September 12th 03, 08:03 PM
What is Periodic Limb Movement Disorder (PLMD)?
Like RLS, PLMD is another sleep disorder that affects the limbs as well as a sufferer’s ability to
get a good night’s sleep. While RLS movements are a voluntary response to unpleasant sensations in
the limbs whilst awake, the movements of PLMD are involuntary and felt most when the sufferer is
asleep.PLMD may accompany obstructive sleep apnoea, narcolepsy and insomnia, and is quite common in
people with RLS.
As implied by its name, the limb movements occur at regular intervals of between 20 to 30 seconds
apart, 5 times or more an hour during non-REM sleep. The movements are similar to jerking or
kicking, and consist of a partial flexing of the big toe, ankle, knee and occasionally, the hips.
Occurrences are not continuous throughout the night, but occasion more in clusters, in the first
half of the night.
PLMD sufferers are generally unaware of their limb movements or the resultant “microarousals” (very
brief awakenings) that lead to excessive daytime sleepiness the morning after. However, they do
often complain of difficulty falling asleep, staying asleep or remaining alert and awake during the
day. Other common symptoms include hot or cold feet, or hair wearing off the legs.
Bedpartners are affected too. Many complain of being kicked during the night, fighting for
bedcovers, or the bed shaking due to continuous leg movements.
What Causes RLS?
Family history – Approximately 30 percent of RLS cases are hereditary related. Passed through the
genes of either the father or mother, the symptoms tend to be more severe and more difficult to
treat.
Pregnancy – RLS can develop during pregnancy, especially in the last 6 months. After delivery, the
symptoms usually disappear.
Low iron levels or anemia – People with these conditions are more likely to develop RLS. Once the
iron level or anemia is corrected, the symptoms generally improve.
Chronic diseases – Sufferers of kidney failure, diabetes, rheumatoid arthritis and peripheral
neuropathy are more prone to developing RLS.
Caffeine and alcohol – decreasing caffeine and alcohol consumption may reduce symptoms.
What Causes PLMD?
The same as above. However, PLMD is more common in people with kidney disease or narcolepsy.
Antidepressant medication may also worsen the symptoms of PLMD.
How Are These Disorders Diagnosed?
• RLS
At present, no laboratory test exists to detect RLS. Diagnosis can instead be made by reviewing your
medical history. Having ruled out other medical conditions, your healthcare provider can ascertain
whether RLS is the primary cause of your sensations.
Words often used to describe RLS include “creepy”, “crawly”, “pulling” and “gnawing”. With these
symptoms comes an almost irresistible urge to move the affected limb.
• PLMD
As sufferers of PLMD are unaware of their limb movements whilst asleep, it is necessary to have a
sleep study. By placing electrodes over the calf muscle of each leg, a determination of whether PLMD
is present can be made.
Are These Disorders Treatable?
• RLS
RLS is treatable with either of the following:
Home remedies – helpful in mild cases. These include: having a hot bath, leg massage, applying heat
or ice packs, aspirin or similar pain relievers, regular exercise and reducing caffeine. Taking
Vitamin E and supplemental calcium can often be effective also.
Prescription drugs – for more severe cases, prescription medicine may be necessary. However, no one
drug is a “cure all” as each person responds differently dependant upon the severity of the
symptoms, other medical conditions, and other medications being used. Furthermore, continued usage
of a particular medication can sometimes lead to a reduction in its effectiveness over time. Thus it
is crucial to alternate between different categories of medication in order to control RLS.
Categories of Commonly Used RLS Medication
Benzodiazepines – these are central nervous system depressants suppress RLS symptoms enough to
enable a patient to fall sleep. Daytime drowsiness can often be a side effect of taking these
medications. Sleep apnoea sufferers should avoid these type when possible.
Dopaminergic agents – used in the treatment of Parkinson’s disease, and also effective in reducing
symptoms of RLS and PLMS
Opioids – these are pain killers that are useful for severe cases, where unrelenting symptoms are
experienced.
• PLMD
Most PLMD sufferers require no treatment as they are not sleepy during the day or suffer insomnia by
night. For those whose sleep is disrupted, the best treatment is to improve one’s sleep hygiene.
Be A Good Sleeper
Keep a regular sleep schedule - that means going to bed and waking up at the same time every day,
including weekends!
Get enough sleep every night - determine how much sleep your body needs to be fully alert and awake
all day and make sure you get it! Research shows that people require at least 60 to 90 minutes more
sleep than they are presently getting.
Go to bed only when sleepy – if you’re not tired, leave the bedroom and do something else.
Restricting your time in bed to just what you need, will enable you to have a deeper and continuous
sleep.
Repay your sleep debt – make up for any lost sleep as soon as possible.
Exercise regularly – exercise can reduce stress, anxiety and insomnia, provided it is conducted at
least 6 hours before bedtime.
