Rhythmic Movement Disorder (RMD)

Last updated: March 28, 2019

The information on this website is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice. Read our full medical disclaimer.

Rhythmic Movement Disorder (RMD) is a sleep-related disorder characterized by the involuntary and repetitive movements of large muscle groups during sleep. These movements often involve the head and neck. It was first independently described by Zappert in 1905 as jactatio capitis nocturna and by Cruchet as rhythmie du sommeil.

Majority of the episodes of RMD happen during non-REM sleep. RMD is a neurological disorder and is often associated with other psychiatric or mental disabilities. This is a sleep disorder typical with babies and children and usually disappears as they grow.

What are the symptoms of RMD?

A person suffering from RMD is often unaware that an episode has occurred or is occurring. Most of the symptoms of RMD do not cause any pain or harm to the patient. However, the rhythmic body movements may cause bodily injuries if the person falls during an episode. Movements caused by RMD can also cause muscle strains although these are not reported in all patients. In rare instances, a patient with RMD may hum or moan asleep while an RMD episode is happening. Just like other sleep-related movement disorders, it is usually the patient’s partner or parent who first see signs of RMD.

There are three types of RMD depending on the type of movement. These are:

  • Body Rocking – The person may rock his entire body while asleep, often while on his hands and knees. Included in this type are those who rock their upper body while sitting up.
  • Head Banging – This happens while a person is lying face down. A person starts by lifting his head or upper body. This is followed by the forcible banging of the head back into the pillow or mattress. These actions get repeated multiple times. Headbanging can also happen while a person is sitting up. That person will bang the back of his head against the wall or the headboard. The banging of the head and the rocking of the body may also happen simultaneously.  A person may rock on his hands and knees while banging the front of his head into the wall. This is a more dangerous type compared to the first one. The actions in this second type can lead to injuries in the head especially if the person bangs his head on a concrete wall.
  • Head rolling – In this type, the person rolls his head back and forth. This usually happens while a person is lying on his back.

What causes RMD?

Rhythmic Movement Disorder may be caused by another medical condition. It can be a result of:

  • Another sleep disorder
  • A medication
  • A mental health disorder
  • Substance abuse

RMD is common even in healthy infants and children. This disorder usually begins when a child reaches the age of six months. It is rare to see RMD in teens and adults. However, RMD may appear to older patients who suffered injuries to the central nervous system. When an adult has RMD, it is often caused by:

  • Mental retardation
  • Autism
  • Pervasive development disorder

Can we treat RMD?

As of this writing, there are still no proven treatments for RMD. It is also worth noting that almost all cases of RMD in children remit without recurrence.

However, parents should take precautions in order to prevent injuries caused by RMD. It is important to create a safe sleeping environment to prevent or minimize injuries. Parents can pad their bed’s headboard to avoid injuries to the head. If needed, a child should wear protective headgear. Lining the walls with pillows can also help ensure that a child won’t hurt himself if he bangs his head against the wall.

Medications have shown limited effects against RMD although clonazepam has been reported as useful in one study.

Additional Resources:

The information on this website is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice. Read our full medical disclaimer.