Seifen Christopher, Herrmann Moritz, Pordzik Johannes, Matthias Christoph, Gouveris Haralampos
Sleep Medicine Center & Department of Otolaryngology, Head and Neck Surgery, University Medical Center Mainz, Mainz, Germany.
Front Med (Lausanne). 2024 Apr 26;11:1378410. doi: 10.3389/fmed.2024.1378410. eCollection 2024.
Periodic limb movement disorder (PLMD) and obstructive sleep apnea (OSA) are overlapping clinical syndromes with common risk factors. However, current literature has failed to establish a clear pathophysiological link between them. Thus, little is known about periodic limb movements (PLM) in otherwise healthy patients with suspected OSA.
We performed a retrospective analysis of 112 patients (age: 44.5 ± 12.0 years, 14.3% female) with suspected OSA who underwent full night polysomnography for the first time. Patients with chronic diseases of any kind, recent infections, malignancies, or daily or regular use of any type of medication were excluded. Group comparisons were made based on the severity of OSA (using the apnea hypopnea index, AHI) or the periodic limb movement index (PLMI).
Both, PLMI and the total number of periodic limb movements during sleep (PLMS), showed a significant increase in patients with severe OSA. In addition, AHI and apnea index (AI) were significantly higher in patients with PLMI >15/h, with a similar trend for hypopnea index (HI) ( < 0.001, < 0.001, and > 0.05, respectively). PLMI was significantly positive correlated with AHI, AI, and HI ( = 0.392, < 0.001; = 0.361, < 0.001; and = 0.212, < 0.05, respectively). Patients with PLMI >15/h were significantly older ( < 0.001). There was no significant association between body mass index (BMI) and PLMI >15/h.
We found a significant association between the severity of OSA and PLM in our study population with suspected OSA but without other comorbidities. PLMI and PLMS were significantly increased in patients with severe OSA. Future prospective studies with larger collectives should verify the presented results and should include mechanistic aspects in their evaluation.
周期性肢体运动障碍（PLMD）和阻塞性睡眠呼吸暂停（OSA）是具有共同危险因素的重叠临床综合征。然而，目前的文献未能在它们之间建立明确的病理生理联系。因此，对于疑似OSA的其他方面健康的患者的周期性肢体运动（PLM）了解甚少。
我们对112例首次接受全夜多导睡眠监测的疑似OSA患者（年龄：44.5±12.0岁，14.3%为女性）进行了回顾性分析。排除患有任何慢性疾病、近期感染、恶性肿瘤或每日或定期使用任何类型药物的患者。根据OSA的严重程度（使用呼吸暂停低通气指数，AHI）或周期性肢体运动指数（PLMI）进行组间比较。
PLMI和睡眠期间周期性肢体运动的总数（PLMS）在重度OSA患者中均显著增加。此外，PLMI>15次/小时的患者的AHI和呼吸暂停指数（AI）显著更高，低通气指数（HI）也有类似趋势（分别为<0.001、<0.001和>0.05）。PLMI与AHI、AI和HI显著正相关（分别为=0.392，<0.001；=0.361，<0.001；=0.212，<0.05）。PLMI>15次/小时的患者年龄显著更大（<0.001）。体重指数（BMI）与PLMI>15次/小时之间无显著关联。
在我们的疑似OSA但无其他合并症的研究人群中，我们发现OSA的严重程度与PLM之间存在显著关联。重度OSA患者的PLMI和PLMS显著增加。未来更大样本量的前瞻性研究应验证所呈现的结果，并应在评估中纳入机制方面的内容。
