Sunday, February 21, 2010

PLMD, what?

At night we can hear Lil' Man kicking his mattress while sleeping.  He often wakes up with a sore leg.  I've mentioned the kicking to his pediatrician as well as to his case worker.  The pediatrician just brushed it off.

Tonight while laying in bed I heard him kicking and decided to Google "kicking during sleep"

I came up with Periodic Limb Movement Disorder (PLMD).  Does anyone have any experience with this disorder?  Do you all think its worth mentioning to the doctor again? Should I request a sleep study?

Keep in mind Lil' Man takes respidol at night to help him sleep.

Most parents have little knowledge or awareness of one of the major pediatric sleep disorders that can cause their child extensive daytime behavior problems and nighttime sleep problems or behavior problems: Periodic Limb Movement Disorder (PLMD). PLMD causes lots of bedtime resistance, difficulty falling asleep, or the child /teen refusing to go to sleep. Once the child / teen is asleep, then s/he exhibits lots of restless sleep, including frequent leg kicking or leg jerking movements, rolling around excessively, and moving arm or other body parts frequently that interrupts the child’s deep sleep. This interruption of deep sleep often results in the child feeling irritable, oppositional, tantrumming or expressing excessive frustration or anger in the daytime. Most of these children and adolescents with PLMD display many symptoms of Attention Deficit / Hyperactivity Disorder (ADHD) or may have a diagnosis of ADHD and are being treated for this disorder or other disorders like Oppositional Defiant Disorder, Conduct Disorder, or other mental health disorders. The good news is that if the Periodic Limb Movement Disorder can be corrected, and it is pretty easy to correct it, these other / adolescent exhibits any of these above-mentioned behavior problems or sleep behavior problems, please read the information below and find out how to screen your child and get treatment for PLMD:

Periodic Limb Movement Disorder (PLMD) is characterized by the periodic (every 20-40 seconds) and sustained (0.5-4.0 seconds in duration) contractions of one or both front leg muscles often causing unperceived arousals or awakenings from light or deep sleep. These contractions result in repetitive jerks for about 2 seconds of the toes, feet, legs, arms, and/or thighs, which often occur in stages 1 and 2 of NREM sleep and disrupt the quality of sleep. There appears to be a strong correlation between Periodic Limb Movement Disorder and ADHD based on initial research by sleep specialists. Sleep specialists and other experts in the field have not been able to determine if the Periodic Limb Movement Disorder causes some forms of ADHD, or whether they both exist simultaneously.

Many children and adolescents with Periodic Limb Movement Disorder display considerable amounts of oppositional behaviors and a very touchy, moody temperament due to not feeling rested when they awaken in the morning. This difficult temperament is caused by their frequent periodic limb movements in the night that prevent these children from getting into their deepest levels of sleep enough hours of the night so they do not feel rested the next morning. Many of these children also resist going to sleep or have difficulty falling asleep at night.

This sleep disorder is correctable or can usually be improved significantly with medication taken before bedtime that diminishes or stops the limb movements. Some sleep specialists are prescribing Neurontin, and some Clonadine or L-Dopa before bedtime. Neurontin and L-Dopa reduce or stop the periodic limb movements so that the student gets a restful night's sleep. The Clonadine helps the student fall asleep quicker so that s/he gets a longer night's sleep, although Clonadine does not stop the leg movements during sleep. Both Neurotin and Clonadine have been used successfully with children for several years, whereas L-Dopa use with children is newer with little known about long-term effects on children.


  1. very interesting. I know my nephew's neurologist insisted on a sleep study before he was medicated for ADHD.

  2. VERY INTERESTING! Yes, mention this to the Doc again. In fact, I would make an appt. today for asap. I am sure his forever parents will be thrilled if this is a result of some of his issues during the day. It makes total sense. I am copying this info and filing it in my office at work. This is brand new to me. Thanks for sharing!