PLM (Periodic Limb Movements) – What is it?

Periodic limb movements are repetitive limb movements that occur during sleep and cause sleep disruption. These episodes of uncontrollable movement usually occur in the lower limbs every 20-40 seconds. The movements are similar to muscle twitches and jerking movements but last longer, and these episodes can last anywhere from a few minutes to several hours while you sleep. Usually, a person with PLM does not notice the movements, whereas, their sleeping partner can be greatly affected by the movement and have difficulty falling and staying asleep. PLM does not keep you from falling asleep but severely disrupts sleep, causing you to wake up periodically through the night and inhibiting your sleep cycle. This causes you to wake up feeling tired and experience prolonged fatigue throughout the day.

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

What causes it?

What causes PLM is unknown. Many studies have been conducted on the underlying cause of PLM. However, these studies have not shown any consistent abnormalities. Many scientists believe the cause is related to the nervous system and possible nervous system mishaps. Physicians agree that PLM is not medically serious. That being said, these movements can contribute to chronic insomnia and/or daytime fatigue because of how often they wake both you and your sleeping partner.

Possible solutions

Treatment for PLM will not cure you of it but can relieve symptoms and help you get a more restful sleep.  Medication is the only treatment, and it will either reduce the movement’s severity or regularity while you sleep or help you sleep through the movements. Some of the medications used for the treatment of PLM include:

  • Benzodiazepines: a sedative used to suppress muscle contractions and help you sleep through the movements.
  • Clonazepam (Klonopin): The most widely used drug for PLM treatment. It reduces the number of uncontrollable movements per hour while you sleep.
  • Dopaminergic agents: These drugs increased your levels of dopamine to regulate muscle movements. These medications are very helpful for some and not so much for others. Anticonvulsant agents: Anticonvulsant medication used to reduce muscle contractions.
  • GABA agonists: These agents relax muscle contractions by blocking the release of certain neurotransmitters that stimulate muscle contractions

Studies have shown that mild cases benefit from sedatives or painkillers.

Why get treatment?

PLM is not curable, but it is manageable and a great night’s sleep every night is obtainable. In certain cases, a doctor will prescribe medication to combat the uncontrollable movements and lessen them in severity and duration. If severe enough that the PLM has developed into a disorder and is causing serious disruptions to your sleep then it could become a factor contributing to, depression, bad memory, short attention span, or fatigue if you have multiple or any of these issues.

Your next step should be scheduling an appointment with your personal physician or one of our Board Certified Sleep Physicians to discuss your concerns.