Periodic limb movement disorder

Periodic limb movement is characterized by periodic episodes of repetitive and highly stereotyped limb movements that occur during sleep (12). It is reported to affect up to 34% of patients over age 60 years, and 1-15% of patients with insomnia. Movements are associated with partial awakening or arousals. Patients with isolated periodic limb movements in sleep (PLMS) without RLS may be asymptomatic. 

The prevalence of narcolepsy with cataplexy is 1 in 10,000 or 0.02% to 0.16% worldwide (69). Patients usually present with complaints of excessive daytime sleepiness before the onset of hypnogogic/hypnopompic hallucinations, sleep 

Prior to the use of wakefulness-promoting agents, and in some pediatric patients, maintenance of wakefulness is dependent on stimulant medications and antidepressants. The safety of such medications during reproductive years and the risk of driving accidents without medication are typically handled during discussions between the prescribing practitioner and the patient. Irritability, anxiety, and erectile or ejaculatory dysfunction have been reported with these medications (78). The costs of newly approved medications for the treatment of narcolepsy, 

Kryger M, Roth T, Dement W, eds. Principles and Practice of Sleep Medicine. 3rd ed. Philadelpia Saunders, 2000. 

Drowsiness Driving and Automobile Crashes NCSDR/NHTSA Expert Panel on Driver Fatigue and Sleepiness. 1999. (Accessed at www.nhtsa.gov/people/injury/ drowsy drivingl/drowsy.html.) 

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Insomnia secondary to a general medical condition, especially with pain- or sleep-disordered breathing Circadian rhythm disturbance Periodic limb movement disorder Restless legs syndrome... 

Periodic limb movement disorder (PLMD), originally described by Symonds as nocturnal myoclonus (11), was questioned as being an epileptic equivalent. Lugaresi et al. (12) demonstrated that it was not epileptic in nature and found a close association between it and restless legs syndrome. Guilleminault et al. (13) showed that it may be associated with insomnia, nocturnal sleep disruption, and daytime fatigue. Further studies have shown that periodic limb movements can vary greatly in severity. 

American Academy of Sleep Medicine (AASM) Report Standard of Practice Committee of the AASM Practice parameters for the treatment of restless leg syndrome and periodic limb movement disorder. Sleep 1999 22 961-968. 

Montplaisir J, Nicolas A, Godbout R, Walters A. Restless legs syndrome and periodic limb movement disorders. In Kryger NH, Roth T, and Dement WC, eds. Principles and Practice of Sleep Medicine. Philadelphia WB Saunders, 2000 742-752. 

Of the 88 sleep disorders listed in the International Classification of Sleep Disorders (12), the better-known and more prevalent disorders are the obstructive sleep apnea syndrome, insomnia, restless legs syndrome/periodic limb movement disorder, and narcolepsy (see also Chap. 5).These sleep disorders are common, and are known to interfere with the quality of sleep this chapter addresses the socioeconomic impact of these disorders. 

Ohayon MM, Roth T. Prevalence of restless legs syndrome and periodic limb movement disorder in the general population. J Psychosom Res 2002 53 547-554. 

The effective management of insomnia begins with recognition and adequate assessment. Family doctors and other health care providers should routinely enquire about sleep habits as a component of overall health assessment. Identification and treatment of primary psychiatric disorders, medical conditions, circadian disorders, or specific physiological sleep disorders, such as sleep apnea and periodic limb movement disorder, are essential steps in the management of insomnia [8],... 

Tabbal SD (2002) Restless legs syndrome and periodic limb movement disorder. Chapter 26. In T Lee-Chiong, MJ Sateia, MA Carskadon (eds) Sleep Medicine. Hanley Belfus, Philadelphia, PA, 225-236... 

Picchietti DL, Walters AS (1996) Severe periodic limb movement disorder in children and adolescents comorbidity with attention deficit hyperactivity disorder. Child Adolesc Psych Clin ofNA 5 729-740... 

The primary sleep disorders found in elderly that may lead to sleep disturbances are (1) circadian rhythm disturbances (CRD) (2) sleep disordered breathing (SDB) (3) insomnia and (4) restless legs syndrome and periodic limb movement disorder. 

Restless legs syndrome and periodic limb movement disorder... 

Periodic limb movement disorder—previously called nocturnal myoclonus. 

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