If you find you’re having a difficult time sleeping at night, you’re not alone.
Millions of people in the U.S. alone suffer from some variety of sleeping Disorder, whether it be insomnia or even a physical disorder, like restless leg syndrome (or RLS for short).
Periodic Limb Movement Disorder is a sleep disorder that you may not have even heard about until looking up the symptoms and finding that they match up to your own experience.
Let’s take a look at what Periodic Limb Movement disorder is, what causes it, and the various ways you can treat it.
What Is Periodic Limb Movement Disorder?
Periodic limb movement disorder (or PLMD for short) is a disorder characterized by the repetitive cramping or jerking of your legs or feet during sleep.
These movements may consist of the big toe randomly extending or the hip, knee, or ankle tightening and flexing (or even all of the above). For some patients, the limb movements may spread higher up your body as well.
However, a sudden change in body position, unconsciously stretching a muscle, or feeling a cramp in the middle of the night does not classify as periodic limb movement disorder.
These movements must be periodic, meaning they are repetitive and almost rhythmic. Each movement can be timed anywhere between 5 to 40 seconds apart.
Periodic limb movement disorder is considered a sleep disorder because these movements, while unconscious, will often disrupt sleep and lead to daytime sleepiness. These movements occur most frequently in light, non-REM-type sleep.
This is the only movement disorder that occurs solely during sleep, although some patients report that they also suffer from periodic limb movement disorder while awake, too. Even in these cases, the disorder occurs far more often when a patient is asleep.
Periodic limb movement disorder can be classed as either primary or secondary.
Unfortunately, the exact cause of primary PLMD is still unknown. Though most scientists believe that the cause may lie in the nervous system, studies on this matter have not been very consistent with one another.
Possible origins of the disorder may also lie in the spinal cord. It has been suggested that the disorder could be associated with increased spinal reflexes, though there hasn’t been much research performed in this avenue yet.
While periodic limb movement disorder is not considered medically serious, it can contribute to chronic insomnia and/or daytime fatigue due to any awakenings these movements cause throughout the night.
Occasionally, this disorder may also be an indicator of a more serious medical condition, such as kidney disease, diabetes, or even anemia.
According to the National Sleep Foundation, primary periodic limb movement disorder is actually rather uncommon.
Secondary PLMD, on the other hand, is linked to underlying sleep disorders and the use of (or sudden change in) certain medications.
This type of periodic limb movement disorder is more common in people with (and often accompanies those who already suffer from):
- Diabetes mellitus.
- Multiple system atrophy, which is a rare, progressive neurological disorder that adversely affects your body’s autonomic functions.
- Narcolepsy, which is a sleep disorder that causes excessive sleepiness, hallucinations, and sleep paralysis throughout the day.
- Obstructive sleep apnea, which is a fairly common sleeping disorder characterized by shallow breathing or pauses in breathing while you sleep.
- REM behavior disorder, which is a sleep disorder where people “act out” their dreams in real life, which can interrupt any restful sleep.
- Restless leg syndrome (or RLS).
- Sleep-related eating disorder (SRED), which is a sleep disorder characterized by eating while sleeping.
- Spinal cord injury.
- Spinal cord tumor.
- Uremia, which is a build-up of waste products in the blood that are a direct result of kidney failure.
Taking antidepressants, antihistamines, anti-nausea medications, or antipsychotics on a regular basis may also cause PLMD.
Alternatively, withdrawal from sedatives such as diazepam may cause PLMD, too.
As stated above, the main symptom of periodic limb movement disorder is the repetitive movement of your legs during sleep.
Though these sporadic movements may not distress (or even wake up) the majority of people who suffer from it, bed partners may find this disorder particularly annoying to deal with.
People who suffer from this disorder may also experience complications such as:
- Daytime sleepiness.
- Poor sleep.
- Chronic insomnia.
The American Academy of Sleep Medicine also warns that, if left untreated, this disorder can be a factor in:
- Poor memory.
- Short attention span.
This video goes into more detail on periodic limb movement disorder.
How Is PLMD Diagnosed?
This disorder is often diagnosed alongside other sleep disorders, mostly restless leg syndrome (or RLS for short) and insomnia.
Though PLMD and RLS may seem like the same disorder, the two are actually quite different.
Here are some factors your doctor will consider if diagnosing you, as well as the steps they may take.
Evaluating Your Condition
Considering PLMD vs. RLS
RLS is a condition that involves feeling strange sensations in your legs and sometimes your arms while you’re awake, giving you an irresistible urge to move these limbs to relieve the sensations.
At least 80% of all people who suffer from restless legs syndrome also suffer from periodic limb movement disorder, but the reverse is not true.
Considering Your Age Group
People can get periodic limb movement disorder at any age, but it is more common in those who are middle-aged and older, affecting over 30 percent of this demographic alone.
Many people also report that they have exhibited these symptoms since childhood.
Considering Your Lifestyle
Shift workers or others who have abnormal sleep patterns; those who snore; and people who drink excessive amounts of coffee even when under severe stress may be more prone to suffering from this disorder as well.
Performing a Physical Examination
Before a doctor recommends any procedures, they will need to physically examine you to rule out other possible conditions first.
Of course, they will go through your full medical history, your family’s medical history, and your lifestyle choices with you to pinpoint when you started showing symptoms.
Taking a Blood Test
After this, they may require some blood tests to detect anemia or other deficiencies related to this disorder.
These tests can identify any problems with your thyroid function or magnesium levels.
