Topic Overview

What is periodic limb movement disorder (PLMD)?

Periodic limb movement disorder (PLMD) is a condition in which a person’s
legs, and sometimes arms, move repetitively and uncontrollably while he or she
is asleep. These episodes of limb movement can disrupt the person’s sleep,
causing insomnia or daytime sleepiness. Periodic limb movement symptoms are
only thought to be a disorder (PLMD) when insomnia or daytime sleepiness cannot be
explained by any other problem, such as
restless legs syndrome. Recently, it has been found
that these movements are often linked to subtle breathing problems.

What causes PLMD?

The exact cause of PLMD is
unknown.

PLMD shares many underlying factors with restless legs
syndrome, such as a hereditary link, iron deficiency anemia, nerve problems,
poor blood circulation in the legs, kidney disorders, and others. But in
general the two conditions are seen as being related rather than as causing one
another.

What are the symptoms of PLMD?

People who have PLMD
have trouble falling or staying asleep (insomnia), or they feel sleepy during
the day because the movements disrupt their sleep. These movements usually are
in the legs and occur in some type of pattern. Although a person often is not
fully awakened by these movements, they interfere with normal sleep cycles. A
bed partner’s sleep may also be disrupted.

How is PLMD diagnosed?

PLMD is diagnosed with a
medical history, often including a sleep history from a bed partner, and a
physical exam. A sleep study is usually required to detect the movements. A
sleep study also can identify other conditions that may be causing symptoms,
such as
sleep apnea or other subtle breathing problems that
may be causing movements.

Many questions remain about the nature
of periodic leg movements and PLMD. Some researchers consider the movements to
be normal. At least a few movements may occur during sleep in people who do not
have restless legs syndrome, especially in the elderly.

How is PLMD treated?

Managing symptoms of PLMD
typically includes:

  • Home treatment, such as relaxation exercises
    or massage.
  • Medicines, including dopamine agonists such as
    ropinirole or pramipexole, benzodiazepines, or the dopamine precursor called
    levodopa. These medicines, some of which are also used to treat Parkinson’s
    disease, are used only when symptoms are frequent and severe or regularly
    disrupt sleep.
  • Regular exercise. Try to do moderate activity at least 2½ hours
    a week. It’s fine to be active in blocks of 10 minutes or more throughout your
    day and week.

References

Other Works Consulted

  • American Academy of Sleep Medicine (2005). Periodic limb movement disorder. In International Classification of Sleep Disorders, 2nd ed., pp. 182-186. Westchester, IL: American Academy of Sleep Medicine.
  • Esteves AM, et al. (2009). Effect of acute and chronic physical exercise on patients with periodic leg movements. Medicine and Science in Sports and Exercise, 41(1): 237-242.
  • Lesage S, Hening WA (2004). The restless legs syndrome and periodic limb movement disorder: A review of management. Seminars in Neurology, 24(3): 249-259.
  • Reite M, Weissberg M (2014). Sleep-wake disorders. In RE Hales et al., eds., American Psychiatric Publishing Textbook of Psychiatry, 6th ed., pp. 607-644. Washington, DC: American Psychiatric Publishing.

Credits

ByHealthwise Staff
Primary Medical Reviewer Anne C. Poinier, MD – Internal Medicine
Adam Husney, MD – Family Medicine
Martin J. Gabica, MD – Family Medicine
Kathleen Romito, MD – Family Medicine
Specialist Medical Reviewer Karin M. Lindholm, DO – Neurology

Current as ofOctober 9, 2017