OSA and RLS/PLMS

[k.c.snorzalot]

Does anyone know if obstructive sleep apnea can contribute to Restless Leg Syndrome or Periodic Limb Movements in sleep.
I've been on CPAP now since March and have been having a lot of trouble with my legs especially at night. Sometimes it feels like a biting feeling and other times it feels kind of crawley. If I move my feet/legs around the feeling diminishes for a while, but then returns when I start to drift off again. Sometimes, I get these same feelings in my arms too, though not as consistantly as in my legs/feet. I never remember having this kind of problem before I started CPAP (and no, there aren't any critters in my bed contributing to the symptoms). I was just wondering if anyone here knew of any kind of link with apnea and RLS.

[Goofproof]

My wife and I both get RLS at times, a Magnesium tab, in 15 minutes the legs settle down. Cheap and effective fix. Jim

[Guest]

The following was posted by deltadave. He manages an accredited sleep lab and is an RT, RPSGT:

Hi all:
PLMS and OSA are entirely separate entities. A leg movement that is caused by the termination of a respiratory event should not be scored as a PLM, but rather an LM (Limb Movement). The disappearance of PLMS following successful CPAP titration would undoubtedly mean that the PLMS were not PLMS at all, but simply part of an overall body jerk accompanying the respiratory arousal. Actually, PLMS often increase in successful CPAP titration as the body is able to enjoy continuous sleep and the PLMS allowed to come to full fruition.
Since PLMS can be medically treated, it becomes important to be sure to differentiate them from LMs, which can not.
Further, PLMS by themselves are harmless. It is only when they cause arousals (listed in the sleep study as PLMAI, Periodic Limb Movement Arousal Index) that they need to be addressed. Usually we're looking at an index of >5.0 for treatment, and/or certainly, a complaint of excessive daytime sleepiness.
deltadave

and

<snip>

PLMs and OSA are not related. For a snapshot of a PLM take a look here:
PLMS
Limb movements that occur following respiratory events are called exactly that, LMs. And if all the LMs disappear with CPAP, then you KNOW they weren't PLMs. If anything, PLMs get much worse as the CPAP allows you continuous sleep and the PLMs are allowed to come to full fruition. You treat PLMs with drugs.
And actually, PLMs themselves are harmless, unless they cause an arousal, so look for your PLMAI. If it's >5.0 and you have EDS, think about treating the PLMs.
Did you see that subtle difference? Arousals don't cause PLMs, PLMs (may) cause arousals.

[cmsmws]

I have been diagnosed with both OSA and RLS. My Neurologist has stated that my BPAP treatment may help but I have not noticed any improvement and I actually think it has been made worse. I am slowly upping my prescription for REQUIP to treat my RLS. It hasn't helped yet but I am only getting started.He also stated that they could be a result of my OSA but I doubt this as they have not gotten any better. Hey at least they are both being treated by the same doctor and reduces the amount of sick time I have to take from work.

[slcoope]

I too have both OSA and PLM. I have taken medication for the PLM for years. About a year ago the medication didn't seem to be working. I went to my Pulmonary specialist who upped the prescription. Still no relief. I switched specialist and was sent for a new sleep study. The study showed my medication wasn't working and I had developed sleep apnea. The CPAP has taken care of the apnea. It has taken a year to find the right prescription to address the PLM. I am taking 1400 mg gabpentin nightly. It takes care of the PLM but I have had significant weight gain.

Always seems to be something.......