Stanford University Center for Sleep Sciences and Medicine, Psychiatry and Behavioral Medicine, Stanford University, CA, USA.
School of Medicine and Public Health, Department of Population Health Sciences, University of Wisconsin-Madison, WI, USA.
Clin Neurophysiol. 2018 Nov;129(11):2306-2314. doi: 10.1016/j.clinph.2018.08.022. Epub 2018 Sep 6.
Periodic limb movements in sleep (PLMS) are thought to be prevalent in elderly populations, but their impact on quality of life remains unclear. We examined the prevalence of PLMS, impact of age on prevalence, and association between PLMS and sleepiness.
We identified limb movements in 2335 Wisconsin Sleep Cohort polysomnograms collected over 12 years. Prevalence of periodic limb movement index (PLMI) ≥15 was calculated at baseline (n = 1084). McNemar's test assessed changes in prevalence over time. Association of sleepiness and PLMS evaluated using linear mixed modeling and generalized estimating equations. Models adjusted for confounders.
Prevalence of PLMI ≥15 at baseline was 25.3%. Longitudinal prevalence increased significantly with age (p = 2.97 × 10). Sleepiness did not differ significantly between PLMI groups unless stratified by restless legs syndrome (RLS) symptoms. The RLS+/PLM+ group was sleepier than the RLS+/PLM- group. Multiple Sleep Latency Test trended towards increased alertness in the RLS-/PLM+ group compared to RLS-/PLM-.
A significant number of adults have PLMS and prevalence increased with age. No noteworthy association between PLMI category and sleepiness unless stratified by RLS symptoms.
Our results indicate that RLS and PLMS may have distinct clinical consequences and interactions that can help guide treatment approach.
睡眠周期性肢体运动(PLMS)被认为在老年人群中较为普遍,但它们对生活质量的影响仍不清楚。我们研究了 PLMS 的流行率、年龄对流行率的影响以及 PLMS 与嗜睡之间的关系。
我们在威斯康星州睡眠队列的 2335 次多导睡眠图中确定了肢体运动。在基线时(n=1084)计算了周期性肢体运动指数(PLMI)≥15 的患病率。McNemar 检验评估了随时间变化的患病率变化。使用线性混合模型和广义估计方程评估嗜睡与 PLMS 的相关性。模型调整了混杂因素。
基线时 PLMI≥15 的患病率为 25.3%。纵向患病率随年龄显著增加(p=2.97×10)。除非按不安腿综合征(RLS)症状分层,否则 PLMI 组之间的嗜睡程度没有显著差异。RLS+/PLM+组比 RLS+/PLM-组更嗜睡。多导睡眠潜伏期试验(Multiple Sleep Latency Test)显示,与 RLS-/PLM-组相比,RLS-/PLM+组的警觉性趋势有所提高。
相当数量的成年人有 PLMS,而且患病率随年龄增长而增加。除非按 RLS 症状分层,否则 PLMI 类别与嗜睡之间没有显著关联。
我们的结果表明,RLS 和 PLMS 可能具有不同的临床后果和相互作用,可以帮助指导治疗方法。