Restless Legs Syndrome and Periodic Limb Movement Disorder — CSCC

Comprehensive Sleep Care Center diagnoses and treats restless legs syndrome (RLS) and periodic limb movement disorder (PLMD) in adults and children across Virginia and Maryland. Our board-certified sleep specialists provide accurate diagnosis and effective, individualized treatment plans for these often underdiagnosed and disruptive conditions.

What Is Restless Legs Syndrome (RLS)?

Restless legs syndrome is a neurological sensorimotor disorder characterized by an uncomfortable, irresistible urge to move the legs — usually accompanied by unpleasant sensations such as crawling, creeping, pulling, throbbing, or itching. Symptoms worsen at rest (particularly when sitting or lying down), typically peak in the evening and nighttime hours, and are temporarily relieved by movement. RLS affects approximately 5–10% of adults and can severely disrupt sleep and quality of life.

Symptoms of RLS

Uncomfortable sensations deep in the legs (rarely the arms): crawling, creeping, pulling, aching, throbbing
Overwhelming urge to move the legs when at rest
Symptoms that worsen in the evening or at night
Symptoms temporarily relieved by walking, stretching, or moving
Difficulty falling asleep or staying asleep due to leg discomfort
Daytime fatigue and sleepiness from disrupted nighttime sleep

What Is Periodic Limb Movement Disorder (PLMD)?

PLMD is characterized by repetitive, involuntary movements of the limbs — most commonly the legs — during sleep. These movements typically involve brief flexion of the ankle, knee, or hip and repeat every 20–40 seconds throughout the night. Unlike RLS, PLMD occurs during sleep and the patient is usually unaware of the movements, though they disrupt sleep architecture and cause daytime fatigue. PLMD is diagnosed through overnight polysomnography.

Diagnosis and Treatment at CSCC

Diagnosis

Clinical evaluation: symptom history, family history, medication review
Blood work: iron studies, ferritin level (iron deficiency is a common, correctable cause of RLS)
Overnight polysomnography (PSG) to diagnose PLMD and assess sleep disruption severity

Treatment

Iron supplementation — first-line treatment when iron deficiency is identified
Dopaminergic medications (pramipexole, ropinirole) for moderate to severe RLS
Alpha-2-delta calcium channel ligands (gabapentin, pregabalin) — often preferred for long-term management
Lifestyle modifications: reducing caffeine, alcohol, and nicotine; regular exercise; sleep hygiene
Opioids for refractory, severe RLS
Treatment of underlying contributing conditions

Frequently Asked Questions — RLS and PLMD

Is restless legs syndrome a serious condition?

While RLS is not life-threatening, it can be severely disruptive to sleep, mood, and quality of life. Severe RLS is associated with significant daytime fatigue, depression, and anxiety. Effective treatment is available and can dramatically improve daily functioning.

How is PLMD different from restless legs syndrome?

RLS occurs while awake and is characterized by uncomfortable sensations and the urge to move. PLMD occurs during sleep and involves involuntary limb movements the patient is typically unaware of. Many patients have both conditions. PLMD is diagnosed through a sleep study, while RLS is diagnosed primarily through clinical history.

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