RE: How important is periodic leg movement index and does it get better with time?
Hi! I started PAP treatment in December of last year. My AHI was 18, and my SLMI was 56. At this point, I had reached complete mental and physical breakdown and was completely non-functional. By Feb. my AHI fluctuated between 1 and 2, SLMI was at 25, and I felt better than I had in a decade, literally life changing.
March rolls around for another lab titration, and my AHI is 0.1 and my SLMI is back up in the 50s, REM IS 0%!!!! and I'm back in dysfunctional hell. Cant see sleep doc until end of June, and im on a "waiting list." Limb movements have yet to be addressed. Just looking at this, I have to say YES limb movements are a MAJOR factor in sleep quality, and no one even mentioned it!!!
I can tell you, after 15 years (almost half my life) of steady health decline, I've learned I have to advocate for myself, which is what seems others above are doing as well yay!!! I must say, I think it is very sad that we have to do this...
So I spend my hours of pre-sleep anxiety researching. What I've found is that a dual diagnosis of PLMD and OSA is very tricky to treat. In fact, research suggests the treatments actually counteract each other. Unobstructed breathing can increase SLMI, and medications that relax the legs, can lead to further obstruction in the throat (also relaxing this area). In my case, I am unable to increase my pressures on the PAP due to swallowing of air (aerophagia).
I refused to sit around and wait for the sleep doc, fortunately my psychiatrist has been willing to work with me on addressing these issues from a nuero perspective (makes sense, PLMD is a nuero issue). You have several options in regards to medication for PLMD, anywhere from anti-anxiety meds, benzos, muscle relaxers, to anti seizure meds. Ive tried the benzo, and anti seizure routes. (Valium and Gabapentin respectively). The Valium kept me in a haze all day (long half life), whereas the Gabapentin is an antiseizure medication, epileptics have to take it 3x/day due to shorter half life. Gabapentin seems to be the best choice for me at this point, but I can only get up to 600mg (I only take it 1x before bed, it makes me sleepy). If i go above 600mg, my AHI kicks up too high. But Im not exhausted all day.
My suggestion is to find a doc that is willing to work with you in regards to the PLMD. Sleep docs arent the only ones that can treat "restless legs" (I dont have RLS... but my legs are still restless lol) Learn to adjust your PAP, calm down those legs, and do what ever you have to do to take care of yourself. There is no doc out there that cares about your well being as much as you do. Be your own advocate!
and I just realized this discussion was from last year :-)
I'd like to hear some updates, how is everyone doing with this???
(This post was last modified: 05-30-2016 04:16 AM by cmdBOSS.)