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Sleep apnea in patients reporting insomnia or restless legs symptoms.
Acta Neurol Scand 2016; 133(1):61-7AN

Abstract

OBJECTIVE

Insomnia and restless legs syndrome (RLS) are defined by self-reported symptoms, and polysomnography (PSG) is not routinely indicated. Occult obstructive sleep apnea (OSA), common even in asymptomatic adults, may complicate management of patients presenting with insomnia or restless legs. To this end, we investigated objective sleep apnea metrics in a large retrospective cohort according to self-reported symptom profiles.

METHODS

We compared sleep apnea findings in patients referred to our center according to self-reported symptoms associated with insomnia, sleep apnea, and restless legs. The cohort included over 1900 adults who underwent diagnostic (n = 1418) or split-night (n = 504) PSGs and completed a symptom and medical history questionnaire.

RESULTS

More than 30% of patients who did not endorse any OSA symptoms, but did endorse insomnia or restless legs symptoms, were found to have OSA based on apnea-hypopnea index (AHI) >5 during overnight laboratory testing. Regression models of the full cohort showed that the risk of OSA was related, as expected, to older age, male sex, elevated body mass index, and presence of OSA symptoms. The presence of insomnia symptoms did not alter the risk of OSA. The presence of restless legs symptoms showed a small odds ratio for lowered OSA risk.

CONCLUSIONS

Objective evidence of OSA occurs similarly in those with insomnia or restless legs symptoms, even among those without self-reported OSA symptoms. Providers should be aware of the potential for occult OSA in populations with insomnia and restless legs, which may complicate their management in addition to presenting an independent medical risk itself.

Authors+Show Affiliations

Neurology Department, Massachusetts General Hospital, Boston, MA, USA. Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA.Neurology Department, Massachusetts General Hospital, Boston, MA, USA.Neurology Department, Massachusetts General Hospital, Boston, MA, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

25974333

Citation

Bianchi, M T., et al. "Sleep Apnea in Patients Reporting Insomnia or Restless Legs Symptoms." Acta Neurologica Scandinavica, vol. 133, no. 1, 2016, pp. 61-7.
Bianchi MT, Goparaju B, Moro M. Sleep apnea in patients reporting insomnia or restless legs symptoms. Acta Neurol Scand. 2016;133(1):61-7.
Bianchi, M. T., Goparaju, B., & Moro, M. (2016). Sleep apnea in patients reporting insomnia or restless legs symptoms. Acta Neurologica Scandinavica, 133(1), pp. 61-7. doi:10.1111/ane.12439.
Bianchi MT, Goparaju B, Moro M. Sleep Apnea in Patients Reporting Insomnia or Restless Legs Symptoms. Acta Neurol Scand. 2016;133(1):61-7. PubMed PMID: 25974333.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Sleep apnea in patients reporting insomnia or restless legs symptoms. AU - Bianchi,M T, AU - Goparaju,B, AU - Moro,M, Y1 - 2015/05/14/ PY - 2015/04/27/accepted PY - 2015/5/15/entrez PY - 2015/5/15/pubmed PY - 2016/8/31/medline KW - ambulatory care KW - diagnosis KW - insomnia KW - polysomnography KW - restless legs KW - sleep disorders SP - 61 EP - 7 JF - Acta neurologica Scandinavica JO - Acta Neurol. Scand. VL - 133 IS - 1 N2 - OBJECTIVE: Insomnia and restless legs syndrome (RLS) are defined by self-reported symptoms, and polysomnography (PSG) is not routinely indicated. Occult obstructive sleep apnea (OSA), common even in asymptomatic adults, may complicate management of patients presenting with insomnia or restless legs. To this end, we investigated objective sleep apnea metrics in a large retrospective cohort according to self-reported symptom profiles. METHODS: We compared sleep apnea findings in patients referred to our center according to self-reported symptoms associated with insomnia, sleep apnea, and restless legs. The cohort included over 1900 adults who underwent diagnostic (n = 1418) or split-night (n = 504) PSGs and completed a symptom and medical history questionnaire. RESULTS: More than 30% of patients who did not endorse any OSA symptoms, but did endorse insomnia or restless legs symptoms, were found to have OSA based on apnea-hypopnea index (AHI) >5 during overnight laboratory testing. Regression models of the full cohort showed that the risk of OSA was related, as expected, to older age, male sex, elevated body mass index, and presence of OSA symptoms. The presence of insomnia symptoms did not alter the risk of OSA. The presence of restless legs symptoms showed a small odds ratio for lowered OSA risk. CONCLUSIONS: Objective evidence of OSA occurs similarly in those with insomnia or restless legs symptoms, even among those without self-reported OSA symptoms. Providers should be aware of the potential for occult OSA in populations with insomnia and restless legs, which may complicate their management in addition to presenting an independent medical risk itself. SN - 1600-0404 UR - https://www.unboundmedicine.com/medline/citation/25974333/Sleep_apnea_in_patients_reporting_insomnia_or_restless_legs_symptoms_ L2 - https://doi.org/10.1111/ane.12439 DB - PRIME DP - Unbound Medicine ER -