What is Periodic Limb Movement Disorder?
Periodic Limb Movement Disorder (PLMD) is a neurological disorder that, as the name suggests, typically results in excessive limb movement throughout the night. This movement is usually focused in the extremities and most often manifests as a rhythmic flexing of the ankle or toes. However, every case is different and PLMD may also cause legs, hips, and even arms to jerk or twitch when a patient is sleeping. In many ways Periodic Limb Movement Disorder is similar to Restless Legs Syndrome (RLS), but the two are separate sleep-related disorders. This is because 80-90% of persons with RLS will have limb movements in sleep, but these movements are often quite different and carry different medical concerns than PLMD.
How Is Periodic Limb Movement Disorder Different Than Restless Leg Syndrome?
Restless Leg Syndrome is a common condition in the United States and is identifiable by the unconscious jerking movement of a person’s legs or feet while they are asleep. Similarly, Periodic Limb Movement Disorder causes twitching or jerking in the extremities and can easily be mistaken for RLS.
The main difference is the reason for the movement. RLS happens because a patient feels discomfort in their sleeping state that can only be relieved through movement. This may happen only a few times during the night or it can happen every few seconds. With RLS, this pain or discomfort in a patient’s foot or leg causes not only the movement of their body but also disrupts their natural sleep pattern.
On the other hand, Periodic Limb Movement Disorder does not necessarily come with the same pain and discomfort associated with RLS. PLMD is a neurological disorder, like many other sleep disorders, and the movement comes from rhythmic muscle movement and is not meant to relieve any kind of pain. In fact, while RLS can fully wake patients up from their sleep, PLMD rarely results in a patient fully waking up. Still, disruptive sleep behaviors such as excessive movement can make it difficult for an individual to achieve a full, restful night’s sleep and maintain a healthy circadian rhythm.
What Are The Symptoms?
The most obvious symptom and result of Periodic Limb Movement Disorder is the frequent jerking and twitching of a person’s limbs, but this symptom can be extremely difficult to notice because it only happens when a patient is sleeping. If you have a bedmate who complains often about your nighttime kicking, that can tip you off that there is a problem, but identifying PLMD simply by the movement itself is fairly rare. Even people who do sleep with another person may never hear about their problematic sleeping habits because of any number of factors such as the time of night their episodes, the position they sleep in, how heavily their partner sleeps, and the intensity of the episodes.
There are, however, some symptoms that can be better watched for. Symptoms common in many sleep disorders also manifest in patients with PLMD. Frequently waking up during the night for no apparent reason or feeling excessively tired during the day is the most obvious symptom. Noting these symptoms, patients may believe they have insomnia, sleep apnea, or any other number of sleep disorders, but a qualified sleep medicine specialist can easily diagnose any of these different conditions.
The repetitive nature of these nighttime motions of patients with PLMD can also cause joint and muscle pain in the affected areas. If you are waking up with unexplained ankle or foot pain and feeling like you did not get enough sleep the night before, it might be time to seek medical intervention.
Who Is Commonly Affected By PLMD?
When it comes to Periodic Leg Movement Disorder, it can be difficult to pinpoint a specific group of people who are more likely to develop this common sleep disorder. PLMD can occur at any age, and affects men and women equally. Although it is considered rare among children, certain medical conditions can make a child more likely to experience PLMD symptoms. For example, Comorbid sleep apnea, neuropsychiatric disorders such as ADHD, autism spectrum disorder, and Turret’s Syndrome can all increase a child’s risk of PLMD.
As with many other sleep disorders, the risk for PLMD increases significantly with age. While PLMD is a rare condition in children, as many as 45% of geriatric adults likely experience symptoms of PLMD. Certain medical conditions may trigger PLMD symptoms in adults as with children, but in older adults these conditions are much more far reaching; adults with common medical conditions such as high blood pressure, obesity, diabetes, anemia, ADD/ADHD, OCD, autism spectrum disorder, and a host of other conditions are at a higher risk for PLMD.
Though it is difficult to know for sure, there is likely also a genetic component in patients. If an individual has a family history of PLMD, RLS, or other sleep disorders, he or she is up to 25% more likely to develop PLMD as they get older.
How Do I Know When To Seek Medical Care?
Sleep disorders, though exceedingly common, are not as commonly diagnosed. This is because we attribute so many of these sleep related symptoms to the everyday stress of life. What many people do not understand, though, is that stress can trigger sleep disorders just as easily as it can trigger one or two sleepless nights. Going through a tough time should not mean feeling tired or drained every day.
If you are having a hard time getting or staying asleep for more than a few nights a week for a month or more, it might be time to see a specialist. If you regularly feel tired during the day despite getting your full eight hours of sleep the night, or you find yourself craving a midday nap every day, it might be time to see a specialist.
Being aware of the way your body naturally functions and recognizing dysfunction in your regular patterns is one of the best ways to catch these problems early on and receive proper treatment.
How Is PLMD Treated?
Though there is no cure for primary PLMD, there are many different approaches to treatment that can significantly relieve symptoms and improve overall sleep. Treatment plans for PLMD may require a patient to make certain lifestyle changes and/or the addition of medication, depending on symptoms and circumstances.
In some PLMD cases, your sleep medicine specialist may set up a treatment plan heavily reliant on lifestyle changes to improve overall health and sleep patterns. This could include increased activity levels during the day, improving diet, limiting caffeine and alcohol intake, and regulating nighttime routines. Some patients also reported relief of their worst PLMD symptoms when they took up yoga or martial arts.
Occasionally, doctors will prescribe medication to reduce or treat PLMD symptoms. Because PLMD is so often associated with other medical conditions, your doctor may want to address other underlying problems first and see if this relieves symptoms of PLMD naturally. This often involves different medications, though not always. In these cases it could take anywhere from a couple of weeks to several months to see the full extent of the results of your treatment. In cases where it takes a longer amount of time, your sleep medicine specialist might recommend treating your PLMD as needed.
In cases of severe PLMD, you may be prescribed medication to treat your PLMD symptoms. Commonly prescribed medications are often similar to those used to treat RLS, including benzodiazepines, melatonin supplements, and Clonazepam are just a few examples of medications that can be used to successfully treat your symptoms and get you back to a healthy sleep schedule.
Why Choose Gingras Sleep Medicine?
If you or a loved one is experiencing Periodic Limb Movement Disorder symptoms, it is important that you see a qualified sleep disorder specialist as soon as possible. Poor sleep quality can negatively impact nearly every part of your life if you do not seek help.
Gingras Sleep Medicine is a North Carolina based sleep medicine facility with a reputation for results! Dr. Jeanine Gingras is a nationally recognized double board-certified sleep medicine doctor and pediatrician. With decades of experience under her belt, Dr. Gingras is highly respected in her field and is known for her attention to details and passion for helping her patients take back their sleep! Along with her team, Dr. Gingras provides thorough evaluations and innovative treatment plans for a wide variety of sleep disorders, including primary and secondary Periodic Limb Movement Disorder.
Call (704) 944-0562 or request an appointment online with Dr. Gingras at Gingras Sleep Medicine in Charlotte and Concord, North Carolina to start your journey to better, more restful sleep!