What is Periodic Limb Movement ?

Periodic Limb Movements Disorder (PLMD) is previously known as Nocturnal myoclonus.  PLMD is a sleep disorder that occurs only during sleep.  Its a condition in which a persons legs and/or arms involuntarily twitch or move and periodically when asleep. PLMD is not the same as night muscle spasms, or hypnic jerks, that occasionally occur when a person is falling asleep. These jerks are normal.   

The Periodic Limb Movements are oftentimes subtle jerks lasting anywhere from half a second to no greater than five seconds in duration that may or may not cause arousals during sleep. It typically occurs 20 to 30 seconds apart, 5 or more times an hour, on and off throughout the night during periods of non-REM sleep. The rhythmic episodes usually involve a partial flexing of the big toe, ankle, knee, and occasionally, the hips. These arousals may cause interruptions in ones quality of sleep resulting in excessive daytime sleepiness (EDS).

The affected individual is usually unaware of the repetitive motion or the brief awakenings that disrupt sleep. Thus, people who have PLMD usually complain of difficulty in falling asleep, staying asleep, or staying awake during the day. They may also note restless sleep and hot/cold feet. The bed partners often report being kicked, fighting for bed covers, or being awakened by the movements.

PLMD can be either primary or secondary. Primary PLMD, has no known cause. It has been linked to abnormalities in regulation of nerves traveling from the brain to the limbs, but the exact nature of these abnormalities is not known.  
Secondary PLMD is caused by an underlying medical problem. It has many different causes include the restless legs syndrome, diabetes mellitus, iron deficiency, spinal cord tumor, spinal cord injury, sleep apnea and a number of other problems 
The following symptoms can indicate the presence of PLMD. If you notice one or more of these symptoms, give us a call at (818) 80-SLEEP and we can diagnose your sleep disorder.

The most common symptoms noted by people with PLMD are not leg movements but poor sleep and daytime sleepiness. Many people with PLMD are unaware of their leg movements unless their bed partner tells them.  

•Leg movements involve one or both limbs.
•Knee, ankle, and big toe joints all bend as part of the movements. 
•Movements vary from slight to strenuous and wild kicking and thrashing. 
•Movements last about 2 seconds (much slower than the leg jerks of myoclonus). 
•Movements are rhythmic and repetitive and occur every 20-40 seconds. 
After being diagnosed for PLMD, the most common treatment would be medications that are aimed at significantly reducing or eliminating the leg jerks or the arousals.  There is no cure for PLMD and medical treatment must be continued to provide relief. Any medical decisions should be made in follow-up visits with the physician.

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