Page 1 of 1

Characteristics of PLMD/PLMs

Posted: Wed Nov 07, 2018 7:50 pm
by yawny
I’m wondering if people here could please help me by describing the characteristics of PLMD/PLMs beyond “involuntary movements during sleep”? For instance, I’ve heard it can occur in the torso area and wonder what that means. I don’t understand everywhere that it can occur in the body, and what is considered a part of PLMD/PLMs. Thanks in advance...

Re: Characteristics of PLMD/PLMs

Posted: Wed Nov 07, 2018 8:55 pm
by Rustsmith
The classical definition is that it is a periodic movement of the leg or ankle, can be sort of like tapping your foot, that occurs for a short period and then there is a quiet time before it happens again. This is the reason for attaching sensors to the calf muscles during sleep studies. It also has to occur during sleep, otherwise the movements would be due to something else.

I have not heard about PLMS of the torso. The requirement for periodic movement could be an issue. I can just imagine someone doing sit-ups while asleep :lol:. But with that said, my RLS spread to my arms and torso prior to any treatment, so maybe???

Re: Characteristics of PLMD/PLMs

Posted: Wed Nov 07, 2018 10:49 pm
by yawny
LOL, you made me laugh Steve. I despise doing sit-ups so maybe I was secretly hoping this dreaded disease would be doing me a favor? So to confirm (because I obviously get confused)…PLMD/PLMs occur only in the legs, and has to be a repetitive movement?

Does the movement always look the same as in a forward tapping of the foot, or can the foot move sideways?

Re: Characteristics of PLMD/PLMs

Posted: Thu Nov 08, 2018 12:32 am
by Rustsmith
I cannot be sure about always in the legs, but it must be repetitive. It does not need to be tapping, side to side or even flexing at the knee counts.

Re: Characteristics of PLMD/PLMs

Posted: Fri Nov 09, 2018 6:37 am
by sleepdancer2
For movements to be classified as a disorder (the D in PLMD) they have to meet a threshold of activity. Short of meeting that level, one can still have periodic limb movements. Doctors differ a bit on calling all limb movements that reach the threshold PLMD. Some do not classify them as PLMD if they are secondary to another sleep disorder. Mine have always called mine PLMD even though I have RLS and Sleep Apnea.

There are two primary characteristics of periodic limb movements - timing and appearance. Movements will be repetitive and rhythmic in nature. If one stays asleep without arousing, the timing will be surprisingly predictable. If one does become semi-awake, it may take a bit to get back to sleep and for the movements to get in sync again. The second characteristic is that the movements, once asleep, will be stereotypical in nature. They will look very similar. That look may be as small as a repeated flexion of the big toe, to a flexing of the foot, or even a bicycling motion of the leg. One's position can make a difference how the movements manifest. In general, the movements are initiated as a cramp-like tightening for a few seconds followed by release. While it is not as common, other parts of the body can be involved. At my worst when I was experiencing augmentation, at times my whole body would be active. Limb movements can happen while awake, though it is not common. It seems that is reported more when one is experiencing either a med side effect or augmentation on a dopamine agonist. If you could set up a camera to video yourself during sleep, you could get a good idea if PLMD is what you are dealing with.

Contrast these movements with movements during sleep from other causes. Those will be random in timing and appearance.

Re: Characteristics of PLMD/PLMs

Posted: Sat Nov 10, 2018 12:07 am
by ViewsAskew
In the past, I read the same as sleepdancer noted - it must be a joint - toe, ankle, knee, hip are most common, but can be wrist, elbow or shoulder.

Re: Characteristics of PLMD/PLMs

Posted: Sat Nov 10, 2018 8:04 pm
by debbluebird
Well, with those definitions, I don't have PLMD. I have spasms.

Re: Characteristics of PLMD/PLMs

Posted: Mon Nov 12, 2018 1:26 am
by sleepdancer2
Deb, all the standard descriptions of the movements go out the window when medication side effect or augmentation come into play. If you've seen my sleep video, my movements during augmentation look nothing like expected. I was accused of faking it because my movements did not fit "normal" descriptions. What does remain is the movements will still retain a pattern of some sort. An exception to that is if one never goes to sleep enough to establish a pattern.

Re: Characteristics of PLMD/PLMs

Posted: Thu Jan 10, 2019 8:15 pm
by srgraves01
My wife has told me that for years I would sometimes kick her so she had to put pillows between herself and I (I am grateful for such a patient woman). I also sometimes kick the wall. After augmentation I have had more movements in my hips and back. I remember a post by another member who described it as jack-knifing. That description fits me as well. Since augmentation I also have movements prior to sleep in several places as well and the number of places has increased over time.

Re: Characteristics of PLMD/PLMs

Posted: Fri Jan 11, 2019 1:45 am
by debbluebird
sleepdancer2 wrote:Deb, all the standard descriptions of the movements go out the window when medication side effect or augmentation come into play. If you've seen my sleep video, my movements during augmentation look nothing like expected. I was accused of faking it because my movements did not fit "normal" descriptions. What does remain is the movements will still retain a pattern of some sort. An exception to that is if one never goes to sleep enough to establish a pattern.


Turned out, mine are spasms caused by pinched nerves and spinal fluid cut off in my lower back. I had a fusion in Oct., they are getting better. Very seldom severe, mostly mild now with a few nights of no spasms at all.

Re: Characteristics of PLMD/PLMs

Posted: Fri Jan 11, 2019 3:22 am
by ViewsAskew
debbluebird wrote:
sleepdancer2 wrote:Deb, all the standard descriptions of the movements go out the window when medication side effect or augmentation come into play. If you've seen my sleep video, my movements during augmentation look nothing like expected. I was accused of faking it because my movements did not fit "normal" descriptions. What does remain is the movements will still retain a pattern of some sort. An exception to that is if one never goes to sleep enough to establish a pattern.


Turned out, mine are spasms caused by pinched nerves and spinal fluid cut off in my lower back. I had a fusion in Oct., they are getting better. Very seldom severe, mostly mild now with a few nights of no spasms at all.


My brother, too. For years he thought his "RLS" was just a bit different from the rest of us.