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[Diagnosis] PLM vs RLS vs moving around to relieve pressure on injured joints. - Printable Version

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PLM vs RLS vs moving around to relieve pressure on injured joints. - FormerFed - 05-03-2016

Can a sleep study differentiate between PLMs or RLS versus purposeful movements such as small stretches or shifts in position a side-sleeper makes to relieve pressure on her arthritic hips and knees and injured shoulders, situations already aggravated from then-recent snow shoveling and worsened by an uncomfortable bed and particularly awful pillows at the sleep lab? Its not a regular problem, and it doesn’t happen if I stay attentive to daily exercise, but there are periods where I slack off and then have to do some big chore and am, then, achy and again aware I need to be attentive to daily exercise.

But, getting back to the apnea-related question … Can a doctor know whether movements during sleep latency, at arousals, or after arousals, are caused by disorder-related sensations versus injury-related pain?

The sleep specialist didn't want to see me before the study. I concluded that possibly he didn't have an opening and I should proceed w/the study and just see him afterward. But afterward he was not available for an appointment or on the phone. During my repeated calls, and quizzings, a couple of people on his staff did read a little from the study to me, but would not give the report to me. I was told that my AHI was 6.1, in alarmed tones as if that is dangerous. I did not know how blessed one is to have an AHI of only 6.1 until I became aware, on Internet, that so many apnea patients wrangle with such much higher AHI levels. On another attempt to get help/info, a staffer told me she read that the doctor was concerned about significant limb movements. When I was finally lined up with another doctor in the practice, he gave me the report and I saw that the 1st, diagnosing doctor’s finds that I have an apnea condition requiring treatment due to a significant PLM arousal index of 9.1, that CPAP may resolve this, but if not, I should seek direct treatment for what he terms a limb disorder. He, however, has no knowledge of my medical history except that I was referred to him to screen for apnea having been diagnosed a week prior with paroxysmal atrial fibrillation. And that I am 61, post-menopausal, overweight, my neck size is 16.25 inches, and I have high blood pressure. I have no clue if he noted or if it was at all important that I have not ever had any of the daytime sleepiness issues that were asked about in a pre-study questionnaire. He has no knowledge of the history of arthritis or injury or that these were recently aggravated and causing pain at the time of the sleep study.


RE: PLM vs RLS vs moving around to relieve pressure on injured joints. - trish6hundred - 05-03-2016

Hi FormerFed,
WELCOME! to the forum.!
Hang in there for answers to your questions and much success to you with your CPAP therapy.


RE: PLM vs RLS vs moving around to relieve pressure on injured joints. - PaulaO2 - 05-03-2016

Yes, they definitely can. Typically PLM is sudden and quite jerky vs the more gently shifting in one's sleep. And RLS movement will happen just prior to falling asleep vs while you are asleep.


RE: PLM vs RLS vs moving around to relieve pressure on injured joints. - FormerFed - 05-04-2016

Thanks, trish6hundred - I wish you well in your adventure, too!


RE: PLM vs RLS vs moving around to relieve pressure on injured joints. - FormerFed - 05-04-2016

PaulaO2, Thanks! That helps me understand the report a bit better, and helps me better understand aspects of the graphs, also, though if I'm understanding both correctly, the graphs do not altogether track with the report summary. Will get some time on the new doctor's calendar to explain things to me. When we met he had not yet seen the studies or the 1st doctor's reports - they were not in my file - so we talked about the info the nurse had downloaded that morning from the ResMed data card and he sent someone to get the report info for me from the sleep lab.


RE: PLM vs RLS vs moving around to relieve pressure on injured joints. - PaulaO2 - 05-04-2016

PLM *might* start out as gentle-shifting if it is in relation to an apnea event. It is your body trying to wake you. The movement gets more intense and violent as the event continues. You may see a note about that in the report linking the PLM to events.