Periodic Limb Movement Disorder (PLMD) is a movement disorder that occurs often at people with sleep apnea, narcolepsy and Parkinson's disease.
The symptoms of PLMD occur only in sleep, with repetitive movements of the limbs, mostly legs, such as:
extension of the big toe
flexing of the ankle, knee, or hip
extension of the fingers
The movements of the limbs last from 1 to 5 seconds, and occur in intervals of 5 to 90 seconds.
Occasionally the movements are so severe that the whole body moves restless for several hours.
The side effects of periodic leg movement are easily deduced from the observation of the quality of life of the patients:
insomnia
excessive daytime sleepiness
social problems
excessive fatigue
sleep disturbance of the bed partner
The causes of PLMD are not all understood. It is known that movement disorders often occur with breathing disorder such as sleep apnea, or other sleep disorders, like narcolepsy, sleepwalking, or night terrors.
There are medications that can make the condition worse, such as antidepressants, antihistamines, and some antipsychotics.
The treatment can reduce PLMD symptoms, but before treating the patient, he should be analyzed to be sure he is not taking drugs that may be causing periodic limb movement disorder.
If a patient have PLMD due to other disorders, then treating PLMD can be performed with the specific treatment of the coexisting disorders. For example, if you treat sleep apnea with CPAP, your periodic limb movement symptoms will disappear.
There are options to treat PLMD with medications, which is often effective, but should be avoided wherever possible in children and during pregnancy, because of the long-term toxicity.
The medical treatment include dopaminergic agents used to treat Parkinson's disease, sedative drugs and anticonvulsant medications.
Another medications which are sometimes prescribed to help patients sleep more restfully are benzodiazepines, such as diazepam and clonazepam. But these medications should not be used in apnea patients since they can aggravate their disorder.
Whichever drug is chosen, it should be used initially in a low dose and timed to be given before the onset of the symptoms. The dose of the drugs should be gradually increased until the symptoms are adequately controlled.
