Topics in Pulmonary MedicinePeriodic Limb Movements on Polysomnography Should They Be Treated? Better Yet Should They Be Counted?Phillips, Barbara A. MD, MSPH, FCCPAuthor Information University of Kentucky Good Samaritan Sleep Center, Lexington, KY B.A.P. has received honoraria from the American College of Chest Physicians, the American Thoracic Society, the Federal Motor Carrier Safety Administration, PriMed, Philips Respironics, Res-Med, GlaxoSmithKline, Boehringer-Ingelheim, the National Institutes of Health, and Barnwell-Whaley LLC. Address correspondence to: Barbara A. Phillips, MD, MSPH, FCCP, University of Kentucky Good Samaritan Sleep Center, 4th Floor UKGSH Hospital, 800 Rose St, Lexington, KY 40508. E-mail: [email protected]. Clinical Pulmonary Medicine: September 2012 - Volume 19 - Issue 5 - p 221-225 doi: 10.1097/CPM.0b013e3182673895 Buy Metrics Abstract Periodic limb movements are frequently encountered in the scoring of polysomnography, but their definition, prevalence, and significance remain unclear. Scoring criteria for periodic limb movements are arcane, and it is likely that interscorer reliability of these phenomena is poor. Although periodic limb movements are present in a majority of people who have restless legs syndrome, most people who have periodic limb movements do not have restless legs syndrome. Periodic leg movements during sleep are strongly associated with sleep disorders of all kinds, including sleep-disordered breathing. In addition, they are prevalent in individuals with a variety of chronic illnesses and in those who take antidepressants. It is likely that limb movements during sleep are a nonspecific marker of disturbed sleep from a variety of causes. There is scant evidence to support use of medications to treat periodic limb movements or periodic limb movement disorder. On the other hand, there is substantial evidence that the medications that are used for this purpose have significant side effects. Further, there is no drug approved by the Federal Drug Administration for this purpose. The question should not be whether to treat periodic limb movements, but whether to count them. This review focuses on the prevalence, etiology, and management of periodic limb movements in adults. © 2012 Lippincott Williams & Wilkins, Inc.