Are Limb Movements During Sleep Related to Breathing Problems?

In sleep medicine, there’s really no satisfying answer to why some people move their arms or legs during sleep. In general, it’s thought to be neurologic in origin, with dopamine as one of the main components. The same applies with TMJ problems. One of the minority opinions amongst sleep doctors and sleep dentists is that jaw clenching is a protective reflex to wake the obstructing patient, leading to increased muscle tone. This allow the person to breathe again, but in the long term, you’re not able to stay in deep sleep.

Here’s an interesting study which showed that when technicians raised the nasal airflow signals to very smooth, rounded tracings (elimination of flow limitation), limb movements dropped significantly.

As you can imagine, this has huge implications. I’ve always suspected that muscle twitches (arms or jaws) are a protective reflex.

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2 thoughts on “Are Limb Movements During Sleep Related to Breathing Problems?

  1. this is fantastic. of course it was done at Stanford. besides the implications of PLMs being related to SDB, the big point here is that most sleep labs are not using the right hypopnea criteria. Stanford was able to determine these findings because they are using the correct hypopnea criteria, and the rest of sleep medicine needs to get with the program. too many people are undertreated using the 2007 AASM recommended criteria.

  2. I suspect so, if I get out of the rut of sleep itself and look at the human body within a larger context, which is based on the hypothesis” that the design function of the human body is to survive”. Then we can look at breathing and ability to breath as the primary function for survival and see how body functions and biochemistry are constantly influenced by this.
    Given our reverence for the structural confines of the body and its influence upon this, we see the sleep, wake, active, passive, and other states as influencing and being influenced by this anatomy that manages the shape, size and contour of the airway, most critically in the throat area which extends from the domain of medicine and otolaryngology to that of dentistry, with no formal coordination to study and understand this area, most influential for our survival, in its control of airflow.
    Glossing over it and saying it is too complex to fully understand and measure holds no credibility in the domain of “Science”. There is already enough information published to show these relationships and offer questions for further study in the literature to illustrate this and learn more.
    If we take the politics, institutional egos and financial pressures out of this and take accountability for understanding how the body functions, including the anatomy of the jaws-tongue-throat (J-T-T) complex we can see an accounting for what we have to know and understand about the human body and move forward on this rather than in directions that are unscientific, because they are based upon conclusions drawn from ignoring this “primary” information.
    We behave ignoring this area and its influence, addressing the impacts of the influence and spend the majority of our time chasing remedies of effects, the “root cause” of which lies in the interactions associated with this complex and relation to airflow and our ability to breathe.
    The idealized CPAP adjustments are bypassing the anatomy to treat the symptom of “less than ideal” anatomy of the J-T-T complex.
    Google “jaw tongue reflex” for some articles that begin to open the discussion (there is even a reference to one of my articles there). Look at common sense deductions that can be made in observing anatomy of the tongue (5 extrinsic and 4 intrinsic muscles) which includes the often overlooked pharyngoglossus muscle in “Muscles of the Tongue and Hyoid”: http://face-and-emotion.com/dataface/anatomy/tonguemuscles.jsp. Also, looking at the interrelationships in this tongue dissection description: Muscles of the tongue (dissection guide with diagrams from UCLA linguistics shows all five extrinsic and 4 intrinsic muscles and their relationships: http://www.linguistics.ucla.edu/people/ladefoge/manual%20files/chapter7.pdf. Inter-relations and innervation can better be appreciated going from here to looking into illustrations of anatomy of the head and neck. The inter-relationships show postural impacts as in “Compensatory head posture changes in patients with obstructive sleep apnea” http://www.ncbi.nlm.nih.gov/pubmed/12845762., Here the total body round-the -clock inter-relationship is evident.
    You and I (a DDS) are dealing with anatomy that is round-the-clock not confined to sleep. My area is a controller of the dynamic aspect of this relationship yours is mostly the static and the impact of the dynamic by virtue of shared anatomy of origins and insertions of shared muscles and structures. Doesn’t the hyoid bone look like a miniature mandible? And isn’t that in medical territory with dental territory connections through muscle origins or insertions.
    Dr. Park, I invite you in joining me in education the public and our professional colleagues to look at the full picture to see reality and really solve problems rather than a portion of the whole picture as a frame of reference for reality as occurs when we trap anatomy and ease of breathing and airway in the sub-division of sleep.
    I ask you, what it will take to expand this conversation for the sake of humanity.