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An Evidence-based Analysis of the Association between Periodic Leg Movements during Sleep and Arousals in Restless Legs Syndrome.
Sleep. 2015 Jun 01; 38(6):919-24.S

Abstract

STUDY OBJECTIVES

To analyze statistically the association between periodic leg movements during sleep (PLMS) and arousals, in order to eventually support or challenge the current scoring rules and to further understand their reciprocal influence.

SETTING

Sleep research center.

PATIENTS

Twenty untreated consecutive patients with restless legs syndrome (RLS) (13 women and 7 males, mean age 60.9 y).

METHODS

In each recording, we selected all PLMS/arousal pairs that met the following inclusion criteria: (a) PLMS events that were separated from another PLMS event (preceding or following) by at least 10 s of EMG inactivity; (b) arousal events separated from another arousal event (preceding or following) by at least 10 s of stable EEG baseline activity; (c) PLMS/arousal pairs were then selected among events identified according to the previous two criteria, when PLMS and arousals were separated (offset-to-onset) by no more than 10 s, regardless of which was first.

MEASUREMENTS AND RESULTS

We selected a mean of 46.1 (SD 25.55) PLMS/arousal pairs per subject; in these pairs, average PLMS duration was 3.2 s (0.65) and average arousal duration was 6.5 s (0.92). Within these event pairs, the great majority (on average 98.4%, SD 3.88) was separated by less than 0.5 s (i.e., between the end of one event and the onset of the other, regardless of which was first). Arousal onsets preceded PLMS onset in 41.2% of pairs, while the opposite was true for the remaining 58.8% of pairs. A significant correlation between PLMS duration and arousal duration was also found (r = 0.447, P < 0.000001).

CONCLUSION

The results of this study support the current rule for the definition of the association between periodic leg movements during sleep (PLMS) and arousals. The tight time relationship between PLMS and arousals and their correlated durations seem to indicate that both events might be regulated by a complex mechanism, rather than being connected by a simple reciprocal cause/effect relationship.

Authors+Show Affiliations

Sleep Research Centre; Department of Neurology I.C., Oasi Institute for Research on Mental Retardation and Brain Aging (IRCCS), Troina, Italy.Sleep Research Centre; Department of Neurology I.C., Oasi Institute for Research on Mental Retardation and Brain Aging (IRCCS), Troina, Italy.Sleep Disorders Center, Department of Neurology, Scientific Institute and University Ospedale San Raffaele, Vita-Salute University, Milan, Italy.Sleep and Epilepsy Center, Neurocenter of Southern Switzerland, Civic Hospital (EOC) of Lugano, Lugano, Switzerland.Department of Social and Developmental Psychology, Sapienza University, Rome, Italy.Sleep Disorders Center, Department of Neurology, Scientific Institute and University Ospedale San Raffaele, Vita-Salute University, Milan, Italy.Sleep and Epilepsy Center, Neurocenter of Southern Switzerland, Civic Hospital (EOC) of Lugano, Lugano, Switzerland.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25581922

Citation

Ferri, Raffaele, et al. "An Evidence-based Analysis of the Association Between Periodic Leg Movements During Sleep and Arousals in Restless Legs Syndrome." Sleep, vol. 38, no. 6, 2015, pp. 919-24.
Ferri R, Rundo F, Zucconi M, et al. An Evidence-based Analysis of the Association between Periodic Leg Movements during Sleep and Arousals in Restless Legs Syndrome. Sleep. 2015;38(6):919-24.
Ferri, R., Rundo, F., Zucconi, M., Manconi, M., Bruni, O., Ferini-Strambi, L., & Fulda, S. (2015). An Evidence-based Analysis of the Association between Periodic Leg Movements during Sleep and Arousals in Restless Legs Syndrome. Sleep, 38(6), 919-24. https://doi.org/10.5665/sleep.4740
Ferri R, et al. An Evidence-based Analysis of the Association Between Periodic Leg Movements During Sleep and Arousals in Restless Legs Syndrome. Sleep. 2015 Jun 1;38(6):919-24. PubMed PMID: 25581922.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - An Evidence-based Analysis of the Association between Periodic Leg Movements during Sleep and Arousals in Restless Legs Syndrome. AU - Ferri,Raffaele, AU - Rundo,Francesco, AU - Zucconi,Marco, AU - Manconi,Mauro, AU - Bruni,Oliviero, AU - Ferini-Strambi,Luigi, AU - Fulda,Stephany, Y1 - 2015/06/01/ PY - 2014/10/07/received PY - 2014/11/18/accepted PY - 2015/1/13/entrez PY - 2015/1/13/pubmed PY - 2015/11/13/medline KW - PLMS KW - arousals KW - periodic leg movements during sleep KW - restless legs syndrome KW - sleep scoring SP - 919 EP - 24 JF - Sleep JO - Sleep VL - 38 IS - 6 N2 - STUDY OBJECTIVES: To analyze statistically the association between periodic leg movements during sleep (PLMS) and arousals, in order to eventually support or challenge the current scoring rules and to further understand their reciprocal influence. SETTING: Sleep research center. PATIENTS: Twenty untreated consecutive patients with restless legs syndrome (RLS) (13 women and 7 males, mean age 60.9 y). METHODS: In each recording, we selected all PLMS/arousal pairs that met the following inclusion criteria: (a) PLMS events that were separated from another PLMS event (preceding or following) by at least 10 s of EMG inactivity; (b) arousal events separated from another arousal event (preceding or following) by at least 10 s of stable EEG baseline activity; (c) PLMS/arousal pairs were then selected among events identified according to the previous two criteria, when PLMS and arousals were separated (offset-to-onset) by no more than 10 s, regardless of which was first. MEASUREMENTS AND RESULTS: We selected a mean of 46.1 (SD 25.55) PLMS/arousal pairs per subject; in these pairs, average PLMS duration was 3.2 s (0.65) and average arousal duration was 6.5 s (0.92). Within these event pairs, the great majority (on average 98.4%, SD 3.88) was separated by less than 0.5 s (i.e., between the end of one event and the onset of the other, regardless of which was first). Arousal onsets preceded PLMS onset in 41.2% of pairs, while the opposite was true for the remaining 58.8% of pairs. A significant correlation between PLMS duration and arousal duration was also found (r = 0.447, P < 0.000001). CONCLUSION: The results of this study support the current rule for the definition of the association between periodic leg movements during sleep (PLMS) and arousals. The tight time relationship between PLMS and arousals and their correlated durations seem to indicate that both events might be regulated by a complex mechanism, rather than being connected by a simple reciprocal cause/effect relationship. SN - 1550-9109 UR - https://www.unboundmedicine.com/medline/citation/25581922/An_Evidence_based_Analysis_of_the_Association_between_Periodic_Leg_Movements_during_Sleep_and_Arousals_in_Restless_Legs_Syndrome_ DB - PRIME DP - Unbound Medicine ER -