Sforza E, Nicolas A, Lavigne G, Gosselin A, Petit D, Montplaisir J
Service d'Explorations Fonctionnelles du Système Nerveux et de Pathologie du Sommeil, Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, France.
Neurology. 1999 Mar 10;52(4):786-91. doi: 10.1212/wnl.52.4.786.
To investigate other physiologic changes that occur with periodic leg movements during sleep (PLMS) that might be considered to be more sensitive indices of sleep fragmentation.
Although PLMS are associated with recurrent microarousals (MA), the frequency of PLMS with MA does not correlate with objective daytime sleepiness. It is postulated that the lack of correlation results from the low sensitivity of the standard criteria used to score MA.
Ten drug-free patients with a polygraphic and clinical diagnosis of restless legs syndrome (RLS) and PLMS were examined. The EEG correlates of PLMS were analyzed by visual scoring and spectral analysis during PLMS that ended in a visible microarousal (PLMS with MA) or not (PLMS without MA). The R-R interval in the EKG signal was also examined.
A total of 34% of PLMS were associated with MA lasting >3 seconds, and 3% of PLMS were associated with MA lasting <3 seconds. Although PLMS with MA were associated with an increase in alpha activity, for PLMS without MA a significant increase in delta and theta activity was present. Both types of PLMS induced a shortening of the R-R interval; this was particularly more marked for PLMS with MA.
First, visual scoring of MA that include a duration of less than 3 seconds has little effect on the detection of PLMS with MA. Second, EEG activation and tachycardia are present during both types of PLMS. Third, a hierarchy in the arousal response is present-going from autonomic activation to bursts of delta activity to alpha activity to a full awakening.
研究睡眠期间周期性腿部运动（PLMS）所伴随的其他生理变化，这些变化可能被视为睡眠片段化更敏感的指标。
尽管PLMS与反复出现的微觉醒（MA）相关，但伴有MA的PLMS频率与客观的日间嗜睡并无关联。据推测，缺乏相关性是由于用于记录MA的标准标准敏感性较低所致。
对10名经多导睡眠图和临床诊断为不安腿综合征（RLS）和PLMS的未用药患者进行检查。通过视觉评分和频谱分析，分析在以可见微觉醒结束的PLMS（伴有MA的PLMS）或未结束的PLMS（不伴有MA的PLMS）期间PLMS的脑电图相关性。还检查了心电图信号中的R-R间期。
总共34%的PLMS与持续时间>3秒的MA相关，3%的PLMS与持续时间<3秒的MA相关。尽管伴有MA的PLMS与α活动增加相关，但对于不伴有MA的PLMS，δ和θ活动显著增加。两种类型的PLMS均导致R-R间期缩短；这在伴有MA的PLMS中尤为明显。
第一，对持续时间小于3秒的MA进行视觉评分对检测伴有MA的PLMS影响不大。第二，两种类型的PLMS期间均存在脑电图激活和心动过速。第三，存在觉醒反应的层次结构——从自主激活到δ活动爆发，再到α活动，最后到完全觉醒。
