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Poor night’s sleep? Twitchy legs might be the culprit

From sleep apnea to blue light exposure, many things can keep people from a good night’s rest. Yet one of the most disruptive problems—limb movements—gets little attention outside physicians’ offices.

Restless leg syndrome (RLS) causes tingling, creepy-crawly sensations, shooting pain, or itching in the legs when people try to fall asleep. Moving the legs alleviates the feelings but makes it challenging to doze off. Periodic limb movement disorder (PLMD) causes patients to move during sleep, keeping them from resting fully or waking them up at night.

Anywhere from 4 to 11 percent of the U.S. population has PLMD, and 7 to 10 percent has RLS. The conditions overlap, so patients with one disease frequently have the other. Both are more common with age.

Because limb movement symptoms can be strange, patients often have a hard time describing the sensations or feel uncomfortable talking with their provider. They can fear appearing like a hyperactive kid who can’t control his or her legs. Or they may feel uncertain about what they are experiencing.

As a sleep medicine provider, I believe it’s important to get the word out that limb movements that disrupt or fragment sleep deserve to be addressed. Providers take these conditions seriously and can suggest treatment options that enable patients to get the rest they need.

When patients bring up sleep concerns, some of the questions providers ask are: Does your partner say you are an active sleeper? Do you wake up tangled in the sheets? Do you feel like your bed is a disaster in the morning? All of these things can point to PLMD.

Sleep experts have a number of options for treating limb movements. One of the first things we do is make sure other health conditions are well-managed. For example, some patients with sleep apnea move around at night. Properly treating this disease can calm their limb movements.

Next, we test for iron. Low blood ferritin levels can sometimes be the cause, and an over-the-counter iron supplement a simple solution. (However, it’s unhelpful and potentially dangerous to take iron if levels are already sufficient.) We examine prescription drugs to consider whether they should be adjusted.

Additionally, patients can benefit from non-invasive treatments. Regular exercise helps almost every sleep disorder. Avoiding caffeine, establishing a calming and regular bedtime routine, and improving other sleep hygiene measure can help too.

For many individuals, however, medications are the most effective solution. A provider can discuss benefits and potential side effects.

I encourage any patients who are experiencing limb movements or poor sleep to make an appointment with a primary care provider. A consultation is the first step in determining whether additional testing or a referral to sleep specialist would be beneficial. Good sleep is a quality of life concern. It makes a significant difference in how people feel during the day, so I always encourage patients to seek solutions for sleep concerns.

Physician Assistant JD Sandhu’s priority is to help improve his patients’ sleep quality and, therefore, their quality of life. He sees patients with a variety of sleep-related issues, but he has a special interest in sleep apnea, insomnia, and restless leg syndrome.