Disturbing reason you feel like you're falling off a cliff right before you nod off

Daily Mail​

28-04-2025

Medication taken by some 8 million people in the UK could trigger a frightening sleep disturbance, research has revealed.
Scientists from Saudi Arabia have found that those who take certain antidepressants are at a dramatically increased risk of suffering hypnic jerks—a feeling of a sudden jolt before falling asleep.
The sensation is caused by sudden involuntary muscle contractions that happen during the transitional stage from wakefulness to sleep.
While harmless in most cases, experts have warned the sleep disturbance could lead to insomnia and major depressive disorder.
Now, a neuroscientist has performed an experiment that suggests psychiatric medications can alter chemicals in the brain, leading to hypnic jerks.
In the study, Professor Alghamdi analysed sleep patterns of a middle-aged man who was taking escitalopram — a type of antidepressant called a selective serotonin reuptake inhibitor (SSRI), which are most commonly prescribed to UK patients.
The patient complained of experiencing the sudden falling feeling at night, along with heart palpitations, feeling tense and an excessive fear of not being able to sleep again.
In order to treat the phenomenon, Professor Alghamdi asked the patient to stop taking the SSRI.
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After this minor adjustment, the patient showed dramatic improvement in his condition and the hypnic jerk movement completely disappeared at night.
His depressive symptoms, which were being treated with the medicine, also vanished.
Prof Alghamdi hypothesised that the constant sleep disruption had made the patient's depressive symptoms far worse.
'Intensified hypnic jerks can cause chronic sleep deprivation, potentially resulting in depression as a consequence of neurochemical changes in the brain,' he said.
Another study, published in the Indian Journal of Psychiatry, found similar results, further underling the link between SSRIs and the distressing sleep disturbance.
What are antidepressants?
Antidepressants are medicines that treat depression symptoms.
There are around 30 different types that can be prescribed.
The NHS says that most people who have moderate or severe depression notice improvement when they take antidepressants. But it notes that this isn't the case for everyone.
Side effects vary between different people and antidepressants but can include nausea, headaches, a dry mouth and problems having sex.
Antidepressants aren't addictive but patients may have withdrawal symptoms if they stop taking them suddenly or miss a dose.
These can include an upset stomach, flu-like symptoms, anxiety, dizziness and vivid dreams.
Researchers found that when a 31-year-old woman started taking escitalopram she began to experience involuntary head movements whilst sleeping.
These movements abrupt, involuntary spasms which significantly disturbed her quality of sleep.
When she stopped taking escitalopram and started on fluoxetine, another type of SSRI, she reported a significant reduction in the frequency and intensity of the jerky head movements during sleep.
This, researchers concluded, highlights the need for healthcare providers to be aware of this 'potentially overlooked' side effect of SSRIs.
'Hypnic jerks can disrupt sleep, cause anxiety, and negatively impact a patient's quality of life.
'Clinicians should recognise that these involuntary movements, while benign, can be distressing and may arise particularly after dosage increases or initiation of SSRIs', co-author, Dr Simran Sandhu added.
Multiple theories have emerged regarding this mostly harmless phenomena, with experts pointing to stimulants including caffeine and nicotine, to exercise as potential explanations for the jolts.
Some scientists believe that hypnic jerks are caused by the brain misinterpreting the transitional stage between wakefulness and sleep.
The brain 'thinks' that the body should be awake, so sends signals to alert the muscles.
While they can be startling, hypnic jerks are completely harmless, affecting around 70 per cent of adults in the UK, and are rarely a sign of any underlying conditions, experts warn.
It comes as figures show an estimated 8.7million people in England take antidepressants, about one in seven people, with numbers increasing annually.
However, experts have urged caution, with patients advised not to quit taking their medication without talking to the medical professional responsible for their care first.
'Close monitoring of patients, especially those who are newly prescribed SSRIs or have had dosage adjustments, is essential,' Dr Sandhu, co-author of the peer-reviewed study advised.
'Encouraging healthy sleep hygiene practices, including regular sleep schedules and relaxation techniques, can further enhance overall sleep quality and potentially reduce the occurrence of hypnic jerks', he added.