Periodic limb movement disorder

I am exhausted today and now I know why!

Periodic limb movement disorder (PLMD), also classified as nocturnal myoclonus, is a sleep disorder in which one or more of the subjects limbs will involuntarily move during sleep. The degree to which this occurs and its frequency varies. Some people with PLM’s will only experience mild symptoms such as slight twitches or ‘shudders’ (periodic limb movement syndrome (PLMS)), while others will have movements best characterized as thrashing or wailing. Those with extreme movements may find themselves waking up at their own movements, and will almost certainly disturb and arouse their partners. Couples are often forced to sleep in separate beds when one or both of them have advanced cases of PLM.

As an insomniac, I have difficulty sleeping, but on occasion, my husband randomly "jumps" throughout the night causing sleep even more difficult than normal. I always thought he was experiencing hypnagogic jerk, because I get those too. However, I am very aware of it, and he claimed he didn't know what I was talking about. I normal can nudge him and make him roll over and it stops, last night however, was unbearable. Ever 22-34 seconds, (yes, I counted) he would jerk and kick for just a second or so, but it was so frequent, there was no sleep for me. Unlike normal, nudging him or waking him up did no good, the moment he would fall back asleep again it would start all over. So, I got up and hit the internet.

In addition to actual physical movement of the limbs, many people with PLM will experience involuntary tightening or flexing of the muscles, which can be quite painful and disconcerting, and causes the subject to wake up at a high frequency. PLM can occur throughout the night, but in most patients occurs in batches, lasting from 30 minutes to 2 hours on average, with actual movements happening every 5 to 90 seconds during that span. Physical movements are likely to occur in both limbs, while involuntary tightening or flexing of the muscles is more likely to occur in just one limb. PLM typically occurs in the slow-wave phase of sleep just before the deep sleep of REM (rapid eye movement) sleep.

PLM has roots in other sleeping disorders, is more likely to occur in patients with those disorders. This includes the aforementioned RLS, as well REM sleep behaviour disorder and narcolepsy. Like RLS, it may also have a connection to low iron levels, specifically low iron levels in the brain.

Guess who is getting an iron pill today!

Has any one heard of this or experienced this?
www.sleepassociation.org...

For the record, he doesn't believe me.

reply to post by calstorm


Yes. My husband tells people he has to sleep in 'full body armor' since marring me.
A sleep study & neurological workup a few years ago finally gave a diagnosis, but no solution.

( There's a reason people own couches.... )

No solutions? That is unfortunate. I am getting ready to see if I can find any natural remedies online.

reply to post by calstorm


Parkinson or anticonvulsant medication is used for PLMD. Are you exclusively looking for 'natural' supplements?

Yes, it's a known diagnosis and quite common. I'm not up on either the AMA style recommendations for this or the alt-medicine ones though.

My advice is to get separate beds, preferably in separate rooms! Lack of sleep or being prevented from sleeping soundly is a form of torture and has been used as such in war.

It's not like you're going to have much of a sex life if you're exhausted and being chronically sleep deprived is a recipe for all sorts of other problems. I'll never understand married people simply presuming they have to put up with this because they're married.

Good luck on figuring out the treatment for it, it may take a while to see what works. Don't expect any 'cure' to work immediately and keep very aware of potential side effects. What modern medicine calls 'unusual moods' is code for 'extreme anger, suicidal impulses, screaming fits' for instance... just a warning. I would definitely try nutritional or alt-style supplements before I'd try anything needing an Rx.

reply to post by calstorm


I suffer from RLS.Restless leg syndrome. Not the same thing as this but just as annoying. RLS is
the urge to move your legs or twitching of the legs. It's a creepy crawling feeling most often brought on by the use of OTC sleep medication. It comes on at bedtime and lasts for a couple of hours sometimes affecting first one leg a d then the other. Dyphenhydromine will cause it as well as some other meds. I've switched to a doxamine succinate formula found in unisom and that seems to work for me. My husband does that jumping thing too. I tell him when you fall asleep you literally fall asleep.

When my RLS gets bad a simple aspirin tablet will most times help. Real aspirin not Advil or Tylenol. I got that off the net also a late night session. LOL.
I have no idea if it will help your husband but the article you linked says that people who suffer PML often also suffer with RLS syndrome.

reply to post by Lucid Lunacy


As he hasn't been seen by a Dr. yet, that would be the first route I would go.

reply to post by signalfire


I had never heard of it before.
Last night was the first night it ever got to the point it did. As I said, normally I can give him a little nudge and it wakes him up just enough to fall back asleep and that stops it. I definitely don't think we are at the point of sleeping in separate beds, as it isn't very frequent.

reply to post by calstorm


At the very least I would go get some labs done so you two can see any mineral/vitamin deficiencies.

reply to post by Lucid Lunacy


I will probably schedule an appointment tomorrow. Now whether or not her goes, that is another story.

A rheumatologist diagnosed me with fibromyalgia, and the neurologist said there was no such thing. She did extensive testing and diagnosed me with Seasonal Effective Disorder and RLS,and PLMD.

I was told it's because my brain doesn't make enough seratonin, and there is no chemical supplement. Just as well; I'm adverse to medication anyway.

