Periodic Limb Movement Disorder 
People with PLMD may be completely asymptomatic, or they may complain of either excessive daytime sleepiness or insomnia, or both. Limb movements can be severe enough to wake an individual from sleep, making it difficult to stay asleep for a significant duration and leading to excessive daytime sleepiness. Many patients who suffer from excessive daytime sleepiness do not know they are being aroused from sleep by periodic limb movements because they do not actually wake up. Rather, they will feel as though they have not slept well. These arousals can occur anywhere from five times an hour up to more than 50 times an hour, depending on the severity of movement.

As mentioned earlier, leg movements in PLMD are typically an upwardly flexed big toe and ankle. Sometimes the hip and knee are flexed and tightened as well.

Because periodic limb movements have been observed in patients with healthy sleep patterns, the claim that they predicate a higher incidence of sleep disorder is controversial. Some studies have shown no greater occurrence of PLMD in patients with insomnia than in those with sleep-wake conditions like excessive daytime sleepiness.


Restless Legs Syndrome 
People with RLS find it difficult to keep their legs still and must move them to alleviate the discomfort. The feeling is usually difficult for them to articulate because it is less of a throbbing or stabbing pain and more of a nonspecific discomfort. Many who experience RLS also experience generalized anxiety that results from the incessant need to change the positioning of their legs. Moving the legs, temporarily relieves the discomfort.

The intensity of RLS can vary significantly throughout the day. Many people have no symptoms at all until nighttime, when they attempt to sleep. The discomfort in the legs and the need to move them prevents them from sleeping. Other patients have severe symptoms all day long, which may affect work, travel, or the ability to concentrate.



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