Last reviewed: November 2017
Last updated: May  2016

Summary

Definition

History and exam

Key diagnostic factors

  • poor sleep
  • daytime somnolence and fatigue
  • periodic limb movements (mostly legs)

Other diagnostic factors

  • age >70 years
  • female gender
  • re-enactment of dreams during the night
  • irresistible urge to move legs, and abnormal sensations in lower limbs
  • snoring
  • early-morning dry mouth
  • headache
  • elevated body mass index
  • withdrawal from benzodiazepines or barbiturates
  • hx of neuroleptic medication
  • hx of dopaminergic medication
  • pallor
  • iron deficiency
  • diabetes mellitus
  • spinal cord injury
  • episodes of sudden onset of sleep during the day; may or may not be associated with loss of muscle tone

Risk factors

  • age >70 years
  • female gender

Diagnostic investigations

1st investigations to order

  • polysomnography: electromyography (EMG) evaluation of limb movements
  • polysomnography: EEG evaluation
  • polysomnography: assessment of sleep-disordered breathing
  • CBC
  • serum ferritin
  • BUN
  • Epworth Sleepiness Scale
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Neurology Registrar

Department of Clinical Neurosciences

Western General Hospital

Edinburgh

UK

Disclosures

TS declares that he has no competing interests.

Suvankar Pal

Consultant Neurologist and Honorary Senior Lecturer

Department of Clinical Neurosciences

Western General Hospital

Edinburgh

UK

Disclosures

SP declares that he has no competing interests.

Richard Davenport

Consultant Neurologist and Honorary Senior Lecturer

Department of Clinical Neurosciences

Western General Hospital

Edinburgh

UK

Disclosures

RD declares that he has no competing interests.

Peer reviewers VIEW ALL

Consultant Neurologist

James Cook University Hospital

Middlesbrough

UK

Disclosures

PR declares that he has no competing interests.

Director

Sleep Disorders Center

Thomas Jefferson University Hospital

Philadelphia

PA

Disclosures

KD is a speaker for Sanofi-Aventis, King Pharmaceuticals, Takeda Pharmaceuticals, Sepracor, and Pfizer; a consultant for Sanofi-Aventis, Takeda Pharmaceuticals, Sepracor, Pfizer, and Neurocrine Biosciences; and has stock in Merck.

Consultant Neurologist

Department of Neurology

Freeman Hospital

Newcastle upon Tyne

UK

Disclosures

KA declares that she has no competing interests.

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