Periodic Limb Movements
Periodic Limb Movements are quite common. They are episodes of simple, repetitive muscle movements which you are unable to control. They usually do not keep you from falling asleep, but they severely disrupt your sleep during the night. This can cause you to be very tired during the day. They do not involve a change in body position, stretching a muscle, or a cramp. Instead, the movements tend to involve the tightening or flexing of a muscle. They occur most often in the lower legs, while you sleep or while you are awake.
Nighttime. When they occur often through the night, they can disrupt your sleep many times. Normally, you are unaware of the movements or of waking up. A typical movement is for the big toe to extend. Often the ankle, knee or hip will also bend slightly. The degree to which these movements occur can change from night to night. They usually happen during the first half of the night. When these movements are very severe, then they may also happen while you are awake.
Episodes may last from a few minutes to an hour and movements tend to occur every 20 to 40 seconds. They may affect only one of the legs or, more often, they will affect both legs. For most people, the movements do not disturb their sleep in a severe way. This means that it is not a sleep disorder. The sleep of the bed partner tends to be affected more often than that of the patient. The movements reach the level of a disorder when they disrupt the patient’s sleep and daily life. This disorder may be a factor in causing you to have any of the following: depression, bad memory, short attention span or fatigue.
Children and Adults. Periodic Limb Movements occur in both children and adults. The chance of having it increases with age, making it very common in the elderly. No difference has been noticed in the rate of males and females who have it. The family pattern has not been studied in detail.
Causes. Periodic Limb Movements can be influenced and caused by a number of factors: restless legs syndrome, a sleep behavior disorder, narcolepsy. Low brain iron may play a role in making the movements worse. High rates have been found in some people with: spinal cord injury, multiple system atrophy and sleep related eating disorder. The following medications are thought to cause Periodic Limb Movements or make them worse: some antidepressants, lithium and some anti-nausea medications.
Self Evaluation. If your answer to each of these questions is yes, then you might have Periodic Limb Movements.
- Has someone else told you that your body makes unusual, repetitive movements while you sleep?
- Do these tend to occur in your lower legs?
- Do you feel like you are never well-rested, even after a full night of sleep?
- Are you often very tired during the day?
- Also, your sleep problems may be a result of one of the following: another sleep disorder, a medical condition, medication use, a mental health disorder or substance abuse.
Seeing a Sleep Specialist. For most people, the movements do not disturb their sleep in a severe way. They do not need to seek medical help. In other cases, severe movements can greatly disturb your sleep and life. In this case, you will want to see a sleep specialist. You will need someone with the proper training and experience to help treat it.
Sleep Diary. You will also want to keep a sleep diary for two weeks. The sleep diary will help the doctor see your sleeping patterns. This information gives the doctor clues about what is causing your problem and how to correct it.
Testing. Your doctor will likely have you do an overnight sleep study. This is called a polysomnogram. The polysomnogram charts your brain waves, heart beat, and breathing as you sleep. It also records how your arms and legs move. Not only will it keep track of your movements, it will also help detect any other sleep disorder that you may have.
Treatments. When it is necessary to treat Periodic Limb Movements, the same drugs that are used for restless legs syndrome also work for Periodic Limb Movements. These include drugs that replace a chemical in the brain called dopamine. Other medications used include the following: sleeping tablets, some anti-seizure medications or narcotic pain killers.
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