Peters Annemieke Emma Josina, van Silfhout Lysanne, Graco Marnie, Schembri Rachel, Thijssen Dick, Berlowitz David J
a Institute for Breathing and Sleep , Austin Health , Melbourne , Australia.
b Department of Physiology , Radboud University Nijmegen Medical Centre , Nijmegen , The Netherlands.
J Spinal Cord Med. 2018 May;41(3):318-325. doi: 10.1080/10790268.2017.1320874. Epub 2017 May 2.
To establish the prevalence of Periodic Limb Movements during Sleep (PLMS) in patients with tetraplegia, controlling for obstructive sleep apnea. To explore whether demographic and injury characteristics affect PLMS.
Retrospective cohorts.
One hundred seventy-three participants with acute (<12 months) and 92 with chronic (>12 months) tetraplegia who underwent full overnight diagnostic sleep studies.
Two hundred sixty-two sleep study recordings were included. A randomly selected subgroup of 21 studies was assessed for PLM during wakefulness. Data were analysed according to the current American Academy of Sleep Medicine guidelines.
Of the participants, 41.6% (43(15.7) years and 14.9% female) had a motor and sensory complete lesion. Sleep was poor with both OSA (87.8% with apnea hypopnoea index ≥ 5) and PLMS (58.4% with PLMS per hour PLMSI > 15) highly prevalent. There was no difference in the PLMSI between those with OSA (36.3(39.8)) or without (42.2(37.7), P = 0.42). PLMS were evident during REM and NREM sleep in all of the 153 patients with PLMSI > 15. All 21 participants in the subgroup of studies analysed for the PLM during quiet wakefulness, exhibited limb movements. None of the modelled variables (injury completeness, gender, OSA severity or time since injury) significantly predicted a PLMSI > 15 (P = 0.343).
In conclusion, this study confirms the high prevalence of PLM in tetraplegia and the presence of leg movements in NREM and REM sleep along with wakefulness after controlling for OSA. No associations between the presence of PLMS and patient characteristics or injury specific aspects were found.
确定四肢瘫痪患者睡眠期周期性肢体运动（PLMS）的患病率，并控制阻塞性睡眠呼吸暂停。探讨人口统计学和损伤特征是否会影响PLMS。
回顾性队列研究。
173名急性（<12个月）四肢瘫痪患者和92名慢性（>12个月）四肢瘫痪患者接受了整夜的全面诊断性睡眠研究。
纳入262份睡眠研究记录。随机选择21项研究的亚组，评估清醒期的PLM。数据根据美国睡眠医学会现行指南进行分析。
参与者中，41.6%（年龄43（15.7）岁，女性占14.9%）存在运动和感觉完全性损伤。睡眠质量较差，阻塞性睡眠呼吸暂停（呼吸暂停低通气指数≥5者占87.8%）和PLMS（每小时PLMS指数>15者占58.4%）的患病率都很高。有阻塞性睡眠呼吸暂停者（36.3（39.8））和无阻塞性睡眠呼吸暂停者（42.2（37.7））的PLMS指数无差异（P = 0.42）。在153名PLMS指数>15的患者中，快速眼动睡眠期和非快速眼动睡眠期均有明显的PLMS。在安静清醒期分析PLM的研究亚组中的所有21名参与者均表现出肢体运动。没有一个模型变量（损伤完整性、性别、阻塞性睡眠呼吸暂停严重程度或受伤时间）能显著预测PLMS指数>15（P = 0.343）。
总之，本研究证实了四肢瘫痪患者中PLM的高患病率，以及在控制阻塞性睡眠呼吸暂停后，非快速眼动睡眠期、快速眼动睡眠期和清醒期均存在腿部运动。未发现PLMS的存在与患者特征或损伤特定方面之间存在关联。
