Hello, 217154-ga!
Your question has intrigued me since I first saw it several weeks
ago. While I have found nothing definitive as a diagnosis for your
symptoms, I have uncovered some interesting forum discussions that
might help you to relax and know you are not alone in experiencing
these unexplained "internal vibrations", and a few medical references
that could possibly point you in some other directions.
First, as highlighted in the disclaimer at the bottom of this page,
"Answers and comments provided on Google Answers are general
information, and are not intended to substitute for informed
professional medical, psychiatric, psychological, tax, legal,
investment, accounting, or other professional advice."
With that said, I would first advise that you have a full physical
exam to rule out any hormonal imbalances, dietary deficiencies or
physical/neurological problems. Some diseases, such as Parkinson's,
can involve internal tremor as an early symptom, but you do not seem
to have any other attendant symptoms. Other conditions, such as
Essential Tremor, vary in their severity, but you don't really fit the
profile from what you have outlined. Blood sugar imbalances can
involve internal shakiness and trembling, but you have mentioned the
lack of sweatiness and light-headedness which also occurs quite
commonly. While Norvasc does list trembling and shakiness of the hands
and fingers as a possible side-effect, this is not the same as the
internal trembling you describe.
==
I think it might be helpful for you to read some forum messages from
others who are wrestling with similar episodes of internal trembling
during sleep cycles - either upon falling asleep or awakening - while
having no success in finding a diagnosis.
I have also included some personal accounts of internal
vibration/trembling from individuals who have been diagnosed with
Parkinson's disease or some form of Essential Tremor - neither of
which appears to be applicable to you from what you have described.
It is worth considering whether your symptoms are related to a
"learned anticipation" of trembling upon awakening, and thus, are
simply a companion to an underlying, subconscious anxiety. You have
mentioned that you don't have the other symptoms of panic disorder -
the racing heart, sweaty palms, shallow breathing, etc. That does not
mean, however, that you have not developed a subconscious,
anticipatory expectation of an unpleasant "wake-up" that elicits the
symptoms when you first awake, and then quickly fade away as you calm
down. I say this simply because of your more recent anticipation of
taking an afternoon nap for fear that this internal trembling will
occur as you awake.
I have a very similar situation that has been happening to me over the
past 5-6 years. I can sleep well at night, but I am unable to nap
during the day without experiencing a panicky feeling as I start to
drift off. I don't feel a trembling or a vibration, but my heart
begins to race and I am gripped with a feeling of fear or dread. This
started during a period of hormonal change coupled with a stressful
life situation, and I have come to anticipate the reaction every time
I try to nap. It has become so uncomfortable that I simply lie there
and try to relax with my eyes open, rather than trying to sleep. To
some degree, I know that the anticipation makes it worse, yet it
occurs whether I am feeling consciously stressed or not. After a
thorough physical exam, I have simply decided that this, too, shall
pass! You might want to ask yourself if there is any underlying stress
that is causing anticipation of the "new day", and whether you can
tackle any issues in this regard.
==
The following messages are from the Brain Talk Community Website:
http://brain.hastypastry.net/forums/showthread.php?t=56686
"INTERNAL VIBRATIONS UPON AWAKENING."
"I've been having "internal" tremor-like feelings for over 1 and 1/2
years. I describe it as a resonating or vibrating feeling. It happens
everytime I'm going into sleep and many times during awakening.
Without some type of sleep aid, it can awaken me during the night. It
has dramaticallly affected the quality of my sleep. It doesn't matter
whether I'm in bed or taking a nap in a recliner. I'm 56 years old, 6
ft and about 190 lbs. I'm physically active, but retired. I take
medication for excessive reflux(prilosec) and irritable bowel
syndrome(levsinex). I've had a sleep apnea study and seen a
neuro-phychologist. The phyc found me normal, without any notable
anxiety, and I experienced only 8 short episodes of apnea, only on my
back, during the sleep study. I've tried stopping my various
medications, increasing exercise, etc. with no luck. My doctor
prescribed Xanax, which helps me sleep longer, but just knocks me out
so much I don't know I'm having problems, and I don't like the fact it
is addictive. The length of these feelings used to be about 5-10 secs
and are now much longer, sometimes over a minute. I also seem to have
unusual dreams associated with this disorder which I never experienced
before. I have difficulty recalling the details of the dreams when
fully awake. The weird thing is that there is no external tremors,
shaking, or vibrating like I'm feeling internally. The feeling is
centered in my chest and upper body, nothing in my lower extremities.
