Do I Have Periodic Limb Movement Disorder?
Key takeaways:
Periodic limb movement disorder is a rare sleep condition that causes the arms or legs to move uncontrollably and repeatedly during sleep.
It must be distinguished from other conditions like restless legs syndrome that can cause similar symptoms.
Treatment may be similar to that of restless legs syndrome.
Periodic limb movement disorder (PLMD) causes the arms or legs to move repeatedly during sleep. It’s an uncommon condition, and we don’t know how many people have it or what causes it. But, if you have PLMD, the symptoms can interfere with your daily life. The repetitive movements of the arms or legs overnight interrupt sleep and lead to daytime drowsiness and fatigue.
Keep reading to find out more about the symptoms and causes of PLMD, as well as how to treat it and cope with it.
What are the symptoms of periodic limb movement disorder?
If you have PLMD, your arms and legs will move periodically and repetitively while you sleep. These movements have their own name and are called periodic limb movements of sleep (PLMS).
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PLMS can actually occur as a part of other sleep disorders like obstructive sleep apnea, restless legs syndrome, and narcolepsy. PLMS also occur more commonly as we age and are seen in up to 34% of people over age 60.
PLMS don’t always disrupt sleep, however, and they don’t always mean you have PLMD. PLMD occurs when an increased number of PLMS lead to:
Disrupted sleep
Daytime sleepiness
In PLMD, the repetitive movements usually occur in the legs, but can also affect the arms. You may see twitching of one or both legs or feet. This can happen in the toes, ankles, knees, or hips and may involve part of the legs or feet or the entire limb. The movements look like jerking or kicking and happen at regular intervals — usually every 30 seconds. They usually happen in the first half of the night.
It’s important to know that these movements happen on their own and can’t be controlled while you’re sleeping. You won’t notice the limb movements yourself, but another person sleeping with you or watching you sleep may tell you about them.
How do you diagnose periodic limb movement disorder?
PLMD is diagnosed using polysomnography or a sleep study. This type of study monitors you overnight while you sleep and can be helpful in the diagnosis of different sleep problems.
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During the sleep study, your limb movements are monitored to determine how often they occur. A diagnosis of PLMD is made when there are more than 15 periodic limb movements per hour of sleep in adults (or more than 5 in children).
To diagnose PLMD, the limb movements must also be interrupting sleep to the point where daytime sleepiness gets in the way of your regular activities.
Another key to the diagnosis is that the symptoms can’t be explained by another cause. Because the limb movements that occur in PLMD can also happen as a part of other sleep problems, it’s important to rule out other causes, including:
Restless legs syndrome
Obstructive sleep apnea
Narcolepsy
Nighttime leg cramps
Muscle twitching with falling asleep (hypnic myoclonus)
PLMS can also be seen in other medical problems or from medication side effects. Other medical problems associated with PLMS include:
Kidney failure
Iron deficiency
Parkinson’s disease
Pregnancy
Medications that can cause PLMS include:
Some antidepressants such as selective serotonin reuptake inhibitors (SSRIs)
Some anti-nausea medications (such as prochlorperazine)
If you have PLMS that can be explained by one of these other causes, you don’t have PLMD. This means other causes for the symptoms should be considered before PLMD is diagnosed.
If you think you have PLMD, talk to your healthcare provider about your symptoms. They may recommend polysomnography or refer you to a sleep specialist. Sleep specialists are healthcare providers who receive extra training in sleep medicine. They are experts in sleep disorders and can help with the diagnosis and treatment.
How is periodic limb movement disorder treated?
PLMD is treated using similar medications used to treat restless legs syndrome (RLS). This is because PLMS can be seen in both conditions. Also, RLS is more common and more research has been done on its treatment.
According to recent guidelines from the American Academy of Sleep Medicine, the following medications have decreased limb movements in people who have RLS and may also be helpful in PLMD:
Pramipexole (Mirapex)
Ropinirole (Requip)
Rotigotine (Neupro)
Carbidopa-levodopa-entacapone (Stalevo)
Gabapentin (Neurontin)
Pregabalin (Lyrica)
It’s important to know that these medications have not been studied in patients with PLMD, so it’s difficult to say how effective they are. Medications that have been shown to help in small studies of people with PLMD include:
Clonazepam (Klonopin)
Selegiline (Eldepryl)
Some of these medications are not approved by the FDA for RLS or PLMD treatment, but can be used off-label. This means they can be prescribed if your healthcare provider thinks they are safe for you to take.
How do I cope with periodic limb movement disorder?
Living with a sleep disorder like PLMD can be very difficult because it makes it harder to do your daily activities when you often feel sleepy and fatigued. Besides talking to your healthcare provider about treatment options to improve your sleep, you can look for patient support organizations. Finding other people with similar symptoms or problems with sleep can provide you with the support you need to make your symptoms easier to manage.
The bottom line
Feeling sleepy during the day can make it hard to function and interfere with your daily life. Sometimes we know why we aren’t getting good sleep, but other times poor sleep is caused by a sleep disorder that needs special attention to be diagnosed and treated.
PLMD is a rare sleep problem that has a negative impact on quality of life. The good news is there are treatments that can help. If you are struggling to get quality shut-eye, be sure to discuss this with your healthcare provider to find out what’s getting in the way of your sleep.
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