Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
J Clin Sleep Med. 2022 Nov 1;18(11):2653-2661. doi: 10.5664/jcsm.10184.
Restless legs syndrome (RLS) is a sleep-related movement disorder, often accompanied by sleep disruption. Obstructive sleep apnea (OSA) has a controversial prevalence among patients with RLS. We evaluated the clinical and sleep features of patients who attended our sleep clinic considering RLS and OSA.
In this cross-sectional study, we obtained health records of 1,497 patients during 2015-2019 who underwent polysomnography (PSG). Baseline characteristics, sleep-related and RLS questionnaires, and sleep microstructure were assessed. Descriptive and analytical assessments were performed. RLS was assessed according to the International Restless Legs Syndrome Study Group criteria.
RLS was found in 19.4% of patients, with more prevalence among women (26.9% vs 16.4%). RLS affected 19.1% of patients with OSA. Patients with RLS were significantly older with higher insomnia and depression and worse PSG results. As the respiratory disturbance index increased, the odds of RLS slightly decreased (adjusted odds ratio [95% confidence interval]: 0.80 [0.67-0.94]). The odds of OSA (respiratory disturbance index ≥ 5) was not affected by RLS. OSA in patients with RLS was significantly associated with a higher limb movement index. RLS in patients with OSA was significantly associated with higher insomnia, depression, and limb movement index (men and women), higher wake after sleep onset and percentage of N1 sleep (men), and lower sleep efficiency (men).
Patients with RLS had worse PSG results, higher insomnia, and depression. Although men with OSA+/RLS+ had worsened PSG results, PSG parameters in women with OSA+/RLS+ did not differ from the OSA+/RLS- group. Patients with either OSA or RLS should be evaluated for possible comorbidities, including insomnia and depression. Notably, sex-specific characteristics need more consideration in sleep clinics.
Amirifard H, Jameie M, Akbarpour S, et al. Sleep microstructure and clinical characteristics of patients with restless legs syndrome. . 2022;18(11):2653-2661.
不宁腿综合征（RLS）是一种与睡眠相关的运动障碍，常伴有睡眠中断。阻塞性睡眠呼吸暂停（OSA）在 RLS 患者中的患病率存在争议。我们评估了在我院睡眠诊所就诊的考虑患有 RLS 和 OSA 的患者的临床和睡眠特征。
在这项横断面研究中，我们获得了 2015 年至 2019 年期间进行多导睡眠图（PSG）的 1497 名患者的健康记录。评估了基线特征、与睡眠相关和 RLS 问卷以及睡眠微结构。进行了描述性和分析评估。根据国际不宁腿综合征研究组的标准评估 RLS。
19.4%的患者患有 RLS，女性患病率更高（26.9%比 16.4%）。19.1%的 OSA 患者患有 RLS。患有 RLS 的患者年龄明显更大，失眠和抑郁更为严重，PSG 结果更差。随着呼吸紊乱指数的增加，患 RLS 的几率略有下降（调整后的比值比[95%置信区间]：0.80[0.67-0.94]）。RLS 对 OSA（呼吸紊乱指数≥5）的发生几率没有影响。RLS 与 RLS 患者的肢体运动指数显著相关。OSA 患者的 RLS 与更高的失眠、抑郁和肢体运动指数（男性和女性）、睡眠后觉醒时间和 N1 睡眠百分比（男性）以及更低的睡眠效率（男性）显著相关。
患有 RLS 的患者 PSG 结果更差，失眠和抑郁更严重。尽管 OSA+/RLS+的男性 PSG 结果恶化，但 OSA+/RLS+女性的 PSG 参数与 OSA+/RLS-组无差异。无论是否患有 OSA 或 RLS，都应评估患者是否存在失眠和抑郁等可能的合并症。值得注意的是，睡眠诊所需要更多考虑性别特异性特征。
Amirifard H, Jameie M, Akbarpour S, et al. Sleep microstructure and clinical characteristics of patients with restless legs syndrome.. 2022;18(11):2653-2661.
