience RLS. In such cases, the patients can only get relief by treating the underlying illness. There are also certain pharmaceuticals that may cause you to experience RLS. These include antipsychotics, drugs used to combat nausea, and allergy meds with antihistamines that have a sedative effect. Some women experience RLS in the third trimester of pregnancy. In such cases, the RLS naturally resolves about four weeks after childbirth.
Nocturnal Leg Cramps
It is necessary not to confuse RLS with nocturnal leg cramps. The latter is defined as a spontaneous contraction of the muscles of the calf while a person is asleep. The cramping is painful enough to cause you to wake up and cry and it may last for as long as ten minutes. However, it is not related to any underlying medical condition and its specific cause is yet to be determined. RLS, on the other hand, is not necessarily painful although it can be extremely bothersome.
REM Sleep Behavior Disorder Risk Factors
The exact cause of REM sleep behavior disorder has not yet been discovered. That said, there are certain risk factors which have been observed.
- As mentioned, this disorder is common in individuals with neurodegenerative disorders. Ironically, REM sleep behavior disorder may also be the first indication that an otherwise healthy person is likely to develop a neurodegenerative disorder in the future.
- REM sleep behavior disorder is also common among narcoleptics, epileptics, and persons with brain tumors.
- Assuming that you're always crying in your sleep even though you have none of those disorders, it's possible that the culprit is a medication that you're taking. SSRIs, tricyclic antidepressants, and sedatives can also cause REM sleep behavior disorder. Sleep paralysis, where you feel like something is sitting on top of you and you can't get up or move, can be treated with SSRIs. Paradoxically, it can cause REM sleep behavior disorder. So in this case, you need to choose whichever sleeping disorder you find less terrible.
- Recent research also shows that REM sleep behavior disorder is likely to occur in workers whose jobs expose them to pesticides and other farming chemicals.
- Other factors that may increase your risk for developing this disorder include sustaining head injuries in the past and chronic smoking.
How is this condition diagnosed and treated?
The worst complication that can occur due to REM sleep behavior disorder is injury to yourself or the person sleeping beside you. When you're frequently crying in your sleep and constantly disrupting your sleeping partner's shuteye, this can lead to strained relationships. Other consequences of lack of sleep include mercurial moods, depressive episodes, chronic tiredness, and decrease in work productivity. This means that it can seriously affect the overall quality of your life.
REM sleep behavior disorder is diagnosed through physical and neurological tests. A doctor may use a polysomnogram to conduct a nocturnal sleep study. While sleeping overnight in a laboratory, a team of doctors will evaluate your brain activity, cardiac and pulmonary activity, blood O2 levels, breathing patterns, and the movements of your extremities though sensors. The doctors will also videotape you as part of the documentation process. Before your condition is truly diagnosed as REM sleep behavior disorder, the doctors will need to compare your symptoms with a certain criteria.
- First, you'll need to reflect repeated incidences of arousal while sleeping. In these times, you should show prominent actions such as crying in your sleep or kicking and punching at something.
- Later on, you will be tested whether you are able to remember the parts of the dream which are associated with the movements you've performed.
- The doctors will also need to determine whether you are alert during each time you awaken as opposed to being disoriented.
- The sleep study will need to reflect a rise in muscle activity while you're in phase V of the sleep cycle.
- Lastly, the doctors will have to ensure that the reason you're crying in your sleep is not due to mental disorders, substance abuse, or other sleep disturbance disorders such as night terrors.
To address the sleeping disorder, a few modifications in your sleep environment have to be made. The doctor may suggest that you place padding on the floor and to remove dangerous items such as pointed objects in the bedroom. It would also be wise to move furniture away from the bedside and to close the windows.
In severe cases, clonazepam may be prescribed to reduce the symptoms. Ironically though, one of the side effects of this drug is the worsening of sleep apnea. If your nighttime crying is accompanied by very limited movements, the doctor might just prescribe a dietary supplement known as melatonin to help minimize the symptoms of REM sleep behavior disorder.
Post Traumatic Stress Disorder
If you've been crying in your sleep within three months after going through a traumatic event, then it's possible that you are suffering from post-traumatic stress disorder. PTSD occurs after a person experiences or witnesses a terrifying experience such as the death of or separation from a loved one, physical or sexual abuse, or involvement in an accident or a natural disaster. It can be any event which has led the person to feel frightened, threatened, hopeless, or horrified. These feelings are accompanied by lasting and increasing emotions of fear, anger, or guilt. What separates PTSD from normal shock or trauma is that it prevents the person from returning to his normal life. In other words, it hinders the individual from functioning as well as he used to before the traumatic incident occurred.
While the symptoms of PTSD usually manifest within three months after the incident, some individuals do not experience the symptoms until years later. This means you may wake up at night crying because of something that had happened many years ago.
Generalized Anxiety Disorder
Another probable reason why you're crying in your sleep is that you're suffering from GAD. Anxiety is a normal response to a distressing situation. However, the response becomes a disorder when you experience it frequently and when the anxiety you're experiencing is extremely disproportionate to the situation. The causes of GAD vary from abnormal brain chemistry to hereditary factors to environmental influences. The latter includes stressful events such as transferring to a new workplace and traumatic incidences such as domestic abuse. Generalized anxiety disorder is exacerbated by periods of stress. GAD may also occur during drug and alcohol withdrawal. It can likewise be caused by withdrawal from caffeine and nicotine.
Aside from sleep disturbances and crying in one's sleep, other symptoms associated with GAD include edginess, extreme irritability, muscular tension, nausea, excessive sweating, inability to concentrate, exhaustion, trembling, and frequent headaches. If you are experiencing any of these symptoms, tell your doctor about it. Help yourself by putting an end to your smoking or drinking habits. Cut down on caffeine. A healthy lifestyle that consists of regular exercise and a nutritious diet has proven to be effective in lessening the symptoms of GAD. In severe cases, cognitive behavioral therapy and pharmaceutical therapy are recommended.
Now that you know all that you need to about the possible reasons why you're crying in bed, try answering the question below.