Periodic Leg Movements during Sleep (PLMS) & Periodic Limb Movement Disorder (PLMD)

Periodic Leg Movements – Research & Treatments

PLMS (Periodic Leg Movement during Sleep) a sleep disorder characterized by involuntary movements of the legs while asleep. People who suffer from PLMS can be unaware of their limb movements, as they do not always wake from them.

These movements happen during the night, at regular intervals before one enters REM sleep. Sufferers often complain of the inability to fall asleep or to remain asleep in association with PLMS. Men and women are equally affected by PLMS; children may develop it as well. This disorder is most common in people over the age of 65, although one may develop it at any age.

What Is Periodic Limb Movement Disorder (PLMD)

If the individual experiences consequences like loss of sleep, irritability or mood changes from Periodic Limb Movements during Sleep, then they have Periodic Limb Movement Disorder PLMD.

Common Symptoms Of PLMD & PLMS

Periodic Leg Movement during sleep.

 People who suffer from PLMS often complain of difficulty falling asleep or staying asleep due to the limb movements they experience. Chronic disruption of sleep can lead to daytime sleepiness, irritability or general changes in mood.  The characteristic movements associated with PLMS usually occur in the legs, but less commonly can occur in the arms as well. Those with extreme movements may find themselves waking up at their own movements, and will almost certainly disturb and arouse their partners. Couples are often forced to sleep in separate beds when one or both of them have advanced cases of PLM.

Not everyone with PLM’s is considered to have PLMD though. Those with only mild forms of PLMS that suffer no consequences from the involuntary limb movement, such as waking up themselves or others, are classified as having periodic limb movements of sleep (PLMS), for which it is considered unnecessary to seek treatment for. In rare cases PLMS can also occur while awake, called periodic limb movements of wakefulness (PLMW)

These rhythmic movements usually consist of involuntary extension of the big toe and then progress to an upward bending of the knee, ankle or hip. The symptomatic limb movements will usually persist over a certain interval, lasting from a few minutes up to several hours. Within these events, the leg movements will occur about 5 – 90 seconds apart and last from .5 seconds to 10 seconds.

Is Periodic Limb Movement Disorder Related To Restless Leg Syndrome?

Sufferers of PLMS may also experience some of the same symptoms of RLS like burning, tingling sensations or general discomfort in their legs when they lay down to rest. Not everyone who has PLMS has RLS; however, about 80% of people who suffer from RLS also suffer from PLMS.

Often ones bed partner will be more aware of the movements than the sufferer is. Many times when one suffers from PLMS, they may not fully awaken from the movements, although it does disrupt their sleep. Additionally, one may find they frequently wake up just as they are falling asleep and not know what work them, as the leg movements usually last only a few seconds.

These movements will often occur in the first stage of your sleep cycle, before REM sleep. REM sleep is the “dream cycle” of sleep; it is also the episode in which one obtains their most restful sleep. Constant disruptions of the sleep cycle can keep one from attaining REM sleep, leaving a person unrested in the morning.  During the REM sleep cycle a persons voluntary muscles are paralyzed, which keeps one from acting out their dreams. It is possible that because of this paralysis, PLMS can only occur before or after REM sleep.There is cross over between individuals with PLMS and Restless Legs Syndrome (RLS).

What Is The Cause Of Periodic Leg Movement during Sleep(PLMS)?

  While there is no known exact cause of PLMS, researchers are working to find the cause and new treatment options. Currently scientists think that the central nervous system and PLMS could be related, but no studies have proven links between central nervous system abnormalities or disorders and PLMS.

In addition to actual physical movement of the limbs, many people with PLM will experience involuntary tightening or flexing of the muscles, which can be quite painful and disconcerting, and causes the subject to wake up at a high frequency. PLM can occur throughout the night, but in most patients occurs in batches, lasting from 30 minutes to 2 hours on average, with actual movements happening every 5 to 90 seconds during that span. Physical movements are likely to occur in both limbs, while involuntary tightening or flexing of the muscles is more likely to occur in just one limb. PLM typically occurs in the slow-wave phase of sleep just before the deep sleep of REM (rapid eye movement) sleep.

PLM is found with high frequency in those suffering with restless legs syndrome, with as many as 85% of people with RLS also having PLM. Conversely, the number of people with PLM also having RLS is quite low, owing to the fact that PLM is somewhat more common than RLS. Like RLS, PLM can occur in the legs or arms, but most often appears in the legs.

