Department of General Internal Medicine, University Hospital Ghent, Gent, Belgium.
Centre for Neurophysiologic Monitoring, University Hospital Ghent, Gent, Belgium.
Pharmacopsychiatry. 2020 Mar;53(2):71-77. doi: 10.1055/a-0991-0498. Epub 2019 Aug 27.
Although the pathophysiology of periodic limb movements in sleep (PLMS) is not well understood, there is increasing belief that management of PLMS can modulate humans' general health. The aim of this study is to investigate the associations between risk factors including the use of antidepressants, hypnotics, and antihistamines as well as of caffeine, alcohol, and nicotine and the occurrence of PLMS and periodic limb movement disorder (PLMD).
Patients with either chronic fatigue or insomnia who underwent polysomnography as standardized clinical assessment were included in a retrospective study. Associations were calculated between substance use and sleep variables.
Tricyclic antidepressants and serotonin and norepinephrine reuptake inhibitor (SNRI) are significantly associated with higher rates of PLMS. Additionally, SNRI is significantly positive associated with PLMD, as also seen for selective serotonin reuptake inhibitors (SSRI). The most frequently used SSRI escitalopram was significantly positively associated with PLMS and PLMD. A significantly negative association was found between paroxetine and PLMS. Benzodiazepines are negatively associated with PLMS and PLMD. Sedative antidepressants, antihistamines, and substance use are not associated with PLMS nor PLMD in this study.
This retrospective study adds supportive evidence to the association of drug classes with PLMS and PLMD. These findings may impact on clinical management of patients with a combined anxiety or mood disorder in need for these drug classes on the one hand and a significant sleep architecture disturbance through PLMS, potentially contributing to daytime symptoms, on the other hand.
尽管睡眠周期性肢体运动（PLMS）的病理生理学尚未得到很好的理解，但越来越多的人认为，PLMS 的管理可以调节人类的整体健康。本研究旨在调查包括使用抗抑郁药、催眠药和抗组胺药以及咖啡因、酒精和尼古丁在内的风险因素与 PLMS 和周期性肢体运动障碍（PLMD）发生之间的关联。
本回顾性研究纳入了接受多导睡眠图作为标准化临床评估的慢性疲劳或失眠患者。计算了物质使用与睡眠变量之间的关联。
三环类抗抑郁药和 5-羟色胺和去甲肾上腺素再摄取抑制剂（SNRI）与更高的 PLMS 发生率显著相关。此外，SNRI 与 PLMD 呈显著正相关，选择性 5-羟色胺再摄取抑制剂（SSRI）也是如此。最常使用的 SSRI 艾司西酞普兰与 PLMS 和 PLMD 显著正相关。帕罗西汀与 PLMS 呈显著负相关。苯二氮䓬类与 PLMS 和 PLMD 呈负相关。在这项研究中，镇静抗抑郁药、抗组胺药和物质使用与 PLMS 或 PLMD 均无关联。
本回顾性研究为药物类别与 PLMS 和 PLMD 的关联提供了支持性证据。这些发现可能会影响需要这些药物类别的合并焦虑或情绪障碍患者的临床管理，一方面是因为 PLMS 导致睡眠结构明显紊乱，可能导致日间症状，另一方面是因为这些药物类别可能会导致 PLMS 和 PLMD。
