Sleep apnea and restless legs

From what I have read online, my restless legs are not clearly defined. About a year ago, I was diagnosed with sleep apnea. My doctor called my OSA “impressively awful”, LOL, with my AHI being 94. I was put on a BiPAP machine and on follow up visits to the doctor, with adjustments to the machine pressures, my latest AHI is 16.6 (they are still adjusting the machine pressure to try to get it lower). The machine has noticeably helped with my daytime drowsiness. My problem is this. Before using the machine, I would do what my wife called “dancing” in the bed. Flailing my legs while I slept. My sleep doctor said that treating my OSA would likelty help that. Instead, it seems to have made it worse. Since using the BiPAP machine, I have actually fallen out of bed twice. I bought a railing for the side of the bed and since then I haven’t fallen out of bed but nightly I will kick the railing. I have awakened in the middle of the night on many occassions with a pain in my foot (always the right leg) where I have kicked the railing and even scratched the top of one of my toes by dragging it across the corner of the railing.

I can’t say this is strictly RLS because it doesn’t really feel like a crawling sensation as I have seen reported by others and I can’t say it is PLM because it does bother me sometimes when I am awake either lying in bed before sleep or sometimes even sitting at my desk at work or driving in a car. It feels like muscle spasms in my leg. Like I need to stretch my leg out to relieve them and it affects both my thigh muscles and my calf muscles. Like I mentioned before, it most often affects the right leg. I have mentioned this to my sleep doctor and he doesn’t seem concerned (they have tested my iron levels and they are in the normal range. During my sleep study , they noted there is no evidence of PLM). Any idea what this would be categorized as? What should be my next step? Why would it get worse after using the OSA machine? Any advice would be appreciated

Hi, there can be many reason for your legs, my husband is the same he was diagnosed with sleep apnoea in 2012, his legs never stop at night, more recently we have associated with more mental health issues than sleep issues, of course without a good sleep your muscles lack oxygen and often ache and I guess as a result they move a lot during sleep because of it. It may be worth discussing it with your doctor rather than connecting it directly to the lack of oxygen you have suffered from. Anxiety and stress are a common cause, don’t rule anything out until the doctor has had a look