Many underlying medical conditions that cause RLS (restless leg syndrome) may cause PLMS as well. Research shows that anemia, iron deficiency, CNS problems, and kidney disorders may cause RLS and may cause symptoms of PLMS as well. A hereditary link has been seen in people suffering from RLS, the same may be true for people suffering from PLMS. While these conditions can be associated, they are not found to cause one and other, they are only seen as being generally related.

Periodic Leg Movement can impact sleep quality

While PLMS by it’s self is not a medically serious condition it can make life unpleasant. Many people who suffer from PLMS often complain of daytime sleepiness, fatigue or feeling unrested when they awake. These symptoms alone can make day-to-day life difficult. If one is unaware of their symptoms, and they are severe enough, PLMS can be a cause of chronic insomnia. PLMS, like RLS, can also be an indicator of more serious underlying medical conditions like diabetes, kidney disease or anemia.

Diagnosis and Treatment For PLMS & PLMD

  If a person thinks they suffer from PLMS or experiences RLS symptoms like burning or general discomfort in their lower legs, one may want to see a health care professional. A medical provider may want to review your medical history and request a current physical. The medical provider may also ask ones bed partner some questions about their sleep habits; often when people suffer from PLMS the movements will wake their bed partner as well.

PLM is found in 5% of adults over 30, and nearly 50% of adults over the age of 65, lending credence to the claim that it is tied to the immune system, and more likely to appear in those with weaker immune systems. It occurs rarely in children. Detailed studies of it have not been conducted though, so detailed statistics on the variance between genders, and its genetic disposition are unknown with any certainty.

PLM has roots in other sleeping disorders, is more likely to occur in patients with those disorders. This includes the aforementioned RLS, as well REM sleep behavior disorder and narcolepsy. Like RLS, it may also have a connection to low iron levels, specifically low iron levels in the brain.

A link has also been found between people with spinal cord injuries having a higher prevalence of PLM.

Treatment for PLM is similar to the treatment for RLS, so someone with both conditions will likely find relief from both syndromes with one treatment. This includes iron supplements when low iron levels are considered to be at the root of the problem and anti-seizure medications. For extreme cases, sleeping pills or pain killers may be prescribed.

Additionally, changes in your daily routine will probably be recommended. This includes a healthier diet and balanced exercise schedule. Most important is to implement good sleep hygiene practices. This will improve the speed you reach REM sleep, and your ability to stay in it. The chances of PLM occurring during REM sleep are much lower than while in earlier sleep phases. Good sleep hygiene includes improving the sleep conduciveness of the environment you sleep in, having a comfortable bed and pillow that is right for you, and avoiding stimulants of any kind before bed time.

Sleep Studies & PLMS

Because of the nature of the disorder, many people may not know they are suffering from it until told by another, as in most cases the PLM will not cause the subject to rouse. Only in the case of extreme jerks or movements, or painful tightening of the muscles is the subject likely to awaken. In all but the most severe cases, treatment will not need to be sought, but as it may be tied to another disorder or medical condition, a doctor should still be consulted concerning it.

The polysomnogram (overnight sleep study) is the best method for detecting the severity of the movements, and also for detecting any other possible sleeping disorders that may be contributing to it.

A medical professional may recommend that a person have a sleep study done to monitor ones movement during sleep. Sleep studies are typically done in a hospital or a sleep center. For the sleep study one will typically spend a night in a private room near the sleep technicians, so they are able to monitor a persons sleep experiences and physical information. A sleep study may also ascertain whether or not a persons’ PLMS is related to other sleep conditions like RLS, sleep apnea or other breathing problems.

PLMS is only diagnosed as a disorder when the symptoms cannot be explained by another condition like RLS. A medical provider may also determine it would be best for one to see a sleep specialist or refer you to a sleep center for further testing and diagnosis.

Medications Often Prescribed For PLMS & PLMD

If your symptoms are very frequent or severe, your medical provider may prescribe medications. The medications most frequently prescribed are dopamine agonists or benzodiazepines. Dopamine agonists are commonly prescribed for Parkinson’s disease to control the associated tremors. Benzodiazepines are a class of anticonvulsants, commonly prescribed for seizure disorders. Both of the types of medications work by suppressing abnormal central nervous system activity. Successful management of PLMS has been found with each of the classes of medication.

