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Periodic Limb Movement Disorder

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Sleeping Problems (Home) > Periodic Limb Movement Disorder > Periodic Limb Movement Disorder Treatment

Periodic Limb Movement Disorder Treatment

Diagnosis

People with Periodic Limb Movement Disorder (PLMD) do not usually feel or remember their nighttime movements, but they may complain of restless sleep or Excessive Daytime Sleepiness (ESD).  If you suspect that you suffer from restless sleep or ESD, then you should have a sleep study done at a Sleep Disorders Center.

Because of the similarities between various sleep disorders, polysomnography plays an important role in confirming or otherwise a diagnosis for PLMD or some other sleep disorder.  A Polysomnogram is a device that continuously records the brain waves and a number of other nerve and muscle functions during nighttime sleep, the results of which can be used to detect and distinguish between a range of possible sleep disorders.
A formal diagnosis of PLMD requires three PLMD episodes during the night, each lasting from a few minutes to an hour or more, and each containing at least 30 involuntarily movements followed by partial arousal or awakening.

Complications / Issues

In addition to a disturbed sleep for the Periodic Limb Movement Disorder (PLMD) sufferer and their family / partner, PLMD can also be a cause of insomnia and Excessive Daytime Sleepiness (EDS).

Treatment

At this time, there is no cure for Periodic Limb Movement Disorder (PLMD), and treatment does not and cannot cure PLMD but it can relieve the symptoms.

Some prescription medications are available for treating Periodic Limb Movement Disorder (PLMD).  However, improved sleep hygiene is also an effective treatment, and most PLMD sufferers can reduce their symptoms by following good sleep hygiene practices:
  • Exercise regularly (but not too close to bedtime)
  • Ensure that they get enough sleep
  • Keep a regular sleep diary
  • Reducing stress levels in their lives
Avoiding medical and other issues that are known to trigger, or are suspected to trigger, PLMD is also a key strategy for treating PLMD and reducing or eliminating the symptoms of PLMD.  See section 4.9.2 Causes above.

The following medications are available that either reduces the movements or helps the person sleep through the movements:
  • Anticonvulsant agents: These medications reduce muscle contractions in some people, and often help people who experience the painful sensations during episodes.  Gabapentin (Neurontin) is one of the most widely anticonvulsant drugs in the treatment of Periodic Limb Movement Disorder (PLMD) and Restless Leg Syndrome (RLS).
  • Benzodiazepines: These drugs suppress muscle contractions and assist in staying asleep and reducing awakenings from the movements.  They are also sedatives and help you sleep through the movements.  Clonazepam (Klonopin) is one of the most widely used benzodiazepines to treat Periodic Limb Movement Disorder (PLMD) and Restless Leg Syndrome (RLS).
  • Dopaminergic agents: These drugs are used to increase the levels of an important neurotransmitter (brain chemical) called dopamine, which is important in regulating muscle movements.  These medications are effective in some people, but not in others.  Levodopa / carbidopa combination (Sinemet), ropinirole, pramipexole (Sifrol in the US, Mirapexen in the EU), and pergolide (Permax) are commonly used medications for Periodic Limb Movement Disorder (PLMD) and Restless Leg Syndrome (RLS).
  • GABA agonists: These agents inhibit release of certain neurotransmitters that stimulate muscle contractions.  The result is relaxation of contractions.  Baclofen (Lioresal) is one of the most widely agents in the treatment of PLMD.
Please Note: many of the medications used to treat PLMD are the same as those used to treat Restless Leg Syndrome (RLS). 

Prevention

The best way to prevent the onset of the symptoms and complications of Periodic Limb Movement Disorder (PLMD) is for the sufferer to work with their doctor, so that the causes can be treated, removed, or reduced.


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