周期性肢体运动与药物类别相关：一项回顾性队列研究。

Association of Periodic Limb Movements With Medication Classes: A Retrospective Cohort Study.

机构信息

From the Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute (O.H., T.J., P. Rajendram, R.Z., P. Ravindran, S.O., M.B., Y.Q., B.J.M., M.I.B.), and Sleep Laboratory (B.M., M.I.B.), Sunnybrook Health Sciences Centre, Toronto; the Ottawa Hospital Research Institute (T.K.), University of Ottawa; and Department of Medicine, Division of Neurology (P. Rajendram, B.J.M., M.I.B.), University of Toronto, Canada.

出版信息

Neurology. 2022 Apr 12;98(15):e1585-e1595. doi: 10.1212/WNL.0000000000200012. Epub 2022 Feb 7.

DOI:10.1212/WNL.0000000000200012

PMID:35131908

Abstract

BACKGROUND AND OBJECTIVES

To investigate the association between various medication classes and the periodic limb movement index (PLMI) in a clinical cohort of adults who completed in-laboratory polysomnography.

METHODS

A single, diagnostic, overnight, in-laboratory polysomnogram was completed for 3,488 patients consecutively referred from 2010 to 2015 to determine PLMI. Medication use and medical comorbidities were collected through patient questionnaires. Associations between medication classes and PLMI were ascertained using multivariable ordinal logistic regression models.

RESULTS

The median age of the cohort was 56.0 years (48.2% male). After adjusting for age, sex, body mass index, relevant comorbidities, and sleep measures, the use of selective serotonin reuptake inhibitors (SSRIs) (odds ratio [OR] 1.52) and serotonin-norepinephrine reuptake inhibitors (SNRIs) (OR 1.99) was associated with increased PLMI. Conversely, gabapentinoids (OR 0.71), stimulants (OR 0.52), benzodiazepines (OR 0.79), and dopamine agonists (OR 0.38) were associated with decreased PLMI. A non-statistically significant trend for decreased PLMI with neuroleptic use was observed. No significant associations were found between PLMI and the use of antihypertensives, statins, tricyclic antidepressants, bupropion, anticoagulants, antiplatelets, modafinil, and antihistamines.

DISCUSSION

The use of SSRIs and SNRIs was associated with elevated PLMI while the use of gabapentinoids, stimulants, benzodiazepines, and dopamine agonists was associated with decreased PLMI. These results can assist physicians in managing periodic limb movements in sleep (PLMS) and invite further research into the relationship between PLMS and medications with the modulating effects of dose, formulation type, and time of administration.

CLASSIFICATION OF EVIDENCE

This study provides Class II evidence that SSRIs and SNRIs are associated with elevated PLMI while gabapentinoids, stimulants, benzodiazepines, and dopamine agonists are associated with decreased PLMI.

摘要

背景与目的

在一项对连续接受 2010 年至 2015 年实验室多导睡眠图检查的成年人进行的临床队列研究中，调查各种药物类别与周期性肢体运动指数（PLMI）之间的关联。

方法

对 3488 例连续就诊的患者进行单例、诊断性、夜间实验室多导睡眠图检查，以确定 PLMI。通过患者问卷收集药物使用情况和合并症信息。使用多变量有序逻辑回归模型确定药物类别与 PLMI 之间的关联。

结果

队列的中位年龄为 56.0 岁（48.2%为男性）。在校正年龄、性别、体重指数、相关合并症和睡眠指标后，使用选择性 5-羟色胺再摄取抑制剂（SSRIs）（比值比[OR]1.52）和 5-羟色胺-去甲肾上腺素再摄取抑制剂（SNRIs）（OR 1.99）与 PLMI 增加相关。相反，加巴喷丁类药物（OR 0.71）、兴奋剂（OR 0.52）、苯二氮䓬类（OR 0.79）和多巴胺激动剂（OR 0.38）与 PLMI 降低相关。观察到神经安定药使用与 PLMI 降低呈非统计学显著趋势。PLMI 与降压药、他汀类药物、三环类抗抑郁药、安非他酮、抗凝剂、抗血小板药物、莫达非尼和抗组胺药的使用无显著相关性。