What Are Natural Treatments For PLMS?

Many people who suffer from mild or moderate PLMS Periodic Limb Movements during Sleep (Periodic Leg Movements during Sleep) can successfully manage their condition with out medication. People often report that relaxation exercises like yoga or meditation can help reduce their symptoms. Some times a hot bath or messaging ones legs before going to sleep will help with the movements as well.

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32 thoughts on “Periodic Leg Movements during Sleep (PLMS) & Periodic Limb Movement Disorder (PLMD)

  1. Torrey Reply

    Why do you say Fibromyalgia? I am a stomach sleeper and lift my legs up at the knees at a 90 degree angle, they circle around for a while and then fall down on the bed. I have been doing this for at least 40 years. I have also been diagnosed with Fibromyalgia. What is the connection?

  2. SleeplessInCali Reply

    I actually had some paranormal things happening in my home recently, primarily in my bedroom closet, and put up a security camera that was motion triggered to record. What I caught (besides paranormal stuff) was my legs suddenly jerking upward, after the toes curled, knees bent, etc., and I thought, GREAT, there’s a spirit messing with my feet. I decided to turn the camera on me and not so much the closet.
    After the first night of recording myself “sleeping”, I got cozy in my recliner, ready to view the paranormal footage. What I saw had my jaw drop to the floor. This cannot be ME!!! No way!
    Not only do my toes curl, knees bend, hips jerk forward as my buttocks tighten for several seconds, but my arms go to work too! If they’re bent up near my face, they slam down, and vice versa. These movements happen every single night, every 10-15 seconds on average (for hours!), begin about 7-10 minutes after I drift off, and wake me constantly. I have ripped my pinky nail clean off of the nail bed in my sleep during a PLMD movement and hit myself in the face and breasts repeatedly. It is insane. Thank GOD I’m not married. I just had a sleep study to confirm the PLMD.
    Now to find out WHY it’s happening and get some SLEEP!!!
    I really wonder sometimes if it’s not related to the blood transfusion (or sepsis, or kidney failure) I had a few months ago. I’ve never had this problem before. My ex would’ve told me. Instead he used to tell me I didn’t move or make a sound in my sleep.

  3. KristanK Reply

    Are there any clinical studies being conducted for this? My husband says I “run” all night and I wake up with my legs just aching as if I’ve run all night. Thanks

    • Darcy Reply

      I would be interested to know this, too. My husband flexes his toes, ankles and knees during the night and while they are not big movements, he wakes up with legs in agony in the morning and very sleep deprived. Other than this, he is healthy. More really needs to be done about research for this disorder as not a lot of people seem to suffer from any pain, or at least it is not mentioned much. Also, most doctors don’t know about this disorder or if they do, don’t know how to treat it.

  4. Danelle Reply

    My Father and my sister always told me that I move my leg alot at night. I didn’t believe them. I thougHTC also that waking up in the middle of the night and earlier even at 2 or 3 for no particular reason was also normal. I am now concorned that I really have an issue and it had gotten worse over the years.
    The worst part is, they took a video of me moving my leg constantly at night, and it was just crazy. It looked like I was possessed or something and I thought that maybe it was just a one time thing.
    Nowe personally after many years and finally taking this serious, I really believe I have plms, have always been unaware of movement and still am. But I am hoping that massage, going to bed when I feel sleepy and yoga can help.

  5. Rita Reply

    I’ve had PLMS since my 30’s. I had to self-diagnose it. Unlike many sufferers, I have symptoms while awake or trying to fall asleep, as well as while asleep. Very unpleasant. It can start up on long car trips, which drives me nuts (pun intended)! I was originally treated with Miripex, but that drug caused exercise induced exhaustion (and exercise definitely helps me). Klonopin worked well for many years, but one physician implied I was faking it, and another changed my prescription to say I was taking it for anxiety. I finally proved I had PLMD by getting a polysomnogram. More recently, my psychiatrist urged me to get off of Klonopin due to recent research linking benzodiazepines to dementia in older adults. Reluctantly I’m back on a dopamine agonist (Ropinirole) which is only partially effective. This is such a frustrating disorder, as it has no cure or definitive treatment, and we sufferers have to deal with medical skepticism and a dearth of adequate research.