I continually check my pulse when awake enough and find no rapidness
or irregularity with my heartbeat. A year ago I had a heart catheter
and was told everything looks good. The only other symptoms I
experience are sometimes my top forearm, thumb, and first two fingers
go to sleep, depending on which side I sleep. Has anyone else ever
experienced this and can offer some help? Doctors have yet to find a
solution to the problem."
-
"I get a feeling of vibrating internally. But it might not be the same
as yours, as I don't get any external vibration. It's usually as I am
falling asleep, sometimes when I wake up in the night, and very
occasionally during the daytime. It has fluctuated over a period of
time, not bothering me at all at the moment but very bad during the
late 80s. At that time it was so bad that I was often scared to go to
sleep, because I thought I was dying. The vibration was all over, face
as well, and replacing the normal sensation of having a body, so that
I felt as though I was turning into an electric machine. But gradually
I learned to get used to it and not be frightened by it. It cleared up
for a few years and then during the mid 90s I had another bout of it.
Only this time it was slightly different, more like a feeling that my
bed was vibrating, like I was sleeping on top of a fridge. This time I
really didn't realise it was me. I thought it was something in the
environment - underground vibration from a factory about a mile from
here. I called out the Environmental Health Department and they went
investigating all the nearby factories, the electricity board and the
sewage works. I have MS with secondary narcolepsy, and I think it is
to do with the narcolepsy. I did find it on one of the narcolepsy
websites that some narcoleptics get a feeling of vibration inside
them."
===
A follow-up from another forum member who has decided to simply relax,
accept and go with the flow.........
"My tremors are fine and now occur not only upon awakening, but
sometimes when I'm just resting. I have consciously decided not to
fear them anymore, but let them occur and then forget about them. I
find some comfort in knowing that anyone I've heard had these tremors
has come back with a clean bill of health...for whatever that's worth.
It could be some crazy illness or it is just a rare sensation that not
everyone experiences. I don't know what else to do."
http://brain.hastypastry.net/forums/showthread.php?t=26742
==
From the Massachusetts General Hospital Dept. of Neurology Forum
http://neuro-www.mgh.harvard.edu/forum_2/NeuromuscularF/10.13.999.02AMInternaltre.html
Internal trembling/vibrating - Anybody?
"About a year ago, I would be taking a nap and feel as if someone was
shaking the bed. I would actually sit up and look around to see if
that was happening. It wasn't. About six months ago, it got worse. I
feel as if my insides are vibrating. It's like you're leaning against
a motor or something. I went on a cruise in June and didn't feel
anything because the ship was constantly vibrating. This was nice
cause I couldn't dwell on it. My GP says it's stress (although I don't
feel stressed) and put me on Paxil. It really helped in the beginning,
but the symptons continue. I'm weaning myself off the Paxil. Another
symptom is the twitching and jerks on falling asleep. Paxil side
effects causes this, so that's one reason I'm trying to get off the
stuff. The vibrating only seemed to bother me at night, but now I seem
to feel it during workhours, as well. It's not painful, but annoying."
==
You might want to read the following messages from the Parkinson's
Disease Forum. Although you have not been diagnosed with any form of
Parkinsons, I though you might find some of the messages of interest.
From "Re: Constant Internal tremors???" (in relation to Parkinson's disease)
http://www.parkinson.ca/board/messages/2454.html
"Although sensory symptoms were not originally described in
Parkinson's disease (PD), in recent years it has been increasingly
recognized that painful sensations and paresthesias occur in
approximately 40% of patients. It has been our observation that PD
patients often describe a sensation of internal tremor, a feeling of
tremor inside the chest, abdomen, arms, or legs that cannot be seen.
