Why You Feel Strange Sensations When You Fall Asleep (Falling Sensation, Tingling, Jerking)
In the past, sleep was perceived to be a passive state where people lost consciousness for a number of hours until they woke. The reality is that the brain goes through several cycles of four different sleep stages. Each sleep cycle is between 70 to 120 minutes long.1
When we drift off into the first stage of sleep, we transition from a waking state into the lightest sleep cycle, and the brain starts preparing for a night of sleep. In stage 1 of sleep, our breathing and heart rate slow down, and our muscles relax.2
After a few minutes, our brain moves into stage 2 of the sleep cycle, where brain activity slows, and our body relaxes further.2
The next stage of sleep, stage 3, is the deepest and most restorative. It is very hard to wake someone in this stage of sleep.2
The last stage of sleep is rapid eye movement (REM) sleep. During this phase, your brain is very active with dreams, but your muscles, except for your eye muscles, are relaxed.2
Some people can experience strange sensations when falling asleep, especially when the brain moves between sleep stages. If you don’t know what they are, this can be a terrifying experience.
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Tingling Sensation When Trying to Sleep
A tingling sensation in part or all over the body can make it hard to fall asleep. If you lie in the same position for an extended time, like when trying to fall asleep, you can constrict blood flow or pinch a nerve, causing a feeling of pins and needles or tingling known as paraesthesia.3 This type of tingling can often be relieved by changing your sleep position.4
Some tingling sensations are related to chronic conditions; if you have concerns, discuss them with your medical providers.
Itchy Skin at Night
Some people notice that their skin feels itchy when trying to sleep, called nocturnal pruritus.5 Most people with chronic skin conditions say itching intensifies at night, especially in the first two stages of sleep.6
Although the cause of nocturnal itching is unknown, the skin can become drier and more irritated at night because of increased blood flow and water loss that happens at night.7
Some medications, like antihistamines, can help reduce itching and help with sleep. Studies have shown that psychological interventions like cognitivbehavioral therapy can help reduce the activating relationship to the symptoms of chronic itching.8
Restless Legs Syndrome
People with restless legs syndrome (RLS) describe an irresistible urge to move their legs along with uncomfortable tingling sensations that are stronger at night than during the day and usually remit with movement.9
Although the cause of RLS is unknown, treating underlying conditions associated with RLS can help. People with both RLS and an iron deficiency often improve after taking supplemental iron.10
Other medications, like muscle relaxants or drugs that increase dopamine in the brain, can help with the symptoms of RLS. Home remedies like massage, baths, and foot wraps can also help alleviate symptoms.9
Falling Sensation When Trying to Sleep (Hypnic Jerks)
Have you ever been just about to drift off to sleep, and suddenly you get a feeling of dropping or falling and awake with a jolt? More than 60% of people have had this experience, called hypnic jerks (also known as hypnagogic jerks, brain zaps, or hypnic myoclonus).11,12
Hypnic jerks occur during the transition between wakefulness and sleep. People describe feeling a sudden,brief jerk of the whole body and a sense of falling. The jerk can be a subtle muscle movement or a large muscle spasm. Some people may also hear, see, or feel things during a hypnic jerk and can awaken with rapid breathing, a drumming heart, or sweating.13
Hypnic jerks may feel scary, but they are nothing to worry about.
What Causes Hypnic Jerks?