    • Chris Reply

      But have you ever had your ferritin levels tested? You may need iron. Found this at 4am. Meripex is waking me up. 3rd night taking.

  6. Liz Reply

    I have found myself suffering from this periodically . Entirely annoying and so hard to explain to anyone what the feeling is like. As I have extreme digestive issues. My drs kept me on weekly blood work for a year , discovering as a result of my body not efficiently processing nutrition I absolutely have to take multi vitamins and pay close attention to my meal plan. In my life I have constant occurrences with extreme muscle spasms, fatigue, headaches and many other random symptoms and they are 95%from lack of absorption of vitamins and minerals in my diet as the blood work has proven. Recently I found myself having this leg symptoms. After experiencing them off and on in passing months I feel I have found the “cause “ to be like muscle spasms a lack of calcium, potassium in diet. It seems to be a jr of muscle spasms, and when I get them I even get out of bed drink my RAW milk, find bananas, or eat a mustard sandwich. ( plain yellow mustard is amazing at ending muscle spasms, I swear by it) .. unfortunately my symptoms do not usually go away that night but they do only last a night or two with me pumping up my nutrition. I feel sometimes we look a little to hard at things and the answers are so simple and right in front of us. I suggest trying these foods and or supplements and seeing if they help as they have me.

    • Sandra Reply

      Everyone in my house says I bend my legs to knee and keep it up while asleep. I didn’t believe them until they showed me a video of me sleeping. Guess I have to start yoga and leg massages now.

  7. Edward L Smith Reply

    My wife keeps telling me to get up at night because my legs are moving too much for her to sleep. I was taking Requip and that was not working very well. My Doctor then switched me to Ropinirole about 2 weeks ago and I still don’t see any relief – my wife keeps “kicking” me out of bed.
    Some days I am so exhausted, it is hard to stay awake – especially during Church Services.
    Right now they are treating me for RLS. I see the Doctor again the first week of June. Should I ask the Doctor if I could have PLMS and what other treatments are there to try?

  8. Thurman Theresa Reply

    My daughter laying on her stomach legs bounce up and down. This has been going on for over 10 yrs. she has no idea it’s going on, I have to wake her up. The weirdest thing is she has somehow slid down to the bed and hits her toes but it doesn’t wake her up. The older she gets the worst it has gotten. This is not RLS.

    • Misty Reply

      This happens to me as well, have done it all my life. I lay on my stomach and bend my leg at the knee and bang the bed over and over. Drives my partner nuts.

      • Toya Reply

        I am 36 and it has gotten works. I think my boyfriend will kick me out the bed soon.

  9. Tom Reply

    I’ve been dianosed with PLMD since I was 39. I was so sleep deprived at that time I would fall alseep in the recliner shortly after sitting down. I took Klonpin for years but due to not wanting to stay on a benozodiazopam I chose to go through another sleep study about a year ago. I still have a case of PLMD that suggests medication but I have not found one that works that isn’t a narcotic. I end up staying in bed and dosing off many times in the morning just to gret enough sleep. It would be great to find a med that doesn’t lead to dementia that would work for my PLMD. Last med I was prescibed was Mirapex and it didn’t work great and I ended up getting up to use that bathroom every night.

  10. Jennfrey fikes Reply

    My husband been telling me i kick through the night both legs.its so frustrating cause i don’t know that I’m doing it.except this night he said loud you’re kicking me,and i heard him in the mist of me doing it.cause i told him to call out to me when im doing it.this time i caught myself doing really scared me.i thought i was possessed.cause i wasnt in a Christian so i know thats not the case.i was diagnosed with sleep apnea
    I haven’t been using my cp machine but i will tommorrow night cause this really scared me.thanks for the help and information i will certainly take it into my knowledge.i will go back to my cp and if that doesn’t work i will let my doctor no.

  11. Mike Reply

    I’m a male in my early 50’s. I’ve had this problem for as long as I can remember. In my early 20s, both legs had varicose veins stripped. Did not stop the insatiable need to move my legs. My legs feel weak, and worn out. At night, I kick, bounce, punch and hang my legs off the bed. Way worse than RLS. as mentioned, I too spend many night in my recliner to spare my wife. This is not just an evening thing. My legs have been tested for oxygen, nerves, compressions, acupuncture terms machine, etc. they’ve tried MANY medications. Dr’s have no solution. I have asked for a leg nerve block, but was told it’s not practical.
    Nonetheless, this pain is all consuming. I don’t know how I’ve managed till now, or how much longer I can deal with it.

