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Are PLMS And Restless Legs Syndrome the Same Thing?

Written By Center for Vein Restoration
Blog Are PLM Sand Restless Legs Syndromethe Same Thing
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Peripheral neuropathy, chronic pain, and other issues involving circulation can significantly affect our quality of life. Two conditions surrounding sleep and blood flow often create confusion because they have similar symptoms and treatments: restless legs syndrome (RLS) and periodic limb movements of sleep (PLMS).

While these two conditions share some common signs and often occur together, it’s important to recognize that they are distinct conditions affecting the nervous system in different ways. Understanding the variances between them is crucial for effective treatment, particularly in the context of vein care.

Keep reading as we discuss PLMS and RLS, their similarities and differences, and their relevance to vein health.

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Understanding RLS

RLS, also called Willis-Ekbom disease, is a neurological disorder characterized by a strong urge to move the legs. According to the Mayo Clinic, it’s often accompanied by uncomfortable sensations such as itching, burning, aching, or crawling in the lower limbs. These symptoms tend to worsen during periods of rest or inactivity, particularly in the evening or at night, making it difficult for sufferers to fall asleep.

Primary symptoms of RLS include:

  • A strong, almost irresistible urge to move the legs
  • Unpleasant sensations in the limbs that are relieved through movement or repositioning
  • Symptoms that typically worsen in the evening or at night
  • Difficulty falling asleep or staying asleep due to this discomfort

Remember that while RLS does not cause movement on its own, the urge to move the legs often leads to frequent fidgeting or shifting positions, which can interfere with sleep. This can severely affect a person’s quality of life and contribute to fatigue and daytime sleepiness.

Understanding PLMS

PLMS, sometimes called sleep-related myoclonus syndrome or nocturnal myoclonus syndrome, involves repetitive, involuntary movements of the limbs during sleep. While the movements typically occur in the lower extremities, such as the ankle, hip, and knee flexing, they can also occur in the upper extremities. The movements often occur at regular intervals—typically every 20 to 40 seconds—and often occur alongside disorders such as RLS, narcolepsy, uremia, ADHD, or obstructive sleep apnea.

Unlike RLS, however, PLMS occurs during sleep, and patients typically don’t remember the movements once they wake.

Primary symptoms of PLMS include:

  • Involuntary leg movements during sleep
  • Movements occur at regular intervals, often affect both legs and may involve flexion of the knees or ankles
  • Patients usually don’t realize the movements are happening
  • Interrupted sleep due to limb movements, leading to poor sleep quality

Though the movements caused by PLMS are involuntary and happen during sleep, they can disrupt a person’s ability to stay in deep, restorative sleep, often leading to daytime fatigue, mood swings, and decreased cognitive function.

An important note: PLMS is also commonly confused with periodic limb movement disorder (PLMD), likely due to its name and symptoms. According to the Cleveland Clinic, the difference lies in whether the patient has other existing conditions:

“Although they have similar names and the same symptoms, PLMD and PLMS are different. Healthcare providers diagnose PLMD when they can’t find any underlying condition causing the movements. They diagnose the movements as PLMS if they happen alongside another condition. PLMD is rare. PLMS is more common.” -Cleveland Clinic

While PLMS and RLS share some overlapping characteristics, such as disturbances in sleep, involuntary leg movements, and worsening of symptoms at night, recognizing their differences can provide valuable insights into managing both.

RLS and PLMS: Key Differences

While RLS and PLMS share many common traits, the specific differences are found in how the symptoms manifest and when they occur. These differences include:

Timing of Symptoms

RLS occurs when a person is awake, often during relaxation or rest. The symptoms tend to intensify in the evening or at night when the person is inactive. Meanwhile, PLMS occurs during actual sleep. Movements happen while the person is in bed and usually don’t wake them up, though they may disrupt sleep quality.

Awareness of Symptoms

People with RLS are typically aware of the discomfort and have an urge to move their legs to relieve the sensations. Those with PLMS are usually unaware of the involuntary leg movements while they are occurring. They may only be aware of their sleep disruption or symptoms of daytime fatigue.

Nature of Movements

RLS is driven by an urge to move the legs due to discomfort, often resulting in fidgeting, tossing, and turning. PLMS, on the other hand, involves repetitive, rhythmic movements, often flexing the ankles, knees, or toes. These movements happen in a more structured pattern, which is typically periodic.

RLS and PLMS: Connection to Vein Health

The relationship between RLS, PLMS, and vein health is complex. Both conditions can exacerbate underlying vein problems, particularly chronic venous insufficiency.

While the precise cause of RLS is not entirely understood, researchers believe RLS may be linked to a dysfunction in the brain's dopamine pathways. However, circulation problems and vein health may play a major role in exacerbating symptoms. RLS patients often report worsening symptoms in the evening when they are less active, with standing or moving around as an effective measure to alleviate the discomfort. This is similar to how certain circulation issues, such as varicose veins, can cause leg pain.

Venous insufficiency occurs when the veins cannot effectively pump blood back to the heart. It can cause leg pain, swelling, and a heavy feeling in the lower limbs, all of which can mimic or intensify the sensations seen in RLS.

PLMS and Venous Disorders

Though less well-established, there may be an indirect connection between PLMS and vascular health. People with poor circulation or vein problems may experience more discomfort at night, making them more likely to move their legs involuntarily. Additionally, chronic venous insufficiency can lead to changes in blood flow that may contribute to the muscle cramps or discomfort associated with PLMS, particularly at night.

PLMS and RLS: Final Thoughts

While RLS and PLMS may seem similar, they are distinct conditions with unique causes, symptoms, and treatments. Both conditions affect sleep and may worsen with periods of inactivity, making them common complaints among those with circulation problems or vein disorders. If you’re experiencing either of these conditions or their symptoms, seeking professional care for vein health is important to address the underlying issues.

The board-certified physicians at CVR are experts at evaluating vein health and helping patients manage symptoms related to these conditions, varicose veins, spider veins, ulcers, and other issues involving chronic venous insufficiency. Proper vein care leads to better circulation, reduced discomfort, and improved sleep, which supports a healthier, more active lifestyle.

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