Periodic Limb Movements

I am a slightly underweight 60 year old woman. I have been dealing with daytime fatigue for years and it has become worse in the last couple of years. After a recent sleep study, my AHI was 6 with only hypopneas and my oxygen levels never went below 91%. However, my PLMI was 64! These movements supposedly keep me from getting an adequate amount of REM and deep sleep. At least 15 years ago, I had another sleep study which also found that I had a problem with limb movements, so I have been taking gabapentin at night for all these years. My recent high PLMI was after taking this medicine as usual. My doctor ordered a CPAP machine for my AHI of 6, but had no help for my severe PLMI except for moving another med to morning, increasing my iron, and asking my GP to increase my gabapentin. I don't like increasing that med especially since it's a controlled substance.

My first question is: has anyone found a way to deal with a high PLMI? The next question is: am I wrong to think that my doctor ordered a CPAP machine that I really don't need, while ignoring the 800lb gorilla in the room (PLMI)? This has caused me to wonder if the doctor gets a kickback from the CPAP manufacturer. I have been using the machine every day for several weeks now, and I think my sleep quality has gotten worse.

Hi BirdLady

I've had PLMD for most of my life but so far I've avoided any specific medications.

I also have RBD which is more of a concern for me but I don't believe there are any real solutions for these kinds of movement disorders.

As to your query regarding what I call the sleep industry I've already caused too many ripples on that subject within this Apnea forum.

It will be interesting to see if there are any helpful responses to your queries.

I really can't comment on the PLM issues, and I am not sure they are related to sleep apnea. An AHI of 6 is very low, and just at the bottom end of the mild range (5-15) where apnea is treated in North America. In the UK they will not prescribe a machine until you are over 15 for AHI. That said some seems to get benefit from a CPAP even in the mild range. It does take some time to get used to using a CPAP though. Many achieve under 1 for AHI when using a CPAP.

Thank you both! My sleep doctor also wanted me to read a particular book about insomnia. I was sent to the sleep doctor for wanting to sleep too much--not for insomnia. I can easily sleep 10 or 11 hours every day. It's just not quality deep and REM sleep. Knowing this, my doctor decides to set me up with a CPAP for my very mild hypopneas and not offer anything significant for my extreme leg movements. Another doctor (cardiologist) told me that it's like I'm trying to sleep while running a marathon! I'm not convinced that getting my AHI down maybe 4 points is going to make that much of a difference in my sleep quality while my leg movements are so disruptive. I was told she was a sleep doctor and not just a CPAP doctor.