The prevalence of periodic limb movement in sleep (PLMS) in patients with Restless Legs Syndrome is estimated between 80 to90%, >34% of the population over 60 years of age and 36% of healthy subjects were found to have a PLMS index >5 event per hour of sleep. PLMS can be associated with sleep breathing disorders, insomnia, narcolepsy, and REM Behavior disorder. Its prevalence in the general population is unknown. Home sleep-monitoring devices (HSMD) could be used to derive some consensus on the clinical and non-clinical characteristics of PLMS. There is need to derive age-adjusted normative values for PLMS, assess their clinical significance when presenting as comorbidities, phenotyping the genetic variants and tracking the pathophysiology along a continuum to determine signs and symptom changes from pre-clinical to clinical relevance. This article provides information on why and how HSMD is the logical approach in bridging the clinically relevant information gap associated with PLMS. It discusses future directions to be taken in utilizing HSMD to objectively measure PLMS and determine their effect on sleep quality.