The exact cause of hypnic jerks is unknown, but scientists have some theories about their origin and function. They can be a reaction to a dream or different parts of your brain trying to go to sleep more quickly than other parts of the brain.12
Some people may notice that they are more likely to experience a hypnic jerk with particular circumstances or triggers. Some triggers include:12
- Drug or alcohol use
- Lack of sleep
Exploding Head Syndrome
Despite the threatening name, exploding head syndrome is a harmless sleep disorder where you hear a loud noise or explosive crashing sound in your head, that no one else can hear, as you fall asleep.15 Many people also experience increased heart rate and muscle twitching.16 Between 10% to 15% of people have experienced an episode of exploding head syndrome.17
Even though this syndrome is not associated with physical pain, it can cause fear and anxiety about sleep in those that experience it. Prevention of an episode usually revolves around addressing anxiety and maintaining healthy sleep habits.18, 19
Sleep paralysis is the unusual occurrence of waking up and being unable to move. During sleep paralysis, the part of your brain that keeps you from moving in your sleep still thinks you are asleep, while part of your brain has regained awareness of your surroundings.20
Sleep paralysis happens when the brain is shifting from REM sleep, causing some people to experience hallucinations while they are still paralyzed. Most episodes end on their own after just a few seconds to minutes.20
The fear people experience with this sleep disorder can cause anxiety and poor sleep quality.21
When to See a Doctor
All of these sensations can be frightening, but these experiences are considered to be a harmless part of sleep. However, if you are experiencing these sensations frequently or avoiding sleep because of the anxiety it causes, you should contact a doctor.
Sleep is a complex biological process that still holds many mysteries. Most of us have experienced strange sensations while falling asleep. Although it can be a scary situation, the best approach is to recognize that this is just a part of sleep and try not to worry about it.
If you are struggling with sleep and think you might be experiencing insomnia, cognitive behavioral therapy for insomnia (CBT-I) is recommended as a first-line treatment by expert groups, including the American College of Physicians and the American Academy of Sleep Medicine.
CBT-I teaches you the skills to reframe your thinking and behaviors surrounding sleep. With CBT-I, you will learn more about sleep and your brain, decrease feelings of worry or frustration surrounding sleep and get support for changing your sleep habits.22
Dawn Health provides a comprehensive CBT-I program that can be accessed through an easy-to-use smartphone app. To discover whether CBT-I may be a good fit for you, fill out our online questionnaire.
Hartmann E. The 90-minute sleep-dream cycle. Arch Gen Psychiatry. 1968 Mar;18(3):280-6. doi: 10.1001/archpsyc.1968.01740030024004. PMID: 5638533.
National Institute of Neurological Disorders and Stroke. (2022, April 1). Brain Basics: Understanding Sleep. https://www.ninds.nih.gov/health-information/patient-caregiver-education/brain-basics-understanding-sleep
Shoen, S. (2022, March 11). Numbness in Hands While Sleeping: Why it Happens And What it Means. Sleep Foundation. https://www.sleepfoundation.org/physical-health/numbness-in-hands-while-sleeping
Roth Bettlach CL, Hasak JM, Krauss EM, Yu JL, Skolnick GB, Bodway GN, Kahn LC, Mackinnon SE. Preferences in Sleep Position Correlate With Nighttime Paresthesias in Healthy People Without Carpal Tunnel Syndrome. Hand (N Y). 2019 Mar;14(2):163-171. doi: 10.1177/1558944717735942. Epub 2017 Oct 11. PMID: 29020829; PMCID: PMC6436122.
Lavery MJ, Stull C, Nattkemper LA, Sanders KM, Lee H, Sahu S, Valdes-Rodriguez R, Chan YH, Yosipovitch G. Nocturnal Pruritus: Prevalence, Characteristics, and Impact on ItchyQoL in a Chronic Itch Population. Acta Derm Venereol. 2017 Apr 6;97(4):513-515. doi: 10.2340/00015555-2560. PMID: 27805720.
Lavery MJ, Stull C, Kinney MO, Yosipovitch G. Nocturnal Pruritus: The Battle for a Peaceful Night's Sleep. Int J Mol Sci. 2016 Mar 22;17(3):425. doi: 10.3390/ijms17030425. PMID: 27011178; PMCID: PMC4813276.
Lavery MJ, Stull C, Kinney MO, Yosipovitch G. Nocturnal Pruritus: The Battle for a Peaceful Night’s Sleep. International Journal of Molecular Sciences. 2016; 17(3):425. https://doi.org/10.3390/ijms17030425
Schut C, Mollanazar NK, Kupfer J, Gieler U, Yosipovitch G. Psychological Interventions in the Treatment of Chronic Itch. Acta Derm Venereol. 2016 Feb;96(2):157-61. doi: 10.2340/00015555-2177. PMID: 26073701.
