Restless Legs Syndrome

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What is PLMD?

In addition to voluntarily moving their legs to alleviate their RLS discomfort,RLS patients also experience a more common condition known as “Periodic Leg Movements (PLM)”. These involuntary leg movements can occur in sleep (PLMS) or in wake (PLMW). PLMS are characteristic movements (typically extension of the big toe accompanied by flexion of the hips, thighs, and knees) that may or may not cause awakening and occur every 10 to 60 seconds. They can during any sleep stage, but occur maximally during NREM sleep. Surprisingly, PLMS does not always cause awakening. “Periodic Leg Movement Disorder (PLMD)” is defined as PLMS causing sleep disturbance that are not part of another diagnosed sleep disorder. A sleep study or polysomnogram (PSG) is required to evaluate and diagnose PLMS or PLMD according to the definition of the American Sleep Disorders Association. [23]

PLMD causes repeated awakening and fitful sleep. It can be extremely irritating to the patient’s unfortunate bed partner. Unlike RLS (in which the leg movements are voluntary and always occur while awake), people with PLMD have no control over their leg movements. Although 80-90% of RLS patients also have PLMD, most people with PLMD do not experience RLS. Like Primary RLS, the cause of PLMD is unknown

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