I bought a full spectrum light box, and it has helped a lot. I think avoiding doctors helps, too. They charge an awful lot of money to run tests, just to tell you a) there's nothing they can do, or b) take these pills; they're expensive, possibly harmful, and no long-term studies have been done.

I really think a 'marriage bed' should have a pull-out trundle bed on each side, should one need to bail during the night!

reply to post by nugget1

I was told it's because my brain doesn't make enough seratonin, and there is no chemical supplement. Just as well; I'm adverse to medication anyway.

I bought a full spectrum light box, and it has helped a lot.

If you have SAD, as I do, I wouldn't necessarily attribute it to serotonin. Also you can take supplements/prescriptions that boost serotonin in the brain. Not sure why you were told otherwise...

Since the full spectrum light is helping I would think the issue is more likely Vitamin D. During the winter I went in to get my labs done and low n behold I was deficient in D and B12. Which makes sense with a lack of sunshine producing D. So I'd say during the darker months take a D sup [they are cheap] in addition to the full spectrum light. Honestly I just needed to bring my levels up with the sups and my winter blues went away.

For serotonin deficiency look into 5-HTP supplements. They were a godsend when I first researched them and then tried them; after living for way too many years in a northern climate, both my serotonin and Vitamin D3 levels were low; you can tell about the serotonin by a chronic blah mood and difficulty falling asleep or staying asleep.

Both supplements are cheap but read up about them first to understand them. Caveat with 5-HTP is that there are serotonin receptors in the small intestine right at the outlet of the stomach; in some people, the first dose or two of this causes extreme nausea (it's a normal feedback loop to the brain to get rid of poisons or bad food). It doesn't happen ever again after the first time or two, and the increased levels of 5-HTP are a natural antidepressant without side effects.

a reply to: defcon5

It happened once last week but, other than that it really hasn't happened in quite some time. The night I wrote this thread was the worst it ever happened and hasn't been like that since. I had just never heard of it before up to that point, I assumed it was hypnagogic jerks, but he had no clue it was happening.

Could sleep apnea be the reason behind being unable to fall asleep? I could see it being the cause of someone waking up after they fall asleep, but what about just straight up inability to fall asleep?

First off, apnea is not a “black and white” thing, it varies depending on numerous conditions. Age, weight, underlying lung dysfunction, tiredness, how relaxed the persons muscles are, position, etc... may all be factors in how bad the person has apnea at any given time. So for example, someone may only have apnea when on their back in Rem Sleep, another may only have it in Rem Sleep no matter the body position, while a third maybe only has it if they take a muscle relaxant, depressant, or is extremely tired or physically fatigued. There are a lot of factors that have to be taken into account, but essentially they come down to how much the tissue can clog up the airway. That is why a sleep study is always required to diagnose it.

So just because you don't notice it happening as much, doesn't mean that it may not be happening...
Now to answer your questions:

originally posted by: calstorm
I assumed it was hypnagogic jerks, but he had no clue it was happening.

Hypnic jerks only happen when falling into sleep. This is a “stage 1” issue, that should only happen at sleep onset. If its going on throughout the night then you have to look for another source. Even if it is a real hypnic jerk, the person should not be in “stage 1” later in the night, so you have to see what is making them not be in the correct sleep stage.

With that in mind, what you are describing is most likely not a hypnic jerk, its an “arousal” associated with another event that's causing it. Again this is most likely apnea.
I found this after a quick search on youtube, not the best example, but it should show you what an arousal might look like.

Some people move more violently after the arousal, and that can be interpreted as PLM's or Hypnic Jerks if you don't understand the underlying issue.

originally posted by: calstorm
Could sleep apnea be the reason behind being unable to fall asleep?
I could see it being the cause of someone waking up after they fall asleep, but what about just straight up inability to fall asleep?

You don't have a single stage of sleep, you have 5 (technically they have moved it back to 4, but classically its 5). Stage 1 is of course the lightest, and what you experience as you are drifting off to sleep. You might not even realize that you are asleep in stage one. You ever been so tired that you are talking with someone, and the next thing you know you're spewing nonsense? That is where you've entered stage 1 sleep. So now, if you have apnea, you can enter stage one sleep (which to you might still feel like you're awake), your O2 drops, and you snap back into being awake. If you “float” like that for hours, between stage 1 and wake, it will feel like insomnia to you, but if I put you on a polygraph I could show where you dosed off, choked, and woke up again.

Believe me, this got to be a major problem in the medical field, which is why all your “sleep aids” now say that you should have a sleep study done before being prescribed. What was happening is that older folks (especially) would compare their symptoms with their friends, who would suggest that their doctor gave them some miracle drug to help them sleep. That person would self diagnose as having insomnia, go to their family doctor and ask for the same med. Often that doctor would just prescribe it based on the patients request (family doctors historically know very little about sleep or apnea). Ultimately though its a depressant, and makes the apnea worse, the periods of apnea longer, and can lead to a very dangerous situation. Most likely, countless people died in their sleep from heart attacks caused by this very issue, but of course its impossible to prove this to be true. However, that's why if you get a sleeping pill now it says on the label that you should have a sleep study run before using it.

Anyway, hope that helps and answers some of your questions.