Periodic Limb Movement

Guest JB · Post by **Guest JB** » Fri Nov 02, 2007 12:39 pm

I have been on CPAP for 6 months. Recently I've been feeling like I did before starting on CPAP. I have a hard time staying awake watching t.v. and usually fall asleep around 9. I average 7 hours sleep per night. My sleep study indicated that an additional factor causing fragmentation of my sleep was the presence of Periodic Leg Movements of Sleep (PLMS). If excessive daytime somnolence persists despite CPAP then there should be consideration for treating this disorder.

I called my family doctor and she recommended that I go see a neurologist. Why would she recommend this instead of prescribing something for the PLMS or sending me to a sleep doctor instead?

I use a RemStar Pro M Series with a pressure of only 6. I have my DME provider print out monthly reports. They always look good. My AHI is always below 4 and I have no large leaks.

dieselgal · Post by **dieselgal** » Fri Nov 02, 2007 1:31 pm

My PLMD is greatly improved because of CPAP and basically went away.
Have you considered tweaking your settings a little and seeing if that helps.
Maybe setting it at 8 for a week and see if you still have the problem?

Guest JB · Post by **Guest JB** » Fri Nov 02, 2007 2:25 pm

I will try that. I still wonder why a neurologist?

snork1 · Post by **snork1** » Fri Nov 02, 2007 9:31 pm

Often RLS/PLMD is unrelated to apnea.
CPAP(eventually dental device) didn't really affect my PLMD.
Make sure your iron levels are up to snuff, which can be a cause.

I am having good results using the homeopathic remedy by Hylands called "Restful Legs".
Its cheap to experiment with it at only $6 a bottle and no side effects.

I also tried some prescription meds but hated the side effects.

sharon1965 · Post by **sharon1965** » Fri Nov 02, 2007 9:38 pm

I called my family doctor and she recommended that I go see a neurologist. Why would she recommend this instead of prescribing something for the PLMS or sending me to a sleep doctor

...because if the plmd is a primary condition (ie. unrelated to or not caused by apneas) then it may be a neurological disorder, which doesn't explain why she doesn't just prescribe meds unless she just isn't familiar enough with the condition to be comfortable doing so, but that may be her reason for the referral to a specialist

kteague · Post by **kteague** » Fri Nov 02, 2007 11:28 pm

I have been treated for RLS/PLMD for nearly 10 years, and personally, I would not want my GP to handle that treatment. Not that my GP isn't great, I just prefer someone who sees a lot of this and is familiar with the management of these meds. A sleep doctor would be fine, but one with a neuro background instead of pulmonary with sleep training just seems a more logical fit to me (I know that's a generalization).

The most commonly used meds to treat limb movement disorders (dopamine agonists) act upon pathways of the brain that can be complex to treat effectively without causing other neurological and/or psychological side effects. I personally think your doctor did well in their referral.

Best wishes in getting your sleep straightened out.

Kathy

Slinky · Post by **Slinky** » Sat Nov 03, 2007 8:15 am

I concur w/KTeague. 100%. And for the same reasons she puts forth. Every med has possible side effects but when we're talking possible neurological side effects .... I prefer an experienced neurologist! (And I"m one who doesn't particularly this "fragmented" practice of medicine and find my most important doctor is my family doctor and I want him kept abreast of EVERYTHING by any specialist I see). I prefer to be seen as a whole, entire person and not a set of lungs, or intestines, or .... whatever.

Guest JB · Post by **Guest JB** » Mon Nov 05, 2007 9:07 am

Thank you for all your input. I'll call the neurologist today.

Also, I found out over the weekend that I can no longer change my pressure setting on my machine. I brought my smart card to the DME provider to download last Friday. Apparently they did something as previous to this I was able to change the setting. Is there any way to change it back without going to the DME?

Sundown · Post by **Sundown** » Mon Nov 12, 2007 4:46 pm

My legs were jumping like they were being electrocuted and I had tingly like seizures in my legs. No sleep.... horrible. I went to a Neurologist. He gave me .50 MG of Mirapex (dopamine drug) and it helped the first month and then after a few months.. I got not only used to the drug, but my RLS got WORSE. I also do not know if is coincidence but I have some heart palps now...be very careful when taking drugs that do something to the receptors of the brain...Requip too. One of the dopamine drugs, Permax has been taken off the market due to heart valve problems. After reading this, and thinking about my heart.. I got off Mirapex and went cold turkey and now I massage my legs and put Vicks on them at night when they get bad.

However both PLMD and RLS has gotten about 70% better since CPAP!!!!

Mask

Periodic Limb Movement

Periodic Limb Movement

PLMD and referral to neurologist