Join Our Newsletter

New? Free Sign Up

Then check our Welcome Center to a Community Caring about Sleep Apnea diagnosis and Sleep Apnea treatment:

CPAP machines, Sleep Apnea surgery and dental appliances.

CPAP Supplies

Latest Activity

Restless Leg Syndrome (RLS) and Periodic Limb Movement Disorder (PLMD)/ Sleep disorders 11, 12

I have noticed that a few of the members have had some questions about these 2 disorders. With this post we will learn about them together. My disclaimer as most of you know I am just a lowly PSG studying for my RPSGT certificate. Please do not take anything that I post as a diagnosis. You should always seek the advice of your PCP before you do or accept any information you might read on the internet, or anywhere else for that matter.

This is what I know. These disorders are both classified as neurological disorders. However studies have proven, or are currently trying to prove, that they are not always neurological in origin. RLS is a disorder that causes an overwhelming urge to move the legs(sometimes arms). Some people just have to rub their feet together while others actually have to get up and walk around. This can be extremely bothersom when you are trying to relax or SLEEP. There is some argument as to whether this is actually a sleep disorder because it happens while you are awake. I believe it to be a sleep disorder because it can keep you from falling asleep. It is more of an all the time disorder, or what some might call a tick. These movements are scored as isolated leg movements from the time of lights out to sleep onset. They are interpreted on a case by case study. Meaning that if you are experiencing this urge let your PCP, sleep doc, or sleep tech know otherwise they might not catch it.

If you have RLS there is a high probability that you have PLMD, but not always.

PLMD is a parasomnia, Which means that it occurs during and disrupts sleep. This is a rythmic movement of the legs usually, but sometimes the arms as well. These movements generally happen every 20-40 seconds. To be counted as a PLM on a psg 4 individual movements must be recorded in 90 seconds or less to count. so 217 scored isolated leg movements would be 54 PLMs. If you are treating your apnea and not your PLMD chances are you are still not getting a good night's sleep.

PLMD and RLS patients can be sleepwalker,talkers, and eaters. They have also been know to lead to REM behavior disorder. This is the neurological side of the problem. I would be happy to cover these in another post if you like.

I have found a few studies that show that RLS and PLMD are not always neurological in origin. They can sometimes be a result of low iron, kidney probelms(passing stones, or an infection), or can be a warning of or happen during renal failure.

They can also be an ealry warning sign for MS, Parkinsons, Or a nervous system disorder of some sort including spinal chord damage.

Please keep in mind that I am just a PSG on the road to certification. If you think you might have one, or both of these disorders consult a physician. I just wanted you to have some of the facts about them. I NEEDED you to know that these are not just things that can be blown off because you doubt your sleep study. THey are serious and could be your body screaming for help. Don't ignore your body it knows you as well as you kknow it, maybe better.

This is discussion. Please feel free to post any questions or pertinent information on the subject. Techs/Docs please correct and educate me on anything I might have been wrong about.

Views: 888

Reply to This

Replies to This Discussion

Its interesting that in some PSGs I have none, some, once a LOT (but that was the sleep lab that was recently indicted for fraudulent practices). It doesn't seem to be consistent. Ah well. As long as I stay in auto mode w/this VPAP I'm feeling rested! THAT to me is what counts. Except these darn doctors that want me in Spontaneous mode. Thank goodness my original sleep doctor agrees w/me to stay in auto mode until SOMEONE is willing to address the Spontaenous mode problem.
RLS is one of the leading causes of insomnia.
Found a great link to some studies on PLMs and how this disorder relates to apnea, and PAP therapy.
Hi Rock-

I had my first sleep study done last month and was shocked to discover that I have Apnea, albeit a milder rating, just under the insurance company requirements. It is more positional with supine AHI 25.7 and sides at about 2.0 each. Nothing major, but that was not a typical night as I usually wake up gasping for air while on my sides, too. I was also diagnosed with PLMD 36.5 per hour (non-related to breathing) which I understand is quite high, and U.A.R.S. I woke up about 75 times that night and had my sleep efficiency rated at 55%. I had no idea all of this was going on and became very proactive on finding solutions.

