Periodic limb movement disorder treatment

You also want to treat underlying OSA if the patient is not effectively treated with CPAP. A lot of times PLMD seen in combination with OSA improves without medications if the patient starts CPAP for OSA.

Also best to avoid caffeinated products and nicotine. Some SSRI may worsen symptoms of PLMD.

Be careful not to treat leg movements just because they are present during a sleep study. Treat them only if they are disturbing sleep and causing arousals

PLMD is relatively uncommon and the limb movements seen in PSGs are mostly due to underlying sleep disordered breathing. In the days when we were doing CPAP titrations routinely, we could clearly see resolution of the limb movements, in many cases, once CPAP was applied. Unfortunately, we don'`t have that luxury anymore. However, in some patients limb movements persist despite good control of SDB. As others mentioned in earlier posts, the key is to identify the following:

- poor clinical response to CPAP with persistent arousals despite good control of AHI

- concomitant RLS symptoms

Cheers!

Gabapentin, Horizant, Klonopin, Lyrica, or last resort Ultram or Narcotics. Dose only prior to bedtime.

Check for other underlying problems such as low iron and thyroid conditions.

Review the diagnosis. Try Sinemet an hour before bedtime.