  12. Herb Klein Reply

    Does anyone know of a convenient home monitor for leg motion? This would be easier and simpler than polysomnography.

  13. max hughes Reply

    just lately my right knee and right foot shake violently at night when i am sleeping my wife says god your knee is shaking like mad and then my foot will shake like mad but they never shake together its one or the other, i dont sleep very well since i retired at aged 65, but i have never experienced this before

  14. rudy Reply

    my experience this almost everynight and it keeps her awake. one night i timed it and it occured every 25-40 seconds lasting for a second or too and it involves her feet. she claimed this problem started after she took benadryl to get sleep during a long flight. she was also treat for iron deficiency. it has been going for years and she receives no treatment and it is affecting her mood. she wakes up tired and irritable. she just turned 45 and i feel bad for her.

  15. Lorriane Reply

    I haven’t been sleeping properly for about a year and a half , i always wake up at 4 (am) . But recently my friends when they stsy iver say i keep kicking them in my sleep . Me and her were lying on the sofa and when i was talking to she said stop kicking me . I couldn’t feel myself doing it , I could feel my foot .That night my feet , knees and my legs were moving like crazy . I done it for 3 hours and it stopped for 5 minutes and started again. My chest or head was not moving. She told me this morning, i had done it other times she stayed but last night was the worse . She said to me when she moved my legs my knees starting banging together. I don’t know what to do please help . Ps I’m 14

  16. JustWantSleep Reply

    I’m in my late forties, Type I Diabetic for over 40 years, a little overweight. I can’t stand this anymore. I’ve taken to sleeping on the recliner in the living room most nights. I’m able to sleep a little better out there, but it’s only because I’m relieved of the guilt I feel of keeping my husband awake. On the other hand, the recliner wasn’t designed for someone to use it as a bed all the time and it’s starting to feel the effects of my thrashing around. And my back is starting to complain as well. I’ve tried massaging, hot baths, stretching, no caffeine or other stimulants, blah, blah, blah and nothing is helping, but the thought of using narcotics or anti-seizure meds scares me to death.

    I know my mother had this issue and she and my father slept apart for the last 30 years of their marriage, to the point of getting rid of their shared bed and getting two twins. She also had RLS and spent many a night pacing the floors unable to sleep, and I’m convinced the lack of sleep eventually had an effect on her mental health — she became depressed, paranoid, emotionally unstable, flying into violent rages over nothing — it was awful. I hate the idea that this could become me in the next 20 years.

  17. jaredh4 Reply

    PLMS is very common as we get older. Many clinicians believe that if it doesn’t cause any symptoms, you just leave it be.

  18. Stella A Sammons Reply

    My legs jerk so hard that when I will try to walk during an episode a jerk of my leg will lift me off the floor causing me me to fall. The episodes not happen just at bed time. Any time (of the day) if I set still for over an hour my leg or both start to jerk severely. I have to try to keep from screaming from the mind boggling attack. Sometimes I get so upset wanting it to stop I feel my heart racing really fast. I feel like my legs are being pulled from my torso. When I was getting my nails done a few weeks ago (at 2:00 pm) my leg jerked so hard off the ground it was knocking the work space table up from the ground, knocking nail polish all over. I had to stop and go back later. It is an everyday, anywhere , anytime happening, therefore I cannot wait till bed time to take any medication. I am so isolated from going out to meetings, lunch, a movie etc. I only get about 4/5 hrs of sleep at night, and if I try to nap during the day, the leg jerking starts.

    • cg Reply

      Wow. That’s really severe. Could it perhaps be some kind of seizure you are having?

    • Mike Reply

      I am sorry, I’ve just left a post, and after a day of work (contractor) especially stairs or ladders will cause my legs to cramp up, Pain, OMG! I down a gatoraid, and try drinking more water. It seems to help.

  19. Lawrence Sahoy Reply

    My wife complain that when I am sleeping my feet move all the time and she can’t sleep. Is there a treatment for that. I don’t know why my feet keep moving all the time while sleeping. Please I need you guys help to stop my legs from moving while sleeping.

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