Periodic leg movements during sleep and periodic limb movement disorder in patients presenting with unexplained insomnia |
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| Affiliation: | 1. Sleep Research Centre, Department of Neurology I.C., Oasi Institute for Research on Mental Retardation and Brain Aging (IRCCS), Via C. Ruggero 73, 94018 Troina, Italy;2. Department of Neurology, Innsbruck Medical University, Innsbruck, Austria;1. Department of Pediatrics, Kitano Hospital, The Tazuke Kofukai Medical Institute, Osaka, Japan;2. Department of Pediatrics, Asahikawa Medical University, Asahikawa, Japan;1. Department of Orthopaedic Surgery, Shanghai Changzheng Hospital, Second Military Medical University, 415 Fengyang Rd., Shanghai, 200003, P.R. China;2. Department of Orthopaedic Surgery, University of California, 675 Charles E. Young Dr. S., Los Angeles, CA 90024, USA;3. Department of Orthodontics, Peking University School and Hospital of Stomatology, 22 South Zhongguancun St., Beijing 100081, P.R. China;4. Research Service, VA Greater Los Angeles Healthcare System, 16111 