Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Sleep Breath. 2020 Dec;24(4):1523-1529. doi: 10.1007/s11325-020-02024-1. Epub 2020 Feb 7.
The impact of periodic limb movements during sleep (PLMS) on excessive daytime sleepiness (EDS) is controversial. We investigated the relationship between PLMS and EDS in men with obstructive sleep apnea (OSA).
This was a cross-sectional study of men with OSA. PLMS parameters were a PLM index (PLMI) > 15 per hour of sleep and a PLM-arousal index (PLMAI) > 5 per hour of sleep. The Epworth Sleepiness Scale (ESS) and the Beck Depression Inventory were used. EDS was defined as an ESS score ≥ 11. Multivariate logistic regression analysis was performed with adjustments for several covariates.
Of 1111 men with OSA, 14.0% (n = 156) had a PLMI > 15/h, and 3.7% (n = 41) had a PLMAI > 5/h. EDS was noted in 39.5% (n = 439) of men. Men with a PLMI > 15/h were less likely to have EDS (odd ratio [OR], 0.598; 95% confidence interval [CI], 0.414-0.864; p = 0.006). This association remained significant after controlling for age, body mass index, depressive symptoms, total sleep time, and severity of OSA (OR, 0.675; 95% CI, 0.456-0.999; p = 0.049). Men with a PLMAI > 5/h were less likely to have EDS, but this result did not reach statistical significance (OR, 0.550; 95% CI, 0.273-1.109; p = 0.095).
PLMS defined as PLMI > 15/h are significantly and inversely associated with EDS in men with OSA, even after controlling for several confounding variables.
睡眠周期性肢体运动（PLMS）对日间过度嗜睡（EDS）的影响存在争议。我们研究了阻塞性睡眠呼吸暂停（OSA）男性中 PLMS 与 EDS 之间的关系。
这是一项 OSA 男性的横断面研究。PLMS 参数为每小时睡眠的 PLM 指数（PLMI）>15 和每小时睡眠的 PLM-觉醒指数（PLMAI）>5。使用 Epworth 睡眠量表（ESS）和 Beck 抑郁量表进行评估。EDS 定义为 ESS 评分≥11。进行了多变量逻辑回归分析，并对多个协变量进行了调整。
在 1111 名 OSA 男性中，14.0%（n=156）的 PLMI>15/h，3.7%（n=41）的 PLMAI>5/h。39.5%（n=439）的男性存在 EDS。PLMI>15/h 的男性发生 EDS 的可能性较低（比值比[OR]，0.598；95%置信区间[CI]，0.414-0.864；p=0.006）。在控制年龄、体重指数、抑郁症状、总睡眠时间和 OSA 严重程度后，这种关联仍然显著（OR，0.675；95%CI，0.456-0.999；p=0.049）。PLMAI>5/h 的男性发生 EDS 的可能性较低，但结果无统计学意义（OR，0.550；95%CI，0.273-1.109；p=0.095）。
即使在控制了几个混杂变量后，PLMS 定义为 PLMI>15/h 与 OSA 男性的 EDS 显著负相关。
