What is the Prime Mover in Periodic Leg Movements in Sleep?

The sympathetic nervous system may play a primary role, but the relation remains hypothetical.

Periodic leg movements (PLMs), repeated dorsiflexions of the big toe and ankle that occur during wakefulness and sleep, are frequently accompanied by arousal and autonomic activation. The pathophysiologic importance of these manifestations remains unclear. These authors used polysomnography to investigate the relation between EEG changes and heart-rate variability in PLMs (8 patients with periodic leg movements disorder but without obstructive sleep apnea), apnea-related leg movements (7 patients), and isolated leg movements (9 individuals with normal polysomnography results).

Autonomic activation was significantly greater during PLMs than during other types of leg movement. The authors concluded that the sympathetic nervous system plays a p…

Reviewing Authors

Roberto Vetrugno, MD, PhD

Pasquale Montagna, MD

Pietro Cortelli, MD, PhD