Is sleep part of the problem?

Is sleep part of the problem?

The question was posed in the Medical Problems of Performing Artists journal and answered by Dr. Altenmüller MD, MA, and Dr. Lee MD. No official research has been done on the topic, but they indeed link sleep problems to a sub-group of sufferers and they regularly ask their patients about their sleep behaviours.

I also had similar results in my last interview study: some of my participants had extremely small amounts of sleep, 2-3 hours per night. Others had a bit more but remembered it being disturbed prior to the onset. Some participants had periods of insomnia, but long before they started experiencing the symptoms. Some had difficulty falling asleep or kept waking up during the night, others just developed unhealthy sleeping habits, such as staying up late. Some were forced to live (and sleep) in a noisy environment, and although they slept, they did not feel refreshed in the morning.

So, does this have to do anything with MFD? It is nearly impossible to answer that question with a clear ‘yes’ or ‘no’, but let me draw on some literature, which shows how sleep might affect our brain and more specifically, our motor skills.

Motor skills and sleep

Walker and his colleges (2002) found significant correlations between the quality of motor learning and time spent asleep. A full night’s sleep increased the motor speed of a newly learned task with 20% without losing accuracy. Similar research showed that both REM sleep deprivation and Total Sleep Deprivation (TSD) had a debilitative effect on learning a motor task, and the lack of stage 2 sleep (when REM stops, brain waves become slower and the body is prepared for deep sleep) was associated with poorer memory (Smith & Macneill, 1994).

So yes, even if it is quite hard to link MFD directly to sleep, it is clear that sleep deprivation has a very negative effect, especially if we consider, that instrumental practice partly consists of repeating and learning new motor patterns.

Other health issues and sleep deprivation

Although it is not the focus of the present article, it is interesting to mention that sleep deprivation affects more than just our motor skills. Researchers have linked it to various health problems, from high blood pressure to an increased risk of heart disease and diabetes, and a weakened immune system. All in all, it is worth looking into what can we do to improve our sleep.

Why do we have sleep problems?

 Insomnia has many roots, and researchers are working to solve this debilitative condition. However, there are a few issues associated with insomnia in the literature, which might be interesting for MFD sufferers.

Sleep deprivation has been linked to perfectionism (Vincent & Walker, 2000), a trait which has been found in many MFD patients (Ioannou & Altenmüller,2014). Strive for perfection is not a bad thing at all, it is the core of any great achievements. However, it can lead to anxiety, rumination and negative mood, which have also strongly associated with insomnia and sleeping difficulties (Monti& Monti, 2000; Papadimitriou & Linkowski, 2009; Thomsen, Mehlsen, Christiansen et al., 2003).

Also, sometimes we do not even have dive down to the complicated world of the psyche, insomnia can be the result of any physical disturbance.

What can we do?

The obvious answer is: sleep. But how, how much and when?

Answering the first question, there are many strategies which can help us improve our sleep quality.

  1. You can use meditation, breathing exercises, and various relaxation techniques before going to bed. Mindful minutes during the day can also work miracles: they can help you to arrive at your bedtime in a calmer manner.
  2. Have a strict screen-off policy at least half an hour before going to bed. There is some research looking into how the blue light emitted by laptops and phones can mess with your brain’s natural clock, but also, scrolling through countless posts on Facebook or Twitter will activate your brain and might affect you emotionally.
  3. Make sure that your bedroom is dark, not too hot and quiet.
  4. Many of us use their brains more for the work they’re doing than their body. We’re just sitting in one place, and although our brain is exhausted by the end of the day, our body has lots of resources left. Having a healthy half an hour in the gym or a brisk walk can be very helpful.
  5. Plan and monitor your sleep. Know when you went to bed and know when you’ve woken up. Try to have a fixed bedtime every night.

The healthy amount of sleep is estimated between 7 and 9 hours per night. If you are not able to sleep that much, try to have a short nap during the day. There are many benefits of sleeping before midnight.


In summary, healthy sleep behaviours play a larger role in your rehabilitation, that you would have thought. Retraining is hard enough as it is, try to make sure that you support your nervous system as much as you can!





Ioannou, C.I. & Altenmüller, E. (2014). Psychological characteristics in musician’s dystonia: a new diagnostic classification. Neuropsychologia, 61, 80-88.

Monti, J.M. & Monti, D. (2000). Sleep disturbance in generalized anxiety disorder and its treatment. Sleep Medicine Reviews, 4(3), 263-276.

Papadimitriou, G.N. & Linkowski P. (2009). Sleep disturbance in anxiety disorders. International Review of Psychiatry, 17(4), 229-236.

Smith, C., MacNeill, C.  (1994). Impaired motor memory for a pursuit rotor task following Stage 2 sleep loss in college students. Journal of Sleep Research, 3(4), 206-213.

Thomsen, K.D., Mehlsen, M.Y., Christensen, S. & Zacharies, R. (2003). Rumination – relationship with negative mood and sleep quality. Personality and Individual Differences, 34(7), 1293-1301.

Vincent, N.K. & Walker, J.R. (2002). Perfectionism and chronic insomnia. Journal of Psychosomatic Research, 49(5), 349-354.

Walker, M.P., Brakefield, T., Morgan, A., Hobson, J.A. & Stickgold, R. (2002.) Practice with sleep makes perfect: sleep-dependent motor skill learning. Neuron, 35(1), 205-211.




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