An Overview of Sleep Talking

Sleep talking, sometimes known as somniloquy, is a common sleep disorder characterized by unknowingly talking in your sleep. On its own, sleep talking is usually harmless. But in some cases, it might be a sign of a more serious sleep problem like sleep apnea or epilepsy.

This article will explain what sleep talking is, why it happens, and when to see your healthcare provider about it.

Symptoms of Sleep Talking

Sleep talking can vary from senseless babbling, shouting, or laughing to speech that a person would use while they are awake. Sleep talkers can appear to be talking to themselves or carrying on a conversation with someone else.

What characterizes sleep talking is that the episodes are not remembered when the sleep talker awakens. Unless someone else overhears them, the condition will go unrecognized.

Sleep talking can be incidental, occurring when a person is sleep-deprived or intoxicated. For others, it can be a chronic (persistent) condition during which they sleep talk several times a week or even nightly.

Sleep talkers generally do not talk for longer than nine seconds at a time, and often far less. The content is usually harmless and incomprehensible but can sometimes be graphic and alarming, laden with profanity or verbal abuse.

What Causes Sleep Talking?

Sleep talking is a type of parasomnia, meaning something that only happens during sleep. It can occur on its own or with other types of parasomnias, such as sleepwalking, night terrors, sleep eating, sleep paralysis, and sexsomnia.

Although it's not always clear what causes parasomnias, they are thought to be linked to a condition—often emotional but sometimes physical—that triggers strong feelings. This not only includes anxiety and fear but also things like happiness or sexual arousal.

Certain things can trigger sleep talking, including:

• Alcohol or drug use
• Fatigue or exhaustion
• Depression
• Insomnia
• Anxiety or stress
• Feverish sleep
• General illness
• Certain medications
• Sleep deprivation

Sleep talking can also run in families, suggesting there may be a genetic component.

Sleep Talking vs. Dreaming

Sleep talking is not exactly the same thing as acting out a dream. The latter occurs during a specific stage of sleep, called REM sleep, while sleep talking infers speech that occurs during any of the four stages of sleep.

The characteristics of speech can differ by the stage:

• Stages 1 to 3: As a person transitions from wake to sleep, they may have a complete and understandable conversation with themselves. As they move toward deeper sleep, their talking may sound more garbled or slurred.
• Stage 4 (REM sleep): This is when a person is actively dreaming. During this stage, they won't likely make sense to anyone overhearing them.

Dream talking can also occur with a type of parasomnia known as REM sleep behavior disorder (RBD). With RBD, a person will enact a dream, particularly those that are frightening, both physically and verbally,

While REM sleep is associated with sleep atonia (a reduction in muscle movement), RBD is characterized by abrupt and even violent movements. RBD is not the same as night terrors, which occur outside of REM sleep.

When to See a Healthcare Provider

Sleep talking isn't usually a problem until it interferes with the sleep of your partner. If it is affecting your relationship or your partner is worried about your sleep talking, speak with your provider or ask for a referral to a sleep specialist known as a somnologist.

You should also make an appointment if you've never talked in your sleep before but suddenly start doing it as an adult. In cases like this, sleep talking may be a sign of an underlying health problem.

Sleep talking is known to accompany certain medical conditions, including:

• Dementia
  
• Parkinson's disease
• Post-traumatic stress disorder (PTSD)
• Epileptic seizures
  
• Obstructive sleep apnea

All of these conditions are serious and require medical attention. In some cases, sleep talking may be the first or only sign of an underlying health condition. This is why sleep taking shouldn't be considered "harmless" if the symptoms are persistent, worsening, or severe.

Diagnosis of Sleep Talking

Sleep talking can occur on its own or be a feature of another sleep disorder. If your symptoms are problematic or disruptive, your healthcare provider may recommend keeping a sleep journal and/or undergoing a sleep study.

Sleep Journal

Keeping a sleep journal can help you identify your sleep patterns by tracking and recording:

• How much you sleep
• When you sleep
• When you wake up
• What gets in the way of your sleep
• Factors that influence sleep (like diet, exercise, medications, alcohol, and caffeine)

This information may help your provider identify the cause of your sleep-talking and offer tips to help relieve your symptoms.

There are also apps and wearable trackers that can help you monitor your sleep.

Sleep Studies

A sleep study, also known as a polysomnogram, involves a sleep specialist team who monitors you while you sleep. The test is done in a sleep lab where you are fitted with probes that track your brain waves, respiratory rate, heart rate, and body temperature while you sleep. The session is videotaped in sync with these vital signs.

The information from a sleep study can help detect common conditions like sleep apnea or better characterize the nature of your symptoms. Even if the test does not show you sleep-talking, it can still be useful because it may help rule out other sleep disorders.

How Sleep Talking Is Treated

Sleep talking usually doesn't need to be treated. However, it can be part of another condition that does need treatment

By way of example:

• For people with chronic insomnia or night terrors, prescription medications may be prescribed. Pre-bedtime routines like meditation and improved sleep hygiene may also help.
• For people with depression, PTSD, or stress-related sleep problems, cognitive behavioral therapy (a form of talk therapy) may be advised.
• For people with sleep apnea, a breathing device called continuous positive airway pressure (CPAP) can ensure they get enough oxygen while sleeping.
  

If sleep talking is bothering a bed partner, a white noise machine or noise-blocking earplugs or headphones may help.