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Table of Contents

Types

Symptoms

Causes

Diagnosis

Treatment

Prognosis

Periodic limb movements of sleep (PLMS) and periodic limb movement disorder (PLMD) are conditions that cause recurrent involuntary movements during sleep. Sometimes PLMS can be part of other sleep disorders, such asnarcolepsyorrestless legs syndrome(RLS). Rarely, PLMD can occur without another sleep disorder.

Excessive limb movements during sleep can cause daytime sleepiness. The diagnosis can involve a detailed medical history, as well as diagnostic testing with sleep studies. This article describes PLMS and PLMD, including the symptoms, causes, and treatments.

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A person’s feet extend from under blanket in a bedroom

PLMS describes movements that occur during non-rapid eye movement (NREM or non-REM) sleep.This is the non-dreaming phase of sleep.

When periodic limb movements are a recurrent problem during sleep, the condition would be defined as PLMD.

The 4 Stages of Sleep

The main symptoms of PLMD are fatigue and daytime sleepiness. Some people may also experience morning headaches. These symptoms occur because the limb movements that occur during sleep can prevent your sleep from being as restful and efficient as it normally would be.

The NREM sleep stages are stages of sleep when you aren’t dreaming. It’s normal to toss and turn during NREM sleep. The movements that are defined as periodic limb movements of sleep include jerking, twitches of the limbs, and muscle cramping—which are different from the typical tossing and turning of the NREM sleep stages.

Associated Symptoms

It’s common for PLMS to be part of another sleep disorder. When someone has periodic limb movements during sleep as part of another sleep disorder, the symptoms of the underlying sleep disorder can be more noticeable than the periodic limb movements that happen during sleep.

Symptoms can include:

Anyone can occasionally experience periodic limb movements during sleep, even without any underlying sleep disorder. Some people might have limb movements during sleep due to short-term sleep deprivation, medications, or a night of insomnia.

These movements can also be recurrent as part of certain sleep disorders. Rarely, the movements are a chronic problem without a risk factor or another sleep disorder.

Conditions associated with periodic limb movements during sleep include:

Medications that can increase the risk of limb movements during sleep include antipsychotics, anti-seizure medications, orselective serotonin reuptake inhibitors (SSRI)andserotonin and norepinephrine reuptake inhibitors (SNRI) antidepressants.

PLMS is diagnosed based on a medical history and testing. You would not notice that you are experiencing limb movements during sleep, but if you have a partner who shares a bed with you, they might notice. Often, sleep disorders are considered when someone has symptoms of excessive daytime fatigue.

During an evaluation for a possible sleep disorder, you might be given questionnaires, such as thePittsburgh Sleep Quality Index(PSQI), which includes questions about the quality of sleep and time spent asleep. Apolysomnogram (sleep study)includes an assessment of movements during sleep and can detect jerks and twitches that occur during NREM sleep.

What Is a Polysomnogram Sleep Study?A polysomnogram is a noninvasive, multifaceted sleep study that uses:Electroencephalogram: To assess the time spent in each sleep stageNoninvasive electrodes: To evaluate muscle movements during sleepPulse oximetry: To measure blood oxygen saturation

What Is a Polysomnogram Sleep Study?

A polysomnogram is a noninvasive, multifaceted sleep study that uses:Electroencephalogram: To assess the time spent in each sleep stageNoninvasive electrodes: To evaluate muscle movements during sleepPulse oximetry: To measure blood oxygen saturation

A polysomnogram is a noninvasive, multifaceted sleep study that uses:

Differential Diagnosis

A key feature of periodic limb movements of sleep is that the movements occur during NREM sleep, which can help differentiate this condition from similar sleep issues.

Other sleep-associated movement disorders that might be considered during an evaluation of periodic limb movements of sleep:

RLS and PLMSPeriodic limb movements during sleep are part of RLS, but many people who have periodic limb movements during sleep do not have RLS.

RLS and PLMS

Periodic limb movements during sleep are part of RLS, but many people who have periodic limb movements during sleep do not have RLS.

There are several treatment approaches for PLMS. Your healthcare provider might recommend a combination of methods.

Treatments can include:

The movements are not harmful, but the consequential daytime fatigue can interfere with the quality of life. Periodic limb movements of sleep can improve with treatment.

Summary

PLMS can occur as part of PLMD or due to other sleep disorders or medical conditions. The movements include jerking, muscle cramping, or twitching during the non-dreaming phases of sleep and may cause daytime fatigue. If you experience daytime sleepiness, you should see a healthcare provider.