We investigated the prevalence and characteristics of internal tremor
by administering a questionnaire to 100 consecutive patients with PD
and 50 age-matched controls seen in our movement disorders center. A
sensation of internal tremor was present in 44% of this sample of PD
patients and in 6% of the control population (p < 0.0001). The
presence of internal tremor was unrelated to Unified Parkinson's
Disease Rating Scale score, Hoehn and Yahr stage, duration of disease,
or the presence of observable tremor. The frequency of other sensory
symptoms (aching, tingling, burning) was higher in the PD patients
with internal tremor (73%) than in those without (45%; p = 0.005).
Internal tremor is associated with anxiety in 64% of patients (p <
0.0001). It was described as uncomfortable and was unrelieved by
antiparkinsonian medication in three quarters of patients. A sensation
of internal tremor is commonly reported by PD patients and should be
recognized as a useful diagnostic factor in PD."
Source:Mov Disord 11:3-7 (1996)[PMID8771060
=
Follow - ups:
In Reply to: Re: Constant Internal tremors ??? posted by Judith on
January 13, 2004 at 01:33:44:
http://www.parkinson.ca/board/messages/2544.html
"I have had internal tremors for about 8 months now. I have had blood
tests and have seen several doctors that offer no explanation. I was
told to take the next step and go see a neurologist. I have not done
this yet and I am somewhat skeptical they will find anything either!"
-
"In Reply to: Re: Constant Internal tremors ??? posted by Judith on
January 13, 2004 at 01:33:44:
http://www.parkinson.ca/board/messages/2543.html
"I've had the same symptoms for the last two years. I've been through
a bunch of tests (scans, blood test, intestin, etc...) and they've
narrowed it down to anxiety and gave my prescriptions that haven't
worked yet...I keep doing research and research and would love to find
the answer!"
==
This post from the Sleep Disorder Forum is more about shaking but it
might be interesting.
Wake Up to Body Shaking Badly
http://ehealthforum.com/health/topic25209.html
"Every morning when I wake up my entire body (head, neck, arms, legs)
shakes for a few moments or so. My husband wakes me up in the mornings
and says it looks like I am having a seziure. I am alert and aware of
the shaking but unable to controll it. I have done this for a little
over a year but it does seem to be getting worse. I shake occasionally
during the day in the hands and legs sometimes mostly due to anxiety.
I have bi polar disorder and panic disoder and have taken several
medications over the last year or so in treatment, none having any
effect on the shaking. Anyone else have this?"
==
ESSENTIAL TREMOR/INTERNAL TREMOR
A series of messages from the Brain Talk Forum
http://brain.hastypastry.net/forums/archive/index.php/t-30823.html
"I have posted primarily in the Sleep Disorders Forum because my
problem usually occurred upon awakening or while falling asleep. In
the meantime it has awaken me from my sleep and also occurred while
resting. I really have only two symptoms and do not know if they are
at all related."
"I experience a fine internal tremor that feels like the earth is
moving or my heart is fibrillating. It is like a motor running. A
buzzing or vibration. It usually lasts only a few seconds and is not
visible to anyone. There's no twitching, shaking or external sign of
movement."
"My other symptom is a very stiff and sore neck. I just had 13 x-rays
taken, and am going in to review them with the doctor tomorrow. I've
had a stiff, sore neck before, but it only lasted a few days. This
time I've had it for about 2 months. Could this be the onset of ET? Or
does it not sound familiar at all?"
"Internal tremor" is fairly common with ET (though I personally have
never had it). Normally you would expect to see other symptoms of ET
(such as hands shaking when threading a needle) if the internal
tremors were due to ET, though.
