NEED Help with PLMD for wife ,What medicine?

[th]

My wife's original sleep study had 7 arousal per hour from periodic limb movement. The sleep doctor said that was not enough to treat her for PLMS. She is still not feeling rested and has been on cpap for over 1 year. I can tell you that she twitches and jerks all night long. What I notice when I am awake.What medicine would you recommend for PLMS she could get her primary doctor to call in and try? additional note:The only medicine she takes is Lexapro........ this is not taken for PLMD
thanks
th

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CPAPopedia Keywords Contained In This Post (Click For Definition): Arousal, CPAP

[sleepyred]

Has her ferritin level been checked? My iron on my regular CBC came out fine, but when the sleep doc did a ferritin specific blood test - my level was 13 - one point away from anemia. He told me that my level needs to be 60! He put me on Klonopin (a benzo) for Restless Legs (I don't know the difference between RLS and PLD). If you read in a PDR about Klonopin - it is used for RLS. I also have inner-ear problems which this helps as well. There are other drugs out there for RLS (anti-parkinson's ones) but I'm afraid to take them because my dad had parkinson's and had bad reactions after taking his for a long period of time.

I am also on an iron supplement (which I would not suggest anyone take without having a doctor tell you to!) and my iron is now at 30. I need to have it checked again.

I don't know how old your wife is and am not asking, but my cycles were so heavy that was making my iron dip as well.

[Sleepless on LI]

th,

At my study, I had 14+ per hour PLMs. That was night 1. Night 2, on cpap, they seemed to disappear (according to them, and I think they did a great study).

When they were beginning my treatment and I was waiting for the equipment, I called my doctor and asked her why they weren't addressing the PLMs since they seemed worse than my AHI and were more of a cause for arousals. Her answer was to try the cpap for a month. If I didn't feel rested after that, she would put me on something to see if that was still a problem since a lot of times, therapy alleviates the occurences of PLMs. Fortunately, I didn't feel I needed it after one month.

However, that changed as time went on and I'm now on Requip every night. When I was out of my medication for a week this past month, I could feel the difference when trying to fall asleep and am so glad to be back on it. It does help make me tired, also, which I think helps me with my sleeping.

I've also heard that Mirapex, which is also a Parkinsons med., can help, besides the Klonopin as mentioned above. Plus, check your wife's iron levels as that has been said to cause RLS, when the iron level is low. I constantly suffer from anemia and now take Slow-Fe to try to keep from being deficient.

Good luck and I hope she feels better soon. Happy Holiday.

[kteague]

Hi. Hopefully you've searched this forum for PLMD and RLS posts to read what's already been said. My info would come up in that search. What I wanted to point out is that a tech told me that the number of times per hour calculated on all sleep time might not look like much, but if it was all during a certain stage of sleep and calculated on that time it might be surprising how frequent the movements are. I have taken Sinemet, now take Mirapex. Fairly effective.

Kathy

[jdschooler]

Clonazepam (which is very cheap) has worked better for my wife than any of the high priced new meds. Plus it's additave sedative effects help a little with the sleep part. She has to take it about 2 hours before bed or else she just lays in bed twitching and kicking her nervous legs. She is not diagnosed with OSA yet though. It could increase the Apnea or hyponea episodes theoreticly in someone with Sleep Apnea.....

[snork1]

The doc gave me a script for gabapentin for my twitchiness at night.
I don't like the stuff since I often wake up groggy, so I save it for really twitchy nights.

I try to minimize my need by getting exercise, doing a quick leg massage just before going to sleep and taking some calcium before bedtime (in addition to a melatonin and an aspirin). Some but not all nights thats enough.

I had my iron checked and I an normal range, but definitely get that checked since that can cause the same symptoms.

[Guest]

hi--

clonozepam is generic klonopin. either one has been the standard treatment for both pmld and rls. the difference between rls and pmld is that rls is specifically confined to the legs theoretically and is more intense than pmld. also, docs have used the anti-parkinson drugs for pmld and rls. the problem with klonopin or clonozepam is that it can be very rough to get off of--there can be lots of nasty withdrawal symptoms. personally, i would be very reluctant to take klonopin because of its withdrawal symptons to go off. of course, if you take it forever, as some people do, that's not a problem. klonopin or clonozepam is a long-acting benzo; it may be the longest acting there is.

there is a new drug i have seen advertised recently that is specifically for rls or pmld, which i would check out if i were you. i have no idea what it's efficacy rate is or how it differs from the others, only that sleep docs aren't too thrilled with either klonopin or the anti-parkinson's. but they haven't had anything else.

you might want to see if your wife can get another sleep study if she hasn't been diagnosed for apnea. pmld or rls is easy unless it's an extreme case--all they're gonna do is give you drugs for it. but i was initially diagnosed in a snooty sleep lab for pmld. the drugs only helped me get to sleep but didn't help the quality of my sleep. dissatisfied, i went to a less snooty sleep lab where the doc couldn't believe that the first lab had missed my apnea. he said the pmld was just a response to my apnea--i was moving around a lot because, he thought, i was having trouble finding a position where i could breathe comfortably. since i have become cpap compliant, i have given up the sleep drugs. i find the air etc relaxes me even though the mask is no fun. so although i used to have a lot of trouble finding a good sleep position, i no longer do.

so those are just some thoughts for you.

caroline

[kteague@fuse.net]

In the different web sites and even news reports I've read, there seems to be some crosssover in how the terms are used and even some discrepancies in the information. I have both diagnoses, and two of my doctors have even used the terms differently. The impression I've come away with is that RLS is a vast array of uncomfortable sensations with the intense need to move that happens when resting prior to sleep. The RLS sufferer consciously feels the need to move and says "I must move and I must move NOW'" PLMD/PLMS(leep) is not a conscious compulsion to move, the movements have a mind of their own and just happen - rythmic (periodic) stereotypical involuntary movements, not the same as occasional or random limb movements that can be related to sleep phase transitions or other stiimuli. PLMD/S involves primarily the legs and to a lesser degree the arms. When limbs are in positions where they can't jerk, I have had my body come up off the bed. Even have had rythmic head jerks.

Hope I haven't muddied the water more.

[sleepyred]

My sleep study showed no PLMD or RLS. When my sleep doc said this, my dear sweet hubby said "but I've slept with her for 18 years, she puts her feet between the mattress and footboard, and shakes the entire bed - completely waking me up. She does this 4-5 time a week."

Luckily, my sleep doc said "I'll take your word (for 18 years) over a sleep study any day of the year." I can tell prior to bed time if I will have RLS, my legs get tingly, I pace, and I just can't sit still.

I have an appt. to see him in May and I am going to bring up the issue again - I did have surgery (of the female kind) in February and I think my iron has dropped again (will have that checked next week) and see what he says about meds to treat this.

I'll post when I know something.

[th]

Hey, I want to thank all of you for the great info. It is my wifes whole body that jerks and moves,her legs does move but I see her face even twitch. It gets so bad I cannot stay in the same bed with her. Her sleep doctor said she was only awaken by this 7 times and hour while using CPAP and that it was no big deal. My wife has been on cpap for 1 year now and is doing better but she still feels tired. She does not want to go back to her sleep doctor. I want her to try something for her PLMD and see if that helps and she has agreed. She just needs to know what medicine she can get her primary doctor to write out for her.
th