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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.
http://www.rls.org/Page.aspx?pid=471
If you have RLS there is a high probability that you have PLMD, but not always.
http://www.rls.org/Page.aspx?pid=471
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.
http://www.faqs.org/patents/app/20080250512
They can also be an ealry warning sign for MS, Parkinsons, Or a nervous system disorder of some sort including spinal chord damage.
http://www.faqs.org/patents/app/20080250512
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.
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.
http://www.rls.org/Page.aspx?pid=471
If you have RLS there is a high probability that you have PLMD, but not always.
http://www.rls.org/Page.aspx?pid=471
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.
http://www.faqs.org/patents/app/20080250512
They can also be an ealry warning sign for MS, Parkinsons, Or a nervous system disorder of some sort including spinal chord damage.
http://www.faqs.org/patents/app/20080250512
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: 1104
Replies to This Discussion
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Permalink Reply by sleepycarol on
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I have read about both disorders and your explanation is the one that I understand. Thanks so much for the down to earth plain English that one can understand.
I need to go have my back worked on next week. My primary care doctor is a DO and does the adjustments herself. I like it that typically she doesn't push drugs on one unless they are necessary.
If anyone else has any more to add to this discussion, I would appreciate the input.
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Permalink Reply by RockRpsgt on
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You are very welcome Carol. Thank you and Mike for this site and all the support you have given me.
sleepycarol said:I have read about both disorders and your explanation is the one that I understand. Thanks so much for the down to earth plain English that one can understand.
I need to go have my back worked on next week. My primary care doctor is a DO and does the adjustments herself. I like it that typically she doesn't push drugs on one unless they are necessary.
If anyone else has any more to add to this discussion, I would appreciate the input.
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Permalink Reply by Judy on
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Thanks, Rock Hinkle!!! I've always had a problem keeping the two disorders straight in my beady little brain. My hubby has the rhythmic, gentle movement of the feet during sleep - he also has had 3 back surgeries, the last one fusing his entire lumbar spine and Isola instrumentation for stabilization of the fusions.
I, on the other hand, have the "herky, jerkies" on occasion. Usually in the evening. Occasionally an arm will be involved. A few rare times virtually the entire body in one big jerk, but not repetitive. I was Dx'd during bi-level titration w/"a few PLMs, but only 12 per hour caused arousals".
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Judy I could be wron, but your jerks sound more like myoclonic jerks(myoclonus) which could be a result of the hypoxia caused by COPD and or apnea. I could not find anything directly linking the 2, but it makes since. RLS is the NEED or URGE to move a body part. Like I said a tick. It has to be done in order to find that comfort zone again. Your Herky Jerkies sound more like a burst of electric energy.
Judy said:Thanks, Rock Hinkle!!! I've always had a problem keeping the two disorders straight in my beady little brain. My hubby has the rhythmic, gentle movement of the feet during sleep - he also has had 3 back surgeries, the last one fusing his entire lumbar spine and Isola instrumentation for stabilization of the fusions.
I, on the other hand, have the "herky, jerkies" on occasion. Usually in the evening. Occasionally an arm will be involved. A few rare times virtually the entire body in one big jerk, but not repetitive. I was Dx'd during bi-level titration w/"a few PLMs, but only 12 per hour caused arousals".
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You could well be right, Rock Hinkle. I do get the "itchy", "creepy crawlies" of the legs and arms where I just have to respond and move them in the evening, occasionally during the day too tho. So maybe I've got both. Whatever, fortunately its not a constant or even every day thing. What goes on at night? Only my sleep labs know for sure. *wicked grin*
Hmmm. "Only" 12 PLMs per hour caused arousals. Let's see: that is 1 PLM arousal every 5 minutes - in addition to any apneas or hypopneas - during a bi-level titration. No wonder I was so doggone tired all these years.
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Permalink Reply by Marie Davis on
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I was told by my great doctor that RLS can be aggrevated by a lack of our a deficincy in B-12 and Viatmin D in your system. A simply and not too costly blood test will show if you need to bump up these over the counter vitamins in your system. I am taking more now and it actually seems to help a little as well as the oxygen traveling through my body with the CPAP!~
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Very interesting Marie thanks for the input. I found this in a search for RLS and vitamin deficiency
http://www.restlesslegsyndromecure.com/cause.html
http://www.digitalnaturopath.com/cond/C454545.html
Marie Davis said:I was told by my great doctor that RLS can be aggrevated by a lack of our a deficincy in B-12 and Viatmin D in your system. A simply and not too costly blood test will show if you need to bump up these over the counter vitamins in your system. I am taking more now and it actually seems to help a little as well as the oxygen traveling through my body with the CPAP!~
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Well, hubby has the PLMD. Me? Who knows? I'm on high Vitamin D (on doctor's orders) for the last 3 years. At first 100,000 IU weekly for two years, then 50,000 IU for almost a year and now 50,000 IU every other week on Friday.
And (also on doctor's orders) a weekly self-injection of Vitamin B12. The B12 due to the Crohn's and the D due to osteoporosis. I can't take calcium supplements, even w/magnesium to reduce or eliminate the constipation, so we used the daily Forteo injection and Vitamin D for the osteoporosis. I had exciting improvement for the osteoporosis w/the Forteo/D combination the first two years so opted to go w/the Forteo a 3rd year with considerably reduced results so we discontinued the Forteo.
Due to the immunosuppressant I take for the Crohn's we do a blood draw every 3 months. Blood tests for the Vitamins D and B12 were added to the draw as indicated. Interestingly after reading the second URL Rock Hinkle gave us, my BUN tends to run low a couple of times per year, a 6 to 9 with a "normal" reference range of 10-20. And interestingly almost consistently in the January blood draws.
We also have to take into my account that while Flagyl (metronidazole) was a miracle drug from my Crohn's, even at 1/2 dose it caused some PN (peripheral neuropathy) which lasted for years after stopping its use and which very gradually receded and that may have something to do w/the "herky-jerkies" and "creepy-crawlies, itchies" I occasionally experience in the legs and feet.
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there are 2 types of LM periodic and isolated. periodic are the 4 in 90 seconds that I talk about above. Isolated are just that. i brought this back up to correct my mistake. As Mollete said it takes 4 in 90 seconds to be considered a PLM. That would be counted as 4 PLMs not 1 as I stated above. Thanks Mollete.
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Hubby definitely has the PLM. But he also has all his lumbar spine fused and Isola instrumentation to stabilize and strengthen the fusion so I'm sure its probably some residual nerve damage.
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