restless legs, too

I'm not absolutely sure about this...trying to remember some things I've read... but it's my impression that PLMs happen more during the first several hours of sleep and often subside completely during the last half of the night.

I also seem to recall reading that PLMs don't happen in REM. REM is not deep sleep, by the way. Stages 3 and 4 are what are considered "deep sleep" or "slow wave sleep", I believe.

Another thing (I may be wrong about ALL this! lol ) is that PLMs don't have to be big, easily seen leg jerks, although they often are. I think they can also be very slight periodic twitches, like just the big toe, for example. Movements that might not be noticeable at all to a bed partner, yet the periodic movement of the big toe could cause arousals.

That's why they hook an electrode to each leg during a study. Even if the movements are too subtle to be seen on video, they'll be picked up through the PSG equipment and appear on the graph. Not all PLMs actually cause arousals (sleep interruptions that we often are not even aware of) even when they are obvious leg kicks, easily observed.

I had the unusual opportunity to watch quite a bit of the video of my sleep study the next day. Amazing to see myself "sleeping" through so many periodic limb movements...watching a leg (sometimes both) jumping abruptly every so many seconds under the bedcovers...forcefully enough to easily see the cover move. Over and over and over again, regular as clockwork both on the video and on the PSG graph. About half of those leg movements were associated with arousals, yet I was never wakened enough to be aware of any of them.

Even though I definitely have PLM, even with cpap going, the number of them actually associated with arousals that disrupt my sleep are apparently not enough to cause me any problem of sleepiness the next day. Am able to wake up refreshed and rested the next day.

However, after seeing the video, I can understand how PLM disorder could sure leave a person feeling worn out after a night's "sleep", if the person were having an arousal with almost every leg jerk.

Well dang! How do you know which one you have?

Min

..

RG - You're right. How limb movements manifest can be so diverse. My early PLMs were contractions, like a repetitive brief mild charley-horse, which a bed partner would not necessarily have noticed. Slept thru most of them just feeling restless until about 3-4am, when misery made me get up. They were in Stage 3 & 4 back then and EVERY time I fell asleep, but now are in Stages 1 & 2 only, are every 3 or 4 seconds and are a wild flailing as high as a couple feet off the bed, but don't happen every nite. I agree with those who don't want to take meds if they're not having arousals.

I am curious about the docs saying there is a correlation between the Ferritin level and RLS/PLMD. (I'm taking Iron now.) Was that true for you? I'm waiting to hear someone say they brought their level up over 50 and the RLS/PLMD symptoms went away. Ever heard anyone say that? I've read testimonials on here that Magnesium resolved RLS for some, but no "after" reports on the Iron.

Kathy

Sorry - thought I was logged in. That was me.

Which "which?" are you asking about, Minerva?

PLM vs RLS?

or

a PLM with arousal vs a PLM without?

or.... LM (limb movement) vs PLM?

"PLM"'s that show up during the diagnostic night could disappear completely during titration. It's my understanding that if that happens....if using cpap makes "PLM's" go away.... then the movements that were originally called PLMs in the diagnostic night (data gathering without cpap being used) weren't "PLM"s at all. They were really just LM's (limb movements) associated with the apneas and or hypopneas causing a limb movement when the brain aroused you to breathe. But, if the PLMs are still there while using cpap at the correct pressure, then they're really PLMs...which may or may not actually disturb your sleep enough to need medication for them.

Of course a person could have RLS, too; or "instead of."

How to know which of any of that is which? I guess that's where a doctor earns his money. If he knows....

kteague accidentally guested wrote:I am curious about the docs saying there is a correlation between the Ferritin level and RLS/PLMD. (I'm taking Iron now.) Was that true for you? I'm waiting to hear someone say they brought their level up over 50 and the RLS/PLMD symptoms went away. Ever heard anyone say that? I've read testimonials on here that Magnesium resolved RLS for some, but no "after" reports on the Iron.

Kathy

Kathy, I've read about the correlation of RLS and/or PLM and the ferritin iron levels. Haven't had my level checked (no doctor, no insurance) nor have I added any iron supplement or magnesium. I do take an excellent vitamin/mineral supplement every day. I haven't looked into adding more of either iron or magnesium. Unless I started having sleepiness symptoms I don't think I'll add anything that might unbalance the well balanced supplement I use now. But, yes, it would be most interesting to hear some "after" reports from anyone who got their ferritin levels up over 50 and had RLS and/or PLMs disappear.

I guess they'd know they had taken care of RLS since that's mostly a "while you're awake" phenomenon. Not sure how they'd prove they had dealt with PLM during sleep, short of another PSG. Of course being less tired and sleepy is the goal, so if they subjectively felt that was improved noticeably, that would be a good enough to report. Like you, I don't recall seeing such reports.

...

Hi, there is a website that gives some information on how to get relief from RLS.

Please contact me at winstoncrichlow@hotmail.com for the site since i don't know if i can post websites here. I'm new here.

Winston

Hi, the website for RLS/PLMD information is the California Restless Leg (RLS) Support Group (sorry, I don't know how to put in a link). If you query with your search engine it will come up. Also the Restless Leg Syndrome Foundation which also has good information....if you join you also get a really informative newsletter periodically, as well as information about their yearly conferences. I went to one once and it was very helpful.

Re: Ferritin levels. Mine are low, and maybe that contributes. Trying to get it up with supplements.

My neurologist/sleep doc says he does have some patients for whom taking iron has made a big difference....got rid of all symptoms and don't need meds. Wish it were me.

I believe that RG is right about the PLMD timing. But you can also have it before you go to bed, just sitting and reading or watching TV....or driving. Also RLS. Unfortunately for me, that describes my RLS/PLMD most of the time. And what makes it PLMD as opposed to just limb movements is that it is periodic in nature, not just one or two, but several and at intervals throughout the time you are having them (every 10-30 seconds not unusual)

I'm glad for all of you that it does not seem to disrupt your sleep or your partner.

It can be a life changing and "life threatening" disorder (it can make you want to jump off a bridge!!!!) when you cannot rest no matter what you do. I hope that none of you ever get to that point!

The last post was from me, sleepy gal, I got guested!

I just checked this thread and see my last post is not here. So here's the nutshell version.....

RLS: Movements involving primarily the lower limbs are voluntary, a response to discomfort to seek relief. No frequency pattern. Can happen when awake or asleep.

PLMD: Movements involving primarily lower limbs (but occasionally known to involve arms, trunk, & head) are involuntary, nearly always associated with sleep but can occur outside sleep, and have a uniform rythmic frequency pattern when fully expressed. (Mine used to be every 4 minutes - now every 4 seconds.) (It will not be right leg this jerk, left arm next jerk, left leg next jerk. More parts can join in, but the different parts will not take turns one at a time.)

A video tape can tell you the difference. Can you set a stop watch by the frequency of the movements? It's PLMD.