Introduction:
The periodic limb movement
disorder is
a condition in which the jerking of limbs occurs during sleep. The repeated
movement with specific intervals of time has been noticed in the patients.
Usually, the episode of the movement is repeated after every 20-45 seconds. The
repeated movements cause the disturbance in the sleep and make the patient
awake during the night. That is why the people suffering from PLMD have been
found sleeping during daytime.
Usually, the term periodic limb movement
disorder is
mixed with restless leg
syndrome because the leg movement is involved in both
the cases. However, you must understand that the episodes of PLMD go on during
sleep whereas restless leg syndrome is a sensory disorder which occurs during
awakens.
Who is susceptible to developing PLMD?
Certainly, it is
complicated to conclude that which age group is likely to develop PLMD because
the cases have been found in every age group. However, the research showed that
people of middle and old age group are more susceptible to developing periodic limb movement
disorders.
The probable causes of periodic limb movement disorder:
The PLMD has been
classified as primary and secondary according to the causative factors. In both
types, the patient shows the same reaction, and the signs and symptoms are
almost same.
Causes of Primary PLMD:
The actual reason for
developing primary PLMD is still unknown. The concept of stimulation of nerves
is closer logical. Due to different reasons, the nerves pass false signals
which cause movement of the limb. It might be due to any abnormality in the
nerves traveling from the brain to the extremities.
Causes of Secondary PLMD
The secondary periodic limb movement
disorder
has been found for different reasons. Most of the causes of secondary PLMD are
associated with pathological and degenerative changes. There are also some
neurological and psychiatric problems which cause periodic limb movement
disorder.
In the following bullet points, you can read some common health issues in which
you may notice limb movement disorder along with other symptoms.
·
The Diabetes Mellitus is a well-known health problem in the world
which is caused due to different reasons. In most of the diabetic patients, periodic limb movement
disorder
has been reported along with other symptoms. However, how diabetes cause PLMD
is still unknown.
·
As you know, the limb movements are associated with brain and
nervous system. The nervous system is linked to spinal cord. Different types of
spinal problems cause PLMD. The underlying reason is the impaired nerves due to
compression or injury. So, you may note the limb movement issues in the
patients have disc degeneration/herniation, spinal tumors, and spinal injuries.
·
Sleep apnea and anemia are the two reasons which cause periodic limb movement
disorder
with the same phenomenon. Basically, in both the cases, the supply of oxygen to
the tissues is reduced which causes limbs movement during sleep. Sleep apnea
syndrome causes difficulty in breathing which causes the reduction in the
supply of oxygen. Similarly, in anemic cases, the oxygen-carrying capacity of
the blood is reduced. The low hemoglobin level in the blood indicates the
anemia in hematology test. The deficiency of oxygen directly affects the brain,
and you see the periodic limb movement disorder in such cases.
·
Adverse effects of the medication may also cause secondary PLMD.
The patients using the narcoleptic, antidopaminergic and antidepressant
medicines have been reported with limb movement disorders during sleep.
·
The withdrawal effects of sedative drugs like benzodiazepine and
barbiturates may also cause PLPMD. Usually, the drugs dependents, using any of
these drugs are more susceptible to developing periodic limb movement disorder. However, the episodes
are short because the patient revives when the withdrawal effects subside.
Signs and symptoms of PLMD
Hence there are no
certain signs and symptoms of periodic limb movement disorder other than strange movements. Usually,
the patient is unaware of the situation and completely asymptomatic because it
happens during deep sleep. Being a roommate or life partner, you may note the
unusual periodic movements. However, you may note some behavioral changes in
the patients.
·
The consistent increase in the sleep hours can be observed in the
patients of PLMD. Usually, the complaints of daytime sleep may be increased.
·
Due to lack of sleep, the patient cannot maintain the usual behavior.
Patient shows lack of interest in routine activities. There may be the lack of
interest in games and parties.
·
The onset of periodic limb movement occurs only during sleep. The
unusual changes which you can note in the people of PLMD are ankle joint and
toe movement.
·
In severe cases, the strenuous movements of arms and legs have
been noticed. Moreover, you may also note the jaw and nasal movements in the
patients. Even, a group of various movements can be observed in PLMD. However,
it is very astonishing that the patient does not know about these movements at
all.
Effects of periodic limb movement disorder on your health:
The periodic limb movement
disorder
affects the general health because of poor sleep which further causes insomnia.
Usually, the patient does not know about the occurrence, but he/she wakes many
times after the episodes. The patient looks tired/confused and prefers to sleep
during daytime. This irregularity in rest and work hours affects his/her health
and behavior.
Although the periodic
limb movement does not cause any further disease, it can aggravate the
preexisting conditions. Lack of sleep and exertion may cause weakening of the
body systems including digestive and nervous systems. Moreover, the immune
system of your body is also affected by PLMD.
Usually, the patient
tries to complete the required sleep during daytime. However, if he/she is
unable to take adequate his/her rest, the symptoms of other sleep disorders may also appear. Even, the patient may develop mental
health problems associated with the sleep deficit.
Diagnosis:
As you have read above,
the patients do not know the onset of the illness. His/her life partner or
roommate can note his/her unusual movements. He/she can provide useful
information regarding the episodes and nature of movements. The polysomnogram
and bioelectrical process to record the sleep are helpful to diagnose the case.
In this connection, you may consult the sleep technicians.
Management of periodic limb movement disorder cases:
As you have read above,
there are two classifications of periodic limb movement disorder; the primary and the
secondary. You can manage both the disorders by treating the causative
elements. Although, the concerned specialist (psychologist, psychiatrist, etc.)
can give you better advice; however, here are some important points that may
help you manage the PLMD cases more efficiently.
Management of Primary PLMD
The cause of primary
PLMD is still unknown, but some research shows that there may be neurological
or psychological issues that cause generation of false singles to the nerves.
Moreover, sleeping with wrong body position may also stimulate the nerves to
move the limbs. So, the movements may be minimized by training the patient to
adopt correct body position while sleeping. You can add some special pillows
and pads in the bedding. As far as the psychological issues are concerned, you
may consult the psychologist for expert advice.
Management of Secondary PLMD:
The secondary periodic
limb movement is caused due to certain diseases. You have already read about
some of the diseases. Here are some important points that you need to consider.
·
In diabetic patients, the onset of the disease starts due to
negligence because the sugar level in the body is disturbed. If the patient is
taking regular medication, the chances of onset are rare. So, if you are the
known case of diabetes mellitus, get your medicines regularly as per your
physician’s advice.
·
You have also read that the adverse effects of medication like
narcoleptic, antidopaminergic and antidepressant may cause PLMD. If you think,
the issue started after taking a particular medicine, consult your physician
immediately. He may recommend any alternative drug for you.
·
The periodic limb movement disorder caused due to the withdrawal of sedative drugs
is a temporary issue. It happened with every drug dependent during cessation
program. So, don’t worry. It will be normalized when the urge of the drug is
treated.
Do you think you are showing
symptoms of periodic limb movement disorder? What have you done to treat
your symptoms?