Recommending a Sleep Pattern Journal
Doctors may also find it helpful if you bring a sleep diary containing at least 14 days’ worth of recorded sleeping patterns.
This should also include any associated symptoms, such as fatigue and daytime sleepiness, and their effects on your daily life. The information can help guide them in your physical examination.
Scheduling a PSG
PLMD is primarily diagnosed through an overnight polysomnogram (or PSG).
This is a type of test carried out in a sleep laboratory, which records your movements throughout the night and assesses the frequency at which they occur.
If your doctor recommends a PSG, you will need to spend the night in a sleeping laboratory to record your sleeping patterns, breathing, bioelectrical signals (like brain waves and your heartbeat), and, most importantly, your movement during sleep.
Again, this overnight test will help rule out any other conditions or sleep disorders that may be disrupting sleep and/or causing your excessive limb movements.
Check for Further Conditions
Once they analyze the results of that test, the neurologist may be asked to either check for other neurological issues or to confirm the diagnosis of this disorder.
If they are still unsatisfied or just want to be thorough, your doctor may recommend you go through additional tests in a sleep laboratory.
Where Does This Leave You?
Though knowing these risk factors, doctors have actually not studied PLMD as much as RLS. Thus, they are unsure of how prevalent the disorder is in the general public.
All we know is that the chances of getting this disorder increase with age and that this likelihood is not tied to any specific gender.
Unfortunately, some people who have this disorder may be asymptomatic up until a certain age, meaning that they will not show any symptoms until far later in their life, making it even more difficult for doctors to properly diagnose.
However, if you are diagnosed, take heart! There are many treatments you can undertake to find relief.
Periodic Limb Movement Disorder Treatment
Periodic limb movement disorder treatment may involve either taking certain medications or exploring natural remedies.
However, you should always consult your doctor first, so you can both choose the best treatment option for you.
Keep in mind that these treatment methods do not wholly cure the disorder, but instead, relieve its symptoms.
Typically, your doctor may prescribe some kind of drug to ease your symptoms. The most commonly prescribed drugs for periodic limb movement disorder include:
- Benzodiazepines: Drugs that suppress muscle contractions. They are also used as sedatives and may even help you sleep through your movements. Clonazepam (Klonopin), in particular, has been proven to reduce periodic limb movements throughout the night. This is perhaps the drug prescribed most often to treat this disorder.
- Dopaminergic Agents: This kind of drug increases the levels of an important neurotransmitter (or brain chemical) called dopamine, which is crucial in regulating muscle movements. The success of these drugs varies from patient to patient. Some patients may find that they are very sensitive to dopamine agonists, such as pramipexole and ropinirole, while others may find it doesn’t work for them. Widely used examples to treat this disorder include a levodopa/carbidopa combination (Sinemet) and pergolide (Permax).
- Anticonvulsant Agents: These medications reduce muscle contractions in some people. The most widely used anticonvulsant to treat this disorder is gabapentin (Neurontin).
- GABA Agonists: These agents inhibit the release of certain neurotransmitters that stimulate muscle contractions, meaning they help your muscles to relax. Baclofen (Lioresal) is often prescribed to those who suffer from this disorder.
While these medications have been effective in treating many patients who suffer from this disorder, treatment is only deemed necessary when the disorder is also accompanied by restless leg syndrome, insomnia, or daytime fatigue.
If you are uncomfortable with taking these types of medications, you can always ask your doctor and your sleep physician if it’s alright to use natural remedies instead.
This video goes into more details on periodic limb movement disorder treatment.
People who suffer from any sleep disorder should avoid foods and drinks that contain caffeine, such as chocolate, coffee, soda, and tea, as this can exacerbate their symptoms and disrupt their sleep even further.
You should also avoid drinking any alcohol before sleeping as well, as it will worsen any periodic limb movement disorder symptoms you already have.
Implementing a Bedtime Routine
Making certain changes to your lifestyle may help as well.
Simple additions such as taking a warm bath (either with or without Epsom salts), taking a short walk before bed, or lightly massaging your legs before going to sleep are all wonderful periodic limb movement disorder natural remedies.
They’ve been proven to help lessen or even prevent symptoms altogether.
Reevaluating the Use of Certain Medications
Certain brands of antidepressants may contribute to your periodic limb movement disorder as well.
However, you should always ask your psychiatrist about perhaps lessening your dose or changing your medication first.
Never cut off any medications your doctor prescribes you cold-turkey, as this could lead to disastrous results.
How to Prevent PLMD
The natural remedies listed above can also help you prevent these troublesome symptoms from returning.
However, if you find that these movements persist throughout the night or even extend into the daytime, then be sure to contact your doctor about it as soon as you can.
Can Periodic Limb Movement Disorder Be Cured?
It depends on the type of periodic limb movement disorder you suffer from.
Primary PLMD is typically chronic in nature, meaning that people who have this type will likely have to deal with it for the rest of their life.
They may often have periods of remission where their symptoms seem to go away for a while, only to relapse back into the disorder all over again.
Fortunately, secondary PLMD is far easier to treat.
You can either have your doctor prescribe you one of the medications listed above, stop taking certain medications altogether, or even opt for a more natural treatment method (like those listed above).
Periodic limb movement disorder can be quite a bothersome disorder, but that doesn’t mean it will ruin your sleep forever.
Now that you are more informed about what it is and how it differs from RLS, you may be able to move forward with a treatment option that works best for you!
Do you have experience with periodic limb movement disorder? How do you treat it?