Clinical significance of periodic limb movements during sleep: The HypnoLaus study

Publication date: Available online 9 October 2017
Source:Sleep Medicine
Author(s): José Haba-Rubio, Helena Marti-Soler, Nadia Tobback, Daniela Andries, Pedro Marques-Vidal, Peter Vollenweider, Martin Preisig, Raphael Heinzer
ObjectivePeriodic limb movements during sleep (PLMS) are prevalent in the general population, but their impact on sleep and association with cardiometabolic disorders are a matter of debate.MethodsData from 2162 participants (51.2% women, mean age 58.4±11.1 years) of the population-based HypnoLaus study (Lausanne, Switzerland) were collected. Subjective sleep complaints and habits were assessed using the Pittsburgh Sleep Quality Index and the Epworth Sleepiness Scale (ESS). Participants underwent a full polysomnography (PSG) at home and were evaluated for the presence of hypertension, diabetes and metabolic syndrome.ResultsParticipants with a PLMS index (PLMSI) >15/h (28.6% of the sample) had longer subjective sleep latency (18.6±17.2 vs. 16.1±14.3 min, p=0.014) and duration (7.1±1.2 vs. 6.9±1.1 h, p<0.001) than participants with PLMSI ≤15/h. At the PSG they spent more time in stage N2 sleep (49.0±11.2 vs. 45.5±9.8%, p<0.001), less in stage N3 (17.6±8.2 vs. 20.6±8.4%, p<0.001) and in REM sleep (20.3±6.4 vs. 22.4±6.0%, p<0.001), exhibited longer REM latency (104.2±70.2 vs. 91.7±58.6 min, p<0.001) and higher arousal index (26.5±12.3 vs. 19.2±9.7 n/h, p<0.001). Participants with a PLMSI>15/h had a lower ESS scores and higher prevalence of hypertension, diabetes and metabolic syndrome. Multivariate analysis adjusting for confounding factors confirmed the independent association of PLMSI>15/h with subjective sleep latency and duration, as well as with objective sleep structure disturbances. However, the associations with sleepiness and cardiovascular risk factors disappeared.ConclusionsIn our large middle-age European population-based sample, PLMSI>15/h was associated with subjective and objective sleep disturbances, but not with sleepiness, hypertension, diabetes or metabolic syndrome.



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