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The significance of the sympathetic nervous system in the pathophysiology of periodic leg movements in sleep.
Sleep. 2007 Jun; 30(6):755-66.S

Abstract

STUDY OBJECTIVES

Periodic leg movements in sleep (PLMS) are frequently accompanied by arousals and autonomic activation, but the pathophysiologic significance of these manifestations is unclear.

DESIGN

Changes in heart rate variability (HRV), HRV spectra, and electroencephalogram (EEG) spectra associated with idiopathic PLMS were compared with changes associated with isolated leg movements and respiratory-related leg movements during sleep. Furthermore, correlations between electromyographic activity, HRV changes, and EEG changes were assessed.

SETTING

Sleep laboratory.

PATIENTS

Whole-night polysomnographic studies of 24 subjects fulfilling the criteria of either periodic leg movements disorder (n = 8), obstructive sleep apnea syndrome (n = 7), or normal polysomnography (n = 9) were used.

MEASUREMENTS AND RESULTS

Spectral HRV changes started before all EEG changes and up to 6 seconds before the onset of all types of leg movements. An initial weak autonomic activation was followed by a sympathetic activation, an increase of EEG delta activity, and finally a progression to increased higher-frequency EEG rhythms. After movement onset, HRV indicated a vagal activation, and, the EEG, a decrease in spindle activity. Sympathetic activation, as measured by HRV spectra, was greater for PLMS than for all other movement types. In EEG, gamma synchronization began 1 to 2 seconds earlier for isolated leg movements and respiratory-related leg movements than for PLMS. Significant correlations were found between autonomic activations and electromyographic activity, as well as between autonomic activations and EEG delta activity, but not between higher-frequency EEG rhythms and EMG activity or HRV changes.

CONCLUSIONS

These results suggest a primary role of the sympathetic nervous system in the generation of PLMS.

Authors+Show Affiliations

Center of Sleep Medicine, Department of Neurology, University of Berne, Inselspital, Bern, Switzerland. aguggis@gmail.comNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17580597

Citation

Guggisberg, Adrian G., et al. "The Significance of the Sympathetic Nervous System in the Pathophysiology of Periodic Leg Movements in Sleep." Sleep, vol. 30, no. 6, 2007, pp. 755-66.
Guggisberg AG, Hess CW, Mathis J. The significance of the sympathetic nervous system in the pathophysiology of periodic leg movements in sleep. Sleep. 2007;30(6):755-66.
Guggisberg, A. G., Hess, C. W., & Mathis, J. (2007). The significance of the sympathetic nervous system in the pathophysiology of periodic leg movements in sleep. Sleep, 30(6), 755-66.
Guggisberg AG, Hess CW, Mathis J. The Significance of the Sympathetic Nervous System in the Pathophysiology of Periodic Leg Movements in Sleep. Sleep. 2007;30(6):755-66. PubMed PMID: 17580597.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The significance of the sympathetic nervous system in the pathophysiology of periodic leg movements in sleep. AU - Guggisberg,Adrian G, AU - Hess,Christian W, AU - Mathis,Johannes, PY - 2007/6/22/pubmed PY - 2007/8/1/medline PY - 2007/6/22/entrez SP - 755 EP - 66 JF - Sleep JO - Sleep VL - 30 IS - 6 N2 - STUDY OBJECTIVES: Periodic leg movements in sleep (PLMS) are frequently accompanied by arousals and autonomic activation, but the pathophysiologic significance of these manifestations is unclear. DESIGN: Changes in heart rate variability (HRV), HRV spectra, and electroencephalogram (EEG) spectra associated with idiopathic PLMS were compared with changes associated with isolated leg movements and respiratory-related leg movements during sleep. Furthermore, correlations between electromyographic activity, HRV changes, and EEG changes were assessed. SETTING: Sleep laboratory. PATIENTS: Whole-night polysomnographic studies of 24 subjects fulfilling the criteria of either periodic leg movements disorder (n = 8), obstructive sleep apnea syndrome (n = 7), or normal polysomnography (n = 9) were used. MEASUREMENTS AND RESULTS: Spectral HRV changes started before all EEG changes and up to 6 seconds before the onset of all types of leg movements. An initial weak autonomic activation was followed by a sympathetic activation, an increase of EEG delta activity, and finally a progression to increased higher-frequency EEG rhythms. After movement onset, HRV indicated a vagal activation, and, the EEG, a decrease in spindle activity. Sympathetic activation, as measured by HRV spectra, was greater for PLMS than for all other movement types. In EEG, gamma synchronization began 1 to 2 seconds earlier for isolated leg movements and respiratory-related leg movements than for PLMS. Significant correlations were found between autonomic activations and electromyographic activity, as well as between autonomic activations and EEG delta activity, but not between higher-frequency EEG rhythms and EMG activity or HRV changes. CONCLUSIONS: These results suggest a primary role of the sympathetic nervous system in the generation of PLMS. SN - 0161-8105 UR - https://www.unboundmedicine.com/medline/citation/17580597/The_significance_of_the_sympathetic_nervous_system_in_the_pathophysiology_of_periodic_leg_movements_in_sleep_ L2 - https://academic.oup.com/sleep/article-lookup/doi/10.1093/sleep/30.6.755 DB - PRIME DP - Unbound Medicine ER -