==
"I have the internal tremors, too, just like you describe. I have the
DX of Essential Tremors, but this is not supposed to be an active part
of it (ET), just as Dan said that he has never experienced internal
tremors. Mine occur fairly regularly when I am laying down to go to
sleep or just waking up, or if I am sitting in my computer chair and
lean my head back. I feel like the chair is rocking back and forth."
"I have seen 4 neuro docs trying to narrow down exactly what is going
on with my health, and the internal tremors have been something that I
have questioned with all 4 docs (the 4th neuro being a specialist in
Parkinson's disease). They all said that this is a benign feature that
I am exhibiting - accept it and move on as it is not a positive sign
of any bad thing."
"Stress seems to play a large part in how many of these episodes I
experience in any given amount of time. The more stress, the more
internal and external tremors I exhibit."
==
"I was recently diagnosed with ET, based on my symptoms of internal
tremor. Is this very common among those you have talked with about ET?
My father has ET, but has never had the "vibes" in his head. I've had
2 months of disturbed sleep and want to know everything I can do to
get these to subside. Do you have it often, or just episodes now and
then? I used to have an episode, maybe for 2-10 days, every few
months. This one is a marathon I want to end soon!"
==
"I, personally, have not heard of someone being diagnosed with ET just
from having internal tremors. I am not saying that you don't have ET,
just that the 4 neuro docs that I work with all said that a person (in
their opinion) exhibit an external tremor of the hands, arms, head or
trunk."
"I previously was having the internal vibrations about once every 10
days when going to sleep or waking up. Now I have them almost every
day. Mine go away quickly in about 30 seconds after they start. I
notice that they increase in intensity when I have a disturbed sleep
or very little sleep the night before."
"I also have experienced the internal tremors during the day, but it
has always been a precursor of the external tremors for me. This
usually occurs when I am under physical stress (a hard day lifting at
work) or emotionally know that I have to be at my best physically
(starting a new job). I feel the internal tremors in my neck/head,
arms and legs for a few minutes beforehand, then the external tremors
start."
"I have not found anything to stop the internal tremors so far. I am
on or have used:
topomax
mysoline
ideneral (sp?)
Klonopin
numerous antidepressants (AD's)
"I also have tremors in my sleep. These are *NOT* ET, and that is one
of the reasons that I was sent to see the MDS. I am currently being
treated for Young Onset Parkinson's Disease, but will not receive a
diagnosis (DX) for it until I am finished with my initial start up of
Requip. The requip has pretty much stopped the night tremors, but have
done little or nothing for the daytime tremors or internal tremors."
==
The following forum thread might be of particular interest to you,
even though each individual has a different variety of symptoms along
with the internal tremor:
"Internal tremor." Forum: The Neurology and Neurosurgery Forum
http://www.medhelp.org/forums/neuro/messages/31070.html
==
This is another thread on essential tremor:
http://www.essentialtremor.org/discus_adult/messages/12/86.html?1109008577
==
You might also want to read the following description of Essential
Tremor, just for informational purposes. What you have described does
not seem to be as severe.
Read "Clinical Characteristics of Essential Tremor." Worldwide
Education for Movement Disorders. http://www.wemove.org/et/et_cc.html
==
More from the Brain Talk community:
http://neuro-mancer.mgh.harvard.edu/ubb/Forum87/HTML/000355.html
===
Again, I would recommend a thorough physical exam for nutritional,
hormonal and neurological imbalances, and a further exploration of any
stress issues which are sitting at a subconscious level. There is no
harm in exploring this from all angles. Once you feel you have been
thorough and ruled out any medical issues, you might try initiating a
short, relaxation program during the day. This may train your body to
react in a more relaxed manner as you awake, thus creating a new
response. It can also be the basis for helping you to fall into a
relaxing nap during the day, when needed. (I think I should follow my
own advice, here!) You might want to look at the following relaxation
exercise for the Stress Education Center.
http://www.dstress.com/guided.htm
While I know these references have not provided you with a definitive
answer, I hope they have supplied some help and insight.
I wish you all the best!
Sincerely,
umiat
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