Med thumb strands of hair

If you’ve ever woken up at night with an irresistible urge to pull your own hair, then there’s a good chance you have trichotillomania.

A body-focused repetitive behavior disorder (BFRB), trichotillomania is defined as the repeated pulling of one’s hair. And it’s not limited to tugging at the hair on your head — eyebrows, eyelashes or any other patches of hair are fair game.

Who suffers from this?

About two to three percent of the world’s population suffer from the disorder, and it’s much more likely to occur in women than men. The average onset age is between 11 to 13, though it can develop at any age. Celebrities such as Katy Perry, Justin Timberlake, Megan Fox and Charlize Theron have all admitted to having it.

It can be embarrassing to have trichotillomania, especially once the hair loss becomes noticeable. Many sufferers will wear hats or avoid social situations altogether; those who frequently yank hairs in a certain spot are also at risk of causing baldness in that area.

Okay. So what causes it?

Mainly stress. But, as is the case with other BFRBs, such as skin picking or nail biting, people will also do it when they’re excited or bored. Many do it right before going to bed, while others do it unknowingly in their sleep.

Wait. So I might be pulling my hair while I sleep, and not realize it?

Yes. But if you have it, you would eventually find out. You might wake while it’s happening or rise with strands of hair on your pillow and a sore scalp. It’s also possible that your spouse (or whoever you’re sharing the bed with) will also notice you doing it.

Is there a relationship between trichotillomania and sleep?

Right now, no one really knows. Typically, if someone pulls their hair at night, then they also do it during the day, according to Dr. Emily Ricketts, who studies the disorder at the UCLA Child OCD, Anxiety and Tic Disorders Program. However, there have been some case reports where people report only pulling their hair while sleeping.

Why some people might only do it during sleep is a mystery — and one that some researchers are trying to learn more about. Ricketts, for example, is currently conducting an Internet study to ask people with trichotillomania about their sleep habits.

So, how do you treat it?

There’s currently no way to get rid of it entirely. But sufferers typically get treated with habit reversal training. That involves helping them become more aware of when they’re pulling, and teaching them to respond with behaviors such as making fists or clasping their hands. Therapists also help patients recognize the sensory and environmental triggers that promote their hair pulling.

For some, it helps to wear hats and gloves as a way to prevent the pulling from occurring.

Are there any medications to take?

Yet again, that's up in the air. But the medication Acetylcysteine showed significantly greater reduction in pulling for adults, Ricketts said. It had no significance in children.

So let’s say I have this, or I know someone who does. What should I do?

Head to the Trichotillomania Learning Center website — they have lots of great resources for patients, including information on local support groups as well as therapists in your area who specialize in the disorder.