Head Banging

When he goes to sleep, Matthew who is 4 years old, starts banging his head on the bed and pillow and at time on the headboard. His mother was rightly concerned so she brought him to his pediatrician.

The pediatrician told her not to worry.  What Matthew is doing is known as rhythmic movement disorder (RMD) which occurs in infant and children and is not uncommon (nearly 50% of infants and kids). It is equal in boys and girls. It typically occurs as the child is falling asleep. Children don’t remember these events. There is an older medical name for head banging that comes in this incredible name, “jactatio capitis nocturna”. It is believed to be the child’s way of self-soothing.

Some children do head banging, other do head rolling and body rocking. With head rolling, the child rolls the head side to side. Body rocking is the most disturbing to parents because the child can get on both hands and knees and rocks his or her body back and forth. Sometimes the child can make vocalization or loud humming during these movements.

Children usually “grow out of it”. However, it persists in mentally challenged children.  Rarely, it persists in healthy adults. Treatment is needed if the movements are causing physical injury (neck) or affecting the sleep quality.

Management of rhythmic movements disorder

  • Most children who have these rhythmic movements need no treatment.
  • Sometimes, the movements can be stopped with a noise or touch.
  • If the movement persists, occurs very frequently or is causing physical injury or affecting the sleep quality leading to daytime fatigue and sleepiness, talk to your child’s pediatrician. A sleep specialist can assist in the more complex cases.
  • Keep a calendar of events:  track your child’s events, timing and any noted injuries, evidence of sleep disruption and daytime sleepiness or fatigue.  Take the calendar when you see the doctor.
  • In adults, one study by Chisholm (published in Sleep 1998) found that two patients benefited from clonazepam for the treatment of head banging.