There are many causes of fatigue. A medical history and physical examination can help narrow down the causes. Sometimes an evaluation for sleep disorders can involve a nighttime sleep study, which can often identify movements during sleep, and may help with diagnosing periodic limb movements.

Sleep Disorders

5 SourcesVerywell 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.Urtnasan E, Park JU, Lee JH, Koh SB, Lee KJ.Deep learning for automatic detection of periodic limb movement disorder based on electrocardiogram signals.Diagnostics (Basel). 2022;12(9):2149. doi:10.3390/diagnostics12092149National Institute of Neurological Disorders and Stroke.Restless leg syndrome.Delrosso LM, Lockhart C, Wrede JE, et al.Comorbidities in children with elevated periodic limb movement index during sleep.Sleep.2020;43(2):zsz221. doi:10.1093/sleep/zsz221Kouri I, Junna MR, Lipford MC.Restless legs syndrome and periodic limb movements of sleep: from neurophysiology to clinical practice.J Clin Neurophysiol.2023;40(3):215-223. doi:10.1097/WNP.0000000000000934Hoxha O, Jairam T, Kendzerska T, et al.Association of periodic limb movements with medication classes: A retrospective cohort study.Neurology.2022;98(15):e1585-e1595. doi:10.1212/WNL.0000000000200012

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.Urtnasan E, Park JU, Lee JH, Koh SB, Lee KJ.Deep learning for automatic detection of periodic limb movement disorder based on electrocardiogram signals.Diagnostics (Basel). 2022;12(9):2149. doi:10.3390/diagnostics12092149National Institute of Neurological Disorders and Stroke.Restless leg syndrome.Delrosso LM, Lockhart C, Wrede JE, et al.Comorbidities in children with elevated periodic limb movement index during sleep.Sleep.2020;43(2):zsz221. doi:10.1093/sleep/zsz221Kouri I, Junna MR, Lipford MC.Restless legs syndrome and periodic limb movements of sleep: from neurophysiology to clinical practice.J Clin Neurophysiol.2023;40(3):215-223. doi:10.1097/WNP.0000000000000934Hoxha O, Jairam T, Kendzerska T, et al.Association of periodic limb movements with medication classes: A retrospective cohort study.Neurology.2022;98(15):e1585-e1595. doi:10.1212/WNL.0000000000200012

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.

Urtnasan E, Park JU, Lee JH, Koh SB, Lee KJ.Deep learning for automatic detection of periodic limb movement disorder based on electrocardiogram signals.Diagnostics (Basel). 2022;12(9):2149. doi:10.3390/diagnostics12092149National Institute of Neurological Disorders and Stroke.Restless leg syndrome.Delrosso LM, Lockhart C, Wrede JE, et al.Comorbidities in children with elevated periodic limb movement index during sleep.Sleep.2020;43(2):zsz221. doi:10.1093/sleep/zsz221Kouri I, Junna MR, Lipford MC.Restless legs syndrome and periodic limb movements of sleep: from neurophysiology to clinical practice.J Clin Neurophysiol.2023;40(3):215-223. doi:10.1097/WNP.0000000000000934Hoxha O, Jairam T, Kendzerska T, et al.Association of periodic limb movements with medication classes: A retrospective cohort study.Neurology.2022;98(15):e1585-e1595. doi:10.1212/WNL.0000000000200012

Urtnasan E, Park JU, Lee JH, Koh SB, Lee KJ.Deep learning for automatic detection of periodic limb movement disorder based on electrocardiogram signals.Diagnostics (Basel). 2022;12(9):2149. doi:10.3390/diagnostics12092149

National Institute of Neurological Disorders and Stroke.Restless leg syndrome.

Delrosso LM, Lockhart C, Wrede JE, et al.Comorbidities in children with elevated periodic limb movement index during sleep.Sleep.2020;43(2):zsz221. doi:10.1093/sleep/zsz221

Kouri I, Junna MR, Lipford MC.Restless legs syndrome and periodic limb movements of sleep: from neurophysiology to clinical practice.J Clin Neurophysiol.2023;40(3):215-223. doi:10.1097/WNP.0000000000000934

Hoxha O, Jairam T, Kendzerska T, et al.Association of periodic limb movements with medication classes: A retrospective cohort study.Neurology.2022;98(15):e1585-e1595. doi:10.1212/WNL.0000000000200012

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