Treating PLMS: Periodic Limb Movement Movements In Sleep
A related disturbance to PLMS, restless legs syndrome (RLS) is associated with uncomfortable, creepy, crawling sensations in the lower legs, feet, or thighs that result in an irresistible urge to move the limbs. Sometimes these sensations are described as "pins and needles" in the leg. These sensations are called dysesthesias or paresthesias. These sensations generally occur when you are relaxed or resting and often interfere with falling asleep.
Some patients experience the same sensations when they wake up at night, and find themselves walking or rubbing their legs to try to relieve the uncomfortable feelings. Restless legs syndrome is frequently seen in patients with uremia, kidney failure, rheumatoid arthritis, or in pregnant women. Drinking large amounts of caffeine may make the symptoms worse, as may being overly tired and exposure to a very cold or very warm environment.
Typically, RLS begins in the third decade of life, but commonly gets worse with age. Often RLS is hereditary. Almost all patients with RLS have periodic limb movements in sleep, but not all patients with periodic limb movements in sleep have restless legs syndrome. Patients with RLS may also complain of insomnia or of excessive daytime sleepiness.
Can PLMS Be Treated?
The cause of periodic limb movements in sleep is unknown. Some doctors have suggested that the movements are caused by reactions in the brain, whereas others suggest it might originate in the spinal cord or may be associated with circulatory problems.
Periodic limb movements in sleep is treatable with several different medications. Unfortunately, since we do not know what causes the leg movements, it is sometimes difficult to know how best to treat it. Not all medications work in all people so you and your doctor may need to try different treatments before you find the one that works best for you. The different medications recommended include certain sleeping pills, certain types of pain killers, and some of the drugs used in Parkinson's disease (although the two disorders are not related).
The most common sleeping pills used to treat PLMS are some of the benzodiazepines such as clonazepam (Klonopin) or temazepam (Restoril). These drugs reduce the number of awakenings at night, but have little effect on the number of leg jerks. Therefore the symptom of insomnia disappears but the symptoms of leg movements do not, or in other words, you still kick your legs but it no longer wakes you up.
The pain killers used to treat PLMS include drugs with opiates (such as Tylenol with codeine). These drugs reduce the number of leg kicks, but do not always reduce all the awakenings. In other words, you may stop kicking, but you may still wake up periodically. These drugs also are potentially addictive and only should be used at the lowest possible dose and only if prescribed by your physician.
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