Mayo Clinic. (2022, March 1). Restless legs syndrome. https://www.mayoclinic.org/diseases-conditions/restless-legs- syndrome/diagnosis-treatment/drc-20377174
Connor JR, Patton SM, Oexle K, Allen RP. Iron and restless legs syndrome: treatment, genetics and pathophysiology. Sleep Med. 2017 Mar;31:61-70. doi: 10.1016/j.sleep.2016.07.028. Epub 2016 Nov 10. PMID: 28057495; PMCID: PMC5334282.
Chiaro G, Calandra-Buonaura G, Sambati L, Cecere A, Ferri C, Caletti MT, Cortelli P, Provini F. Hypnic jerks are an underestimated sleep motor phenomenon in patients with parkinsonism. A video-polysomnographic and neurophysiological study. Sleep Med. 2016 Oct;26:37-44. doi: 10.1016/j.sleep.2016.07.011. Epub 2016 Aug 23. PMID: 28007358.
Summer, J. (2022, June 17). Hypnic Jerks. Sleep Foundation. https://www.sleepfoundation.org/parasomnias/hypnic-jerks
Sander HW, Geisse H, Quinto C, et al. Sensory sleep starts. Journal of Neurology, Neurosurgery & Psychiatry 1998;64:690.
Cheri Mah, Leslie West, Anahid Hekmat, 0807 Sleep-related hiccups: A case report of antidepressant associated hypnic jerks, Sleep, Volume 45, Issue Supplement_1, June 2022, Page A350, https://doi.org/10.1093/sleep/zsac079.803
Summer, J. (2022, April 13). Exploding Head Syndrome. Sleep Foundation. https://www.sleepfoundation.org/parasomnias/exploding-head-syndrome
Sharpless BA. Characteristic symptoms and associated features of exploding head syndrome in undergraduates. Cephalalgia. 2018 Mar;38(3):595-599. doi: 10.1177/0333102417702128. Epub 2017 Apr 6. PMID: 28385085.
Denis D, Poerio GL, Derveeuw S, Badini I, Gregory AM. Associations between exploding head syndrome and measures of sleep quality and experiences, dissociation, and well-being. Sleep. 2019 Feb 1;42(2). doi: 10.1093/sleep/zsy216. PMID: 30544141.
Sharpless BA, Denis D, Perach R, French CC, Gregory AM. Exploding head syndrome: clinical features, theories about etiology, and prevention strategies in a large international sample. Sleep Med. 2020 Nov;75:251-255. doi: 10.1016/j.sleep.2020.05.043. Epub 2020 Jun 10. PMID: 32862013.
Suni, E. (2022, March 11). Sleep Hygeine. Sleep Foundation. https://www.sleepfoundation.org/sleep-hygiene
Suni, E. (2022, June 24). What You Should Know About Sleep Paralysis. Sleep Foundation. https://www.sleepfoundation.org/parasomnias/sleep-paralysis
Denis D. Relationships between sleep paralysis and sleep quality: current insights. Nat Sci Sleep. 2018 Nov 2;10:355-367. doi: 10.2147/NSS.S158600. PMID: 30464663; PMCID: PMC6220434.
Edinger, J. D., Arnedt, J. T., Bertisch, S. M., Carney, C. E., Harrington, J. J., Lichstein, K. L., Sateia, M. J., Troxel, W. M., Zhou, E. S., Kazmi, U., Heald, J. L., & Martin, J. L. (2021). Behavioral and psychological treatments for chronic insomnia disorder in adults: an American Academy of Sleep Medicine clinical practice guideline. Journal of clinical sleep medicine, 17(2), 255–262. https://doi.org/10.5664/jcsm.8986)
Dr. Colleen Ehrnstrom is a licensed clinical psychologist with a specialty practice in Acceptance and Commitment Therapy (ACT). Areas of expertise include insomnia and other sleep disorders, anxiety, and depression.
Dr. Ehrnstrom is not a medical provider and is not providing any recommendations regarding medications. Rather, she is sharing and reviewing the research as it relates to education when learning how best to treat insomnia.
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