Valproate for sleep consolidation in periodic limb movement disorder

In this study, open-label valproate (VPA) was administered to patients as a treatment for periodic limb movement disorder (PLIMD). Six patients aged 2 8 to 62 years with complaints of sleep disturbance and at least five period ic limb movements (PLMs) per hour of sleep underwent polysomnograms (PSGs) with and without low-dose VPA treatment (125-600 mg at bedtime). After a ba seline PSG, patients received VPA therapy from 2 weeks to 14 months, until the time of the follow-up PSG on VPA (median, 5 months; mean, 6 months). AU six patients experienced subjective improvement in daytime alertness. Slee p efficiency was improved from 76% to 88% (p = 0.003), stage 1 (light) slee p decreased from 26% to 13% (p = 0.04), stage 3 and 4 (deep) sleep increase d from 19% to 30% (p = 0.01), and rapid eye movement sleep was unchanged. T here was a trend toward a reduction in the number of PLMs per hour of sleep and in the percentage of arousals associated with PLMs. AU of the patients continued taking VPA after the PSGs were completed. One patient discontinu ed VPA 1 month after completion of the last PSG because of short-term side effects, and one patient stopped VPA 22 months after the last PSG because o f weight gain. Thus, these data indicate that VPA has a long-term beneficia l effect on sleep consolidation in patients with PLIMD.