Q: I am a 52-year-old Hispanic woman with type 2 diabetes. For several months now I find that my legs, feet, hands and sometimes my whole body will twitch. There are times that my leg or foot will twitch at just the time I am falling asleep. I can be sitting in my chair watching TV or reading and my foot will twitch. It never hurts but can make me want to scratch the area. It does make me angry when it happens right before I am falling asleep and once I am asleep since it will cause me to wake up several times throughout the night. What is strange is that I have noticed that my two adopted granddaughters twitch during their sleep, especially the youngest who is 18 months old. I have mentioned this to my doctor who thinks it might be a restless leg condition.

Any help you can give me would be greatly appreciated.

A: Muscle twitches are often common, normal, and caused by contractions; however, in some instances they can represent a vitamin deficiency, an overdose of caffeine, stress, dehydration, hypothyroidism, a nervous system disorder such as myopathy (weak muscles), spinal muscular atrophy, nerve damage, and more. Symptoms of some of these diseases may include a loss of sensation to the area, weakness, and loss of muscle size. If the condition is benign, treatment is probably unnecessary. However, your physician or a neurologist is the one to make that decision. He or she may choose to order lab work, an electromyelogram (EMG), nerve conduction studies, and a possible MRI.

Do you drink coffee or soft drinks to excess that could be contributory? Perhaps you have an undiagnosed thyroid issue, exercise to extreme, or fail to eat well several days a week because you watch the children and don’t have the time to prepare well-balanced meals. Answers to some of the simpler issues might reduce the magnitude of he issue and fit the puzzle pieces together to give you the answer you are seeking. Your twitches just prior to falling asleep are a normal event; however, you may have a discussion with your physician as to why they occur during sleep and awaken you. Because you have an urge to scratch the areas, be sure to ask him or her about RLS and whether there could be a connection.

Muscle twitching in children is relatively similar to an adult version and represents a muscle spasm that might be completely benign, be caused by a diet deficiency, or other causes. Both children may simply have had a particularly active day, be over tired, or even be dreaming when the events occur. Your step-grand children’s parents should advise their pediatrician so he or she can continue to monitor the situation or perhaps run some simple testing.