I learned of a clinical trial for RLS being held at the Sleep Center here in San Diego where I had my study done. I was just accepted into this trial and will begin on Monday. I did this so that I would also have the opportunity, at no cost to me, for an additional 8 more overnight studies and possibly get more realistic results on my breathing as we move forward, and deal with the PLMD issues all at once. My main goal is to be able to sleep again and to know that refreshing feeling in the morning that I keep hearing about.

I am guessing that I may have had these problems for the last ten years and it is now beginning to have an effect on my abilities as a numbers person and a concert performer. I am usually a very good letter writer but find that I make lots of mistakes these days, and everything I do is done very carefully and often reviewed over and over again before I hit send the key. All the clues were there. My Primary care doctor listened to me and made the suggestion for a sleep study before he started me on meds for depression. I scoffed at the sleep study idea because I thought my sleeping was fine, but went along with it anyway. As it turned out, I have no clue about how I sleep and now very glad I listened to the man with a medical degree. ;>

My question to you is: Before lights-out, the tech placed a nasal mask on me and stated that this was a fitting, just in case it was needed later. When she placed the active mask on me and I began breathing like that, I immediately fell into a relaxation mode like non I've ever experienced before. She saw I was okay and left me with it for a few minutes more while she went to another room. I felt like I was on my way to heaven as I've never felt so relaxed about breathing before. I wanted to fall asleep with the cpap on which struck me as odd because prior to this I was hoping I would never have to endure 'the mask', ever! In your experience, is this a common reaction to this first-timer experience?

The two drugs being used in the study, as well as the Placebo, are already FDA approved. One is approved for RLS treatment (Mirapex) the other is not, yet. I will be a good patient and follow all of the rules for the next 5 months in hopes that I can find a solution to all of this.

I am glad that you were able to get into the San Diego Trial. I will have to do some research on it. While your reaction to PAP therapy is very refreshing it is not typical. Most people can't stand it until we prove that it will improve their sleep efficiency. This is the ultimate goal in any titration.

Do you have both RLS and PLMS? How are your vitamin levels? Iron?
I will know more about blood work results when I go in for the start of the Study tomorrow afternoon.

I've been told I have both RLS and PLMS. I have not yet read up enough to know the difference between the two. This is all still very new to me.
My first concern is that I can find a way to sleep better. My confidence and energy is at an all time low these days and I worry about driving long trips. Even though I've already lost 20lbs since the beginning of the year I know I cannot go any further unless I improve on the sleep efficiency. Because of my overall AHI Index, the CPAP was not suggested, but I've oftened wondered if the U.A.R.S. problem could be remedied by this, and might be the reason why CPAP had impacted me so positively that night. I still gasp for air at times even while sleeping on my sides ( nose breather), but I'm guessing this did not happen enough times during the overnight study for any concern. Perhaps these 8 more overnights something else will show up.

Thanks Rock----I've enjoyed reading up on everyone's experiences in this area. There is a lot of very helpful information here.

Rock Hinkle said:

I am glad that you were able to get into the San Diego Trial. I will have to do some research on it. While your reaction to PAP therapy is very refreshing it is not typical. Most people can't stand it until we prove that it will improve their sleep efficiency. This is the ultimate goal in any titration.

Do you have both RLS and PLMS? How are your vitamin levels? Iron?
There was no mention of iron or vitamin levels in the report unless there are some latin terms for them that I would not immediately recognize. I was told 'everything is normal', but still got a copy of that report. Found no mention of cholesterol either. My TSH level went down to 5.0. Prior to this, TSH was running a little too high.

Last night was my first on the trial med. It was the usual rollercoaster night for me, down for about two hours, then up and down about 7 more times that I can remember after that. I think I only slept for about half the night in total and was very tired this morning. Might take a while for the meds to kick in with me. I'll stick with it. I have 2 overnight sessions coming up on Monday and Tuesday of next week at the Sleep Center.

Reply to Discussion


© 2018   Created by The SleepGuide Crew.   Powered by

Badges  |  Report an Issue  |  Terms of Service