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People who frequently startle awake while falling asleep—a phenomenon researchers call "sleep starts" or hypnic jerks—report poorer sleep quality, greater insomnia severity and higher anxiety than those who do not, according to a new study published in PLOS Mental Health by Tanja Grünberger and Manuel Schabus of Paris Lodron University Salzburg, Austria, and colleagues.
Sleep starts are sudden jolts that occur in the moments between wakefulness and sleep, most often felt as an abrupt muscle jerk or twitch, sometimes strong enough to jolt a person fully awake. The experience can also involve a sudden sensation of falling or loss of balance, electric-shock-like feelings, tingling or numbness, flashes of light, or brief, dreamlike imagery. These experiences are frequently accompanied by a rush of emotion—alarm, confusion, fear or panic—and physical signs of a startle response, such as a racing heart or rapid breathing. Afterward, most people fall back asleep quickly.
In the new study, researchers conducted an online survey of 194 adults in Austria and Germany who answered questions about their sleep quality, insomnia severity, daytime sleepiness, dysfunctional sleep-related beliefs, and symptoms of anxiety and depression. Ninety-six of the participants experienced abrupt awakenings and at least one other symptom weekly, while the other 98 were used as a control group.
Compared with the control group, the sleep-starts group reported poorer sleep quality, greater insomnia severity, more dysfunctional sleep-related beliefs, and higher levels of anxiety and depressive symptoms (all statistically significant).
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