Kovitch,Oh yeah, my twitches seem to get worse at night. Maybe it's because I'm more relaxed or just more aware of them. I don't know but I have had some looong nights with twitching. Today, I'm getting the "bubbling" twitches all over my back and in my shoulders and butt. I get them in my arms a lot but I wouldn't call them a hotspot... at least not this week. I'm getting several twitches per minute. I've also had a clean EMG. For you though, if you've been twitching for 1 year with a clean EMG, doesn't that give you some reassurance that it's not ALS? I've read that in the vast majority of ALS cases, weakness comes before twitching. And in the rare cases where the patient notices twitching first, they probably didn't have a clean EMG. Trust me, I understand your anxiety over this, I have a lot myself. -Matt