From the Guidelines
The term for involuntary limb movements during sleep is periodic limb movement disorder (PLMD) or restless legs syndrome (RLS), as defined by the American Academy of Sleep Medicine in their 2025 clinical practice guideline 1. The involuntary movement of limbs during sleep can be characterized by an urge to move one or both legs (and sometimes the arms) when immobile, which is relieved by movement and is most prominent in the evening or at night. Key features of RLS include:
- An urge to move the legs, usually accompanied by uncomfortable sensations such as dysesthesias
- Symptoms that are worse in the evening or at night
- Symptoms that are relieved by movement
- Symptoms that occur at least once a week, as defined by the American Academy of Sleep Medicine 1 PLMD specifically refers to repetitive cramping or jerking of the legs during sleep, occurring every 20-40 seconds. These movements can disrupt sleep quality and may be associated with other sleep disorders. The exact cause isn't always clear, but they can be related to certain medications, neurological conditions, or stress. Some key points to consider when diagnosing and treating PLMD or RLS include:
- A careful clinical history is imperative, as there is no objective test to aid in making a diagnosis 1
- Clinically significant RLS is a common condition, defined as occurring at least once a week 1
- Treatment options may include medications, reducing caffeine and alcohol consumption, and addressing underlying conditions that may be contributing to the symptoms.
From the Research
Involuntary Limb Movements During Sleep
The term for involuntary limb movements during sleep is referred to as Periodic Limb Movements of Sleep (PLMS) or Periodic Limb Movement Disorder (PLMD) 2, 3, 4, 5, 6.
Characteristics of PLMS and PLMD
- PLMS are characterized by involuntary limb movements during sleep, which can be accompanied by Restless Legs Syndrome (RLS) or occur independently 2, 3, 4, 5, 6.
- PLMD is a distinct sleep disorder that arises in individuals without RLS and is a diagnosis of exclusion 2.
- The clinical significance of PLMS has been argued, and most individuals with PLMS do not have RLS 2.
Diagnosis and Treatment
- Diagnosis of RLS and PLMD is based on clinical criteria, polysomnography, and the suggested immobilization test 4, 5.
- Treatment of RLS and PLMD includes dopaminergic agents, anticonvulsants, opioids, and sedative/hypnotics 3, 4, 5, 6.
- The choice of treatment depends on the pattern and severity of the disorder, as well as the presence of other sleep disorders or medical conditions 5.