Periodic limb movements of sleep (PLMS) is one of the sleep disorders that may cause disruptive movement of your legs, much likerestless legs syndrome (RLS). What is PLMS? Learn how movements of the legs at night may relate to other sleep disorders and lead to sleep disruption, insomnia, and even daytime sleepiness.
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Periodic limb movements of sleep (PLMS) consist ofsudden jerking movementsof the legs which occur involuntarily during sleep and which the affected individual may remain unaware. It may involve kicking, twitching, or extension of the legs. Importantly, restless legs syndrome (RLS) symptoms are noted during wakefulness while PLMS occur during sleep.
The movements associated with PLMS often consist of flexion or extension at the ankle. In some cases, this may also occur at the knee. It may occur on one side or alternate back and forth between the left and right sides.
It tends to increase with age and often, but does not always, accompanies restless legs symptoms. If PLMS causes daytime impairment such asexcessive daytime sleepinessor significant sleep disruption and insomnia (even to a bed partner), it may be termedperiodic limb movement disorder (PLMD).
Diagnosis
The gold standard for diagnosis of PLMS is asleep studycalled apolysomnogram. As part of this study, superficial electrodes are placed on the legs and sometimes even the arms. These are able to detect any muscle contraction or movements.
In individuals with PLMS, there will be repetitive movements (at least four in a row) that may last from 1/2 second to 5 seconds. If these movements occur more than 15 times per hour in adults or 5 times per hour in children this is abnormal.
If the movements are associated with arousals or awakenings from sleep, they may be more significant. They also may be deemed important if they become disruptive to the bed partner. When they are noted in isolation on a sleep study without associated symptoms or impacts, no further treatment may be necessary.
Treatment
In general, it is not necessary to treat PLMS if the person affected does not have any complaints of sleep disruption. If it causes partial or total arousal from sleep, contributing toinsomniaor undermining sleep quality, then treatment can be considered. Also, if the movements are disruptive to a bed partner, it may also be desirable to get them under control.
Prescription medications can be effective in treating PLMS.Many of the drugs used to treat RLS are also helpful. These may include benzodiazepines (often clonazepam), Mirapex (generic name pramipexole), and ropinirole. These movements may also occur in relation to obstructive sleep apnea events, and then the treatment would target the breathing disorder.
A Word From Verywell
If your leg movements are disruptive to you at night, you should make an appointment to see a sleep specialist and have your condition properly evaluated. After a diagnostic study, the cause can be properly identified and the appropriate treatment may be pursued. As movements may also occur secondary to breathing events, it will be necessary to ensure that sleep apnea is not causing the disruption. Fortunately, effective treatment options can calm legs down at night and lead the rest that you need to function at your best.
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5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Walters AS, Rye DB.Review of the relationship of restless legs syndrome and periodic limb movements in sleep to hypertension, heart disease, and stroke.Sleep. 2009;32(5):589-97. doi:10.1093/sleep/32.5.589
Cleveland Clinic.Periodic limb movement disorder (PLMD) in adults.
Stefani A, Högl B.Diagnostic criteria, differential diagnosis, and treatment of minor motor activity and less well-known movement disorders of sleep.Curr Treat Options Neurol. 2019;21(1):1. doi:10.1007/s11940-019-0543-8
Cleveland Clinic.Periodic limb movement disorder (PLMD) in adults: Management and treatment.
American Academy of Sleep Medicine.International classification of sleep disorders.2nd ed.Lesage, S.et al. “The restless legs syndrome and periodic limb movement disorder: a review of management.“Semin Neurol. 2004;24:249.
American Academy of Sleep Medicine.International classification of sleep disorders.2nd ed.
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