06-01-2022, 10:37 PM
RE: How to identify arousals? PLM?
I was just taking a peek through uptodate files I have and I think they sum it up well, to paraphrase.
PLM accompanies many sleep and neurologic disorders and increases in frequency with age. PLM does not have a consistent relationship with symptoms or with polysomnograph findings such as arousals. PLM is generally considered to be an age related phenomenon, a response to arousals, or related to other disorders. Occasionally PLM occurs abundantly and causes frequent arousals in the absence of other disorders in which case the PLM may be the primary cause of symptoms.
This all falls in lines with my earlier comments that all this is extremely complicated and the hard part is trying to determine cause of your symptoms. Your apnea appears treated so does not appear to be the cause of symptoms. You appear to have PLM but it is unclear if it is a cause of symptoms or just something you have. A titration study is about the only way you can try to confirm breathing is good and PLM is or isn't an issue although it is still an imperfect test. Treatment if PLM is found or believed to be an issue is to trial different medications, supplements, diet modifications etc to see if they help. Main medications appear to be ropinirole, gabapentin, pregabalin and occasionally clonazepam. All of these can help or make your symptoms worse or introduce other symptoms, same as supplements etc. Unfortunately there isn't a good way to measure success so all you can do is try different options and see if something makes you feel better.
What I have found in my journey through my own issues and sleep research is that the only thing doctors are halfways decent at treating is sleep apnea. Most of these other sleep issues are extremely complicated and they don't have great tests or treatments for them.
PLM accompanies many sleep and neurologic disorders and increases in frequency with age. PLM does not have a consistent relationship with symptoms or with polysomnograph findings such as arousals. PLM is generally considered to be an age related phenomenon, a response to arousals, or related to other disorders. Occasionally PLM occurs abundantly and causes frequent arousals in the absence of other disorders in which case the PLM may be the primary cause of symptoms.
This all falls in lines with my earlier comments that all this is extremely complicated and the hard part is trying to determine cause of your symptoms. Your apnea appears treated so does not appear to be the cause of symptoms. You appear to have PLM but it is unclear if it is a cause of symptoms or just something you have. A titration study is about the only way you can try to confirm breathing is good and PLM is or isn't an issue although it is still an imperfect test. Treatment if PLM is found or believed to be an issue is to trial different medications, supplements, diet modifications etc to see if they help. Main medications appear to be ropinirole, gabapentin, pregabalin and occasionally clonazepam. All of these can help or make your symptoms worse or introduce other symptoms, same as supplements etc. Unfortunately there isn't a good way to measure success so all you can do is try different options and see if something makes you feel better.
What I have found in my journey through my own issues and sleep research is that the only thing doctors are halfways decent at treating is sleep apnea. Most of these other sleep issues are extremely complicated and they don't have great tests or treatments for them.
