Periodic Limb Movement Disorder

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Houston Methodist sleep specialists will help you find the optimal treatment for periodic limb movement or restless legs syndrome. Our expertise will help return you to restorative sleep and a healthier quality of life. 

Experienced sleep disorder experts at Houston Methodist — one of nine sleep centers accredited by the American Academy of Sleep Medicine (AASM) — are highly skilled at diagnosing periodic limb movement disorder (PLMD) and restless legs syndrome (RLS).  

Our integrated sleep medicine and neurology team combines the expertise of physicians who specialize in brain and movement disorders. Using the latest diagnostic technology and research, we will design a treatment plan to improve involuntary, nocturnal muscle movements that disrupt your sleep.

Diagnosing & Treating PLMD

How is PLMD diagnosed?

The first symptom most patients with PLMD or their bed partners notice is involuntary limb movements during sleep. Movements often cluster at the beginning of slumber and can include anything from extending the big toe to flexing the knee or hip. Regular intervals of 20 to 40 seconds typically occur between movements.  

To be diagnosed with PLMD, patients must demonstrate involuntary limb movement at least four times in a row during sleep and have symptoms of restless legs syndrome, such as an uncomfortable tingling in leg muscles or nearly uncontrollable urge to move the legs. 

PLMD can occur on its own or result from medical conditions such as: 



To diagnose PLMD, our sleep experts will perform a physical and neurological exam. Next, we will schedule an overnight sleep study in our hotel-like sleep laboratory, where you will have a private, comfortable room.  

During the sleep study, we will monitor your movements and record your breathing patterns as you cycle through the stages of sleep. Your results will help our sleep medicine team determine whether you have PLMD or another condition that is causing your symptoms. 

What treatment options are available?

Before beginning treatment for PLMD, we will address any underlying conditions first. In some patients, PLMD symptoms resolve once the underlying cause has been treated. 

Patients with PLMD who sleep through their involuntary movements may not require treatment. However, most people experience repetitive "micro-arousals" throughout the night, preventing them and their bed partner from getting adequate sleep. These patients may benefit from making small daily routine changes or taking medication. 

Some patients get relief from behavior modifications such as: 


  • Eliminating caffeine and tobacco 
  • Exercising regularly 
  • Massaging the affected area 
  • Taking pain relievers 
  • Taking warm baths 
  • Using heat and ice packs


If these methods do not provide sufficient relief, medication may work by helping to: 


  • Increase calcium or iron levels 
  • Mimic the effects of dopamine in the brain (dopamine agonists) 
  • Relax the muscles 


Everyone responds to medication differently. Your doctor may recommend trying various treatments over time to pinpoint the most effective therapy for you. 

I am looking for advanced care or a second opinion.

Symptoms of PLMD are similar to those of restless legs syndrome. If you are being treated for RLS with limited results, or if your PLMD therapy is not providing sufficient relief, you may benefit from a second opinion from our integrated sleep medicine and neurology team. 

Sleep medicine specialists are an integral part our neurology department. By combining our expertise in the brain, respiratory system and heart, we offer precise diagnoses and personalized treatment that restores and optimizes your holistic sleep health.  

How Much Sleep Do You Really Need?

PLMD and RLS can cause significant sleep loss — how bad is that, really?

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