Like RLS, PLMD is another sleep disorder that affects the limbs as well as a sufferer’s ability to
get a good night’s sleep. While RLS movements are a voluntary response to unpleasant sensations in
the limbs whilst awake, the movements of PLMD are involuntary and felt most when the sufferer is
asleep.PLMD may accompany obstructive sleep apnoea, narcolepsy and insomnia, and is quite common in
people with RLS.
As implied by its name, the limb movements occur at regular intervals of between 20 to 30 seconds
apart, 5 times or more an hour during non-REM sleep. The movements are similar to jerking or
kicking, and consist of a partial flexing of the big toe, ankle, knee and occasionally, the hips.
Occurrences are not continuous throughout the night, but occasion more in clusters, in the first
half of the night.
PLMD sufferers are generally unaware of their limb movements or the resultant “microarousals” (very
brief awakenings) that lead to excessive daytime sleepiness the morning after. However, they do
often complain of difficulty falling asleep, staying asleep or remaining alert and awake during the
day. Other common symptoms include hot or cold feet, or hair wearing off the legs.
Bedpartners are affected too. Many complain of being kicked during the night, fighting for
bedcovers, or the bed shaking due to continuous leg movements.
What Causes RLS?
Family history – Approximately 30 percent of RLS cases are hereditary related. Passed through the
genes of either the father or mother, the symptoms tend to be more severe and more difficult to
treat.
Pregnancy – RLS can develop during pregnancy, especially in the last 6 months. After delivery, the
symptoms usually disappear.
Low iron levels or anemia – People with these conditions are more likely to develop RLS. Once the
iron level or anemia is corrected, the symptoms generally improve.
Chronic diseases – Sufferers of kidney failure, diabetes, rheumatoid arthritis and peripheral
neuropathy are more prone to developing RLS.
Caffeine and alcohol – decreasing caffeine and alcohol consumption may reduce symptoms.
What Causes PLMD?
The same as above. However, PLMD is more common in people with kidney disease or narcolepsy.
Antidepressant medication may also worsen the symptoms of PLMD.
How Are These Disorders Diagnosed?
• RLS
At present, no laboratory test exists to detect RLS. Diagnosis can instead be made by reviewing your
medical history. Having ruled out other medical conditions, your healthcare provider can ascertain
whether RLS is the primary cause of your sensations.
Words often used to describe RLS include “creepy”, “crawly”, “pulling” and “gnawing”. With these
symptoms comes an almost irresistible urge to move the affected limb.
• PLMD
As sufferers of PLMD are unaware of their limb movements whilst asleep, it is necessary to have a
sleep study. By placing electrodes over the calf muscle of each leg, a determination of whether PLMD
is present can be made.
Are These Disorders Treatable?
• RLS
RLS is treatable with either of the following:
Home remedies – helpful in mild cases. These include: having a hot bath, leg massage, applying heat
or ice packs, aspirin or similar pain relievers, regular exercise and reducing caffeine. Taking
Vitamin E and supplemental calcium can often be effective also.
Prescription drugs – for more severe cases, prescription medicine may be necessary. However, no one
drug is a “cure all” as each person responds differently dependant upon the severity of the
symptoms, other medical conditions, and other medications being used. Furthermore, continued usage
of a particular medication can sometimes lead to a reduction in its effectiveness over time. Thus it
is crucial to alternate between different categories of medication in order to control RLS.
Categories of Commonly Used RLS Medication
Benzodiazepines – these are central nervous system depressants suppress RLS symptoms enough to
enable a patient to fall sleep. Daytime drowsiness can often be a side effect of taking these
medications. Sleep apnoea sufferers should avoid these type when possible.
Dopaminergic agents – used in the treatment of Parkinson’s disease, and also effective in reducing
symptoms of RLS and PLMS
Opioids – these are pain killers that are useful for severe cases, where unrelenting symptoms are
experienced.
• PLMD
Most PLMD sufferers require no treatment as they are not sleepy during the day or suffer insomnia by
night. For those whose sleep is disrupted, the best treatment is to improve one’s sleep hygiene.
Be A Good Sleeper
Keep a regular sleep schedule - that means going to bed and waking up at the same time every day,
including weekends!
Get enough sleep every night - determine how much sleep your body needs to be fully alert and awake
all day and make sure you get it! Research shows that people require at least 60 to 90 minutes more
sleep than they are presently getting.
Go to bed only when sleepy – if you’re not tired, leave the bedroom and do something else.
Restricting your time in bed to just what you need, will enable you to have a deeper and continuous
sleep.
Repay your sleep debt – make up for any lost sleep as soon as possible.
Exercise regularly – exercise can reduce stress, anxiety and insomnia, provided it is conducted at
least 6 hours before bedtime.