Shake a Leg - PLMD
Up to 80% of patients with RLS also have PLMD, involuntary movements of the legs and sometimes the arms while a person is sleeping. PLMD is distinct from sleep starts because the movement isn’t jerky.
It occurs throughout the night and not just when a person is falling asleep, and the movement recurs fairly regularly, sometimes as often as every 20 seconds. PLMD movements happen primarily during non-REM sleep.
Needless to say, people who have PLMD may not feel rested in the morning. Doctors don’t really understand what causes PLMD and as a result, currently available treatments are designed to address the symptoms and not the underlying cause of PLMD.
This can also arise in association with other conditions like spinal cord tumor, diabetes, anemia, uremia, narcolepsy or sleep apnea. Certain drugs like tricyclic and SSRI antidepressants can also cause PLMD.
The incidence increases as people age rising from 4% of people ages 30-50, 25% of people ages 50-65, and 44% of people age 65 and older. Unlike RLS, which can produce leg movement around the clock, PLMD movements occur only while the person is sleeping
PLMD produces distinct movements that begin as a flexing of the big toe, but sometimes involve the ankle, leg and hip. Each flex usually last from ½ a second to 5 seconds. Because the movements recur so frequently, in a 20- to 90-second cycle, PLMD can be a great sleep disruptor
Often the person with PLMD complains of sleep-maintenance insomnia or non-restful sleep. Sometimes he or she complains of daytime sleepiness. Many patients aren’t aware of their constant nocturnal movement and don’t believe their bedmates when they complain of being kicked all night.
PLMD doesn’t require treatment unless it’s interfering with sleep. When non-restful sleep is prominent or insomnia and/or sleepiness adversely affect the patient, treatment is usually a prescribed medication.
Sometimes your doctor will prescribe the same medicines for PLMD that he or she uses to treat RLS (that is, low doses of drugs used for Parkinson’s disease.)
However, some doctors have prescribed sleeping pills called benzodiazepines to alleviate the symptoms and improve sleep quality. Patients also benefit from employing the principles of good sleep hygiene, including a regular bedtime and a comfortable sleep environment.
Regular exercise, like walking and nightly stretching, and limited intake of caffeine and alcohol seem to help.
|
