Periodic limb movements during sleep are common in children and adults. They involve involuntary leg or arm movements. Most often they occur in the legs and feet. Periodic limb movement disorder (PLMD) is much less common. It involves frequent movements that cause arousals from sleep. These disruptions can cause daytime sleepiness or fatigue.

KEY POINTS:

Symptoms of periodic limb movement disorder include:

  • Repetitive, involuntary leg movements during sleep
  • Trouble staying asleep
  • Daytime sleepiness or fatigue
  • More than 5 limb movements per hour of sleep as measured during a sleep study for a child.
  • More than 15 limb movements per hour of sleep as measured during a sleep study for an adult.
PERIODIC LIMB MOVEMENT DISORDER (PLMD)

Am I At Risk:

PLMD can occur at any age, but it is more common in older adults. PLMD occurs equally in men and women. Periodic limb movements are common in people who have restless legs syndrome (RLS). Some drugs can cause the involuntary movements or make them worse. These include drugs used to treat depression, nausea and allergies. People with low iron levels have a higher risk of periodic limb movements.

GENERAL OVERVIEW

A typical periodic limb movement is for your big toe to extend during sleep. Often your ankle, knee or hip also will bend. You may be unaware of these movements. But if you have PLMD, the frequency of the movements is likely to disrupt your sleep. You also may notice that you feel tired or fatigued during the day. Your bed partner might notice your jerking movements during sleep.

Many people with restless legs syndrome (RLS) also have frequent periodic limb movements during sleep. RLS involves a strong urge to move the legs when you are resting or sitting still. You also may have a creepycrawly, tugging, itchy or tingly sensation in your legs. If you have RLS, you will not receive a diagnosis of PLMD. Your doctor will simply note that you also have periodic limb movements during sleep.

TREATMENTS:

PLMD can be treated with a prescription medication. Your doctor will help you decide if you need a medication. If your iron levels are low, your doctor may recommend that you take iron supplements.

TIPS:

Here are some strategies to reduce involuntary leg movements during sleep:

  • Eat a well-balanced diet including foods that are rich in iron.
  • Exercise each day at a pace that feels comfortable.
  • Stretch or massage the legs before bed.
  • Take a warm bath before bed.
  • Talk to your doctor about any causes of stress in your life.
  • Limit caffeine and alcohol.
  • Do not smoke.

Next Steps:

  • Talk with your doctor about your symptoms. It may help to write down your symptoms including the time of day when they occur.
  • Ask your bed partner to describe your sleep symptoms.
  • Discuss all of your medications and herbal supplements with your doctor. Some of these could cause periodic limb movements or make them worse.
  • Your doctor may test your iron levels.

ACKNOWLEDGEMENT: CONTENT DEVELOPED BY THE AMERICAN ACADEMY OF SLEEP MEDICINE