RUNNING HEAD: Medical Disorders 2 Periodic Limb Movement Disorder & Restless Leg Syndrome Chelsea Reese The University of Alabama at Birmingham PSY 488: Kristin T. Avis, Ph.D., CBSM December 14, 2018 Abstract The restless legs syndrome (RLS) and periodic limb movement disorder (PLMD) can be separated but overlapping sicknesses. Both feature night-living happening by chance, without any planning occasional limb movements that can cause sleep disruption, but each has separate medicine-based features that are clearly connected with or related to the management of the patient. The cause of RLS is made by meeting established medicine-based judging needed things, not from discovery of occasional limb movements of sleep (PLMS) on a sleep study. PLMD does require the presence of PLMS on polysomnography as well as a connected sleep complaint. Both PLMS and RLS can happen with other sleep problems as well as in healthy people. Treatment of RLS is based on the pattern and extremeness of the problem, with rgic drugs generally liked for/preferred for first treatment. Anticonvulsants, pain-relieving drugs, and drugs that cause sleep also have a role. A treatment set of computer instructions is given to help with the management of RLS. Treatment of PLMD depends on many of the same medicines but is generally more plain/honest/easy and places a greater reliance on levodopa compounds and drug that calms or causes sleep. Periodic Limb Movement Disorder (PLMD) This disorder is characterized by repeated and uncontrollable movements of arms or legs occurring during sleep. This condition may affect the legs and arms and is sometimes confused with restless leg syndrome. This condition causes brief muscle twitches and leg kicks. The involuntary movements of limbs causes sleep disturbances or insomnia and a child suffering from this condition usually experiences other mental, physical, behavioral or social problems seen during the day. As a result of disturbed sleep at night, the child may experience daytime sleepiness. However, the exact cause of this problem is not known but is associated with a family history of this condition. Low iron levels, nerve problems, poor blood circulation and kidney disorders are also common causes of this problem. This condition is also associated with other sleep problems such as narcolepsy and restless leg syndrome To diagnose this problem, a parent may notice the signs at night when the child is sleeping, an overnight sleep study is often required to confirm the diagnosis along with other medical and physical examination such ad blood tests to determine the iron levels. Treatment Children and adolescents with PLMD are advised to have good sleep hygiene by having enough sleep and having regular sleep patterns, the children should also avoid caffeine as it worsens the symptoms of PLMD. In case the iron level are.

1. RUNNING HEAD: Medical Disorders 2
Periodic Limb Movement Disorder & Restless Leg Syndrome
Chelsea Reese
The University of Alabama at Birmingham
PSY 488: Kristin T. Avis, Ph.D., CBSM
December 14, 2018
Abstract
The restless legs syndrome (RLS) and periodic limb movement
disorder (PLMD) can be separated but overlapping sicknesses.
Both feature night-living happening by chance, without any
planning occasional limb movements that can cause sleep
disruption, but each has separate medicine-based features that
are clearly connected with or related to the management of the
patient. The cause of RLS is made by meeting established
medicine-based judging needed things, not from discovery of
occasional limb movements of sleep (PLMS) on a sleep study.
PLMD does require the presence of PLMS on polysomnography

2. as well as a connected sleep complaint. Both PLMS and RLS
can happen with other sleep problems as well as in healthy
people. Treatment of RLS is based on the pattern and
extremeness of the problem, with rgic drugs generally liked
for/preferred for first treatment. Anticonvulsants, pain-relieving
drugs, and drugs that cause sleep also have a role. A treatment
set of computer instructions is given to help with the
management of RLS. Treatment of PLMD depends on many of
the same medicines but is generally more plain/honest/easy and
places a greater reliance on levodopa compounds and drug that
calms or causes sleep.
Periodic Limb Movement Disorder
(PLMD)
This disorder is characterized by repeated and
uncontrollable movements of arms or legs occurring during
sleep. This condition may affect the legs and arms and is
sometimes confused with restless leg syndrome. This condition
causes brief muscle twitches and leg kicks. The involuntary
movements of limbs causes sleep disturbances or insomnia and
a child suffering from this condition usually experiences other
mental, physical, behavioral or social problems seen during the
day.
As a result of disturbed sleep at night, the child may
experience daytime sleepiness. However, the exact cause of this
problem is not known but is associated with a family history of
this condition. Low iron levels, nerve problems, poor blood
circulation and kidney disorders are also common causes of this
problem. This condition is also associated with other sleep
problems such as narcolepsy and restless leg syndrome
To diagnose this problem, a parent may notice the signs at

3. night when the child is sleeping, an overnight sleep study is
often required to confirm the diagnosis along with other medical
and physical examination such ad blood tests to determine the
iron levels.
Treatment
Children and adolescents with PLMD are advised to have
good sleep hygiene by having enough sleep and having regular
sleep patterns, the children should also avoid caffeine as it
worsens the symptoms of PLMD. In case the iron level are low,
iron supplements are given to improve this condition.
Restless Leg Syndrome (RLS)
Restless leg Syndrome (RLS) is a neurological disorder
characterized by a need to move the legs in order to relive
uncomfortable feelings in the legs. These feelings may be
defined as tingling sensation or “creepy-crawly” feeling
(Kotagal, & Pianosi, 2006). When the child moves the leg, these
undesired feelings are often relived. However, these feelings
and sensations in the legs affect child’s sleep patterns and the
child suffering from this condition may have a hard time falling
asleep.
When sleeping, the child kicks and twitches the legs
affecting their sleep. The child may wake up feeling tired, the
child with this condition may not understand what is happening
but a parent or guardian may help to detect the problem.
The problem is usually genetic although other risk factors
such as iron deficiency, caffeine, and certain medications such
as Prozac may cause or worsen the condition. Symptoms
include, difficulty falling asleep, bedtime behavioral problems
such as difficulty falling asleep, day time problems such as
sleepiness during the day, mood and behavioral problems are
also common in children with RLS.
This condition is diagnosed after a history of symptoms is
described as well as a physical examination to rule out other

4. problems. An overnight sleep study may also be conducted to
evaluate the disorder. Patients with RLS are divided into
different treatment categories Intermittent RLS:RLS that is
troublesome enough when present to justify treatment but does
not occur frequently enough to necessitate daily therapy. Daily
RLS: RLS that is frequent and troublesome enough to require
daily therapy. Refractory RLS: Refractory RLS is daily RLS
that has been unsuccessfully treated with two classes of drugs
(one dopaminergic and one non-dopaminergic) at the correct
dose and for an adequate length of time.
Treatment
Treatment methods include; good sleep hygiene,
changing bedtime habits, reading bed time stories, avoiding
caffeine and reducing the discomfort with massages, cold
compressors to provide temporary relief. If the blood test
indicates that the iron levels are low, iron supplements are
recommended to increase the ferritin levels. Self-Treatment
consists of getting up and moving around it helps the unpleasant
feeling temporarily go away.
Periodic limb movement disorder (PLMD) and restless leg
syndrome (RLS) are sleep disorders that, at first glance, appear
to be the same thing. Both conditions are characterized by a
sleeper not being able to keep still. However, the two sleep
disorders are distinctly different. Diagnosing which condition a
patient might be suffering from is important is determining what
the best course of treatment might be.
PLMD is a condition in which a patient’s limbs usually, one or
both legs involuntarily and rhythmically move several times
during the night. These movements are different from the
normal spasms that might occur as someone tries to fall asleep
with PLMD, the movements cluster at periodic intervals during
the first non-REM stage of sleep. Periodic leg movement
disorder suffers often do not know they have the condition.
Restless leg syndrome is characterized by the uncontrollable
urge to move one’s legs or other limbs or parts of the body.

5. Sufferers of feel an uncomfortable sensation an unexplained
pain, or a crawling feeling in their legs during restful periods
including while trying to fall asleep.
The difference between these two sleep disorders is that PLMD
is an involuntary action in which the patient often sleeps
through an episode of leg movements. With RLS however
patients are awake the whole time and are jerking or kicking
their legs in an effort to overcome the discomfort their brains
are perceiving. So, in other words, restless leg syndrome keeps
the patient awake and periodic limb movement disorder occurs
when the patient is already asleep.
PLMD is often confused with restless legs syndrome (RLS) but,
while the two conditions often occur together, they're not the
same thing. While RLS can happen at any time, PLMD only can
affect sleeping patients.
An estimate of 1 million children of school age have restless leg
syndrome. Typically, restless legs symptoms are worse in the
evening, when the child is at rest, lying down, or sitting.
Treatments for PLMD and RLS can differ, although some drug
solutions do overlap for both disorders. The exact causes for
each are unknown, though certain medications, Parkinson’s
disease, and narcolepsy can trigger both disorders.
One similarity between PLMD and RLS that must not be
overlooked Fatigue and excessive daytime sleepiness (EDS) are
side effects of both disorders. After all, restless leg syndrome
prevents sufferers from falling asleep; periodic leg movement
disorder can prevent sufferers from getting a good night’s sleep
even after dozing off. Seeking a diagnosis and treatment is
important not only for sufferers of these disorders, but also for
sleep partners whose slumber is disrupted by the restlessness of
the person beside them. The mechanism is unclear but may
involve abnormalities in dopamine neurotransmission in the
CNS.
The role of the pediatric psychologist to determine diagnosis of
RLS is based primarily upon interview with the patient. A
clinical diagnosis of RLS can only made if patients complain of

6. four key symptoms which constitute the essential criteria.
Currently, there are no lab tests that can definitively confirm or
deny the presence of RLS. The use of sleep studies or a
suggested immobilization test may occasionally be helpful in
difficult cases by demonstrating the presence of periodic limb
movements. It has been proposed that response to a
dopaminergic medication can be formalized as a confirmatory
test. Treatment comprises the recognition and reversal of causes
and symptom control. For patients with mild or infrequent
symptoms, non-drug based options may be sufficient to provide
symptom relief. Pharmacologic therapy of idiopathic RLS is
designed to relieve the patient's sensory and motor symptoms
and sleep disturbances. Such therapy is symptomatic it does not
cure RLS but merely suppresses the disorder's unwanted
manifestations. Curative therapy may be available to treat the
underlying disorder in secondary RLS, such as iron deficiency
or renal failure. The first step in selecting RLS treatment is to
characterize symptoms according to intensity, persistence
circadian pattern of onset, and etiology (primary or secondary).
The role of the pediatric psychologist to determine diagnosis of
Periodic limb movement disorder (PLMD) is especially hard to
diagnose in kids because it sometimes takes years for specific
symptoms to show up. Often, children with PLMD are described
as "restless sleepers" by parents.
Parents with the condition have a 50% chance of passing it onto
their kids. The psychologist will also ask you about your child’s
sleep history and perform a physical exam to rule out other
medical conditions. A parent simply watching a child while he/
she sleeps is not good enough for a diagnosis of PLMD. The
best way to diagnose it is a sleep study.
During the sleep study the child will spend the night in a sleep
lab. Besides limb movements, polysomnography records eye
movements, brain activity, heart rate and blood pressure. It also
can tell how much oxygen is in your child’s blood and how
much air is moving through her nose while she breathes.

7. References
https://www.alaskasleep.com/blog/bid/285073/Periodic-Limb-
Movement-Disorder-PLMD-vs-Restless-Leg-Syndrome-RLS
Picchietti MA, Picchietti DL. Restless legs syndrome and
periodic limb movement disorder in children and adolescents.
Semin Pediatr Neurol 2008; 15:91.
https://www.everydayhealth.com/sleep/0613/how-restless-legs-
syndrome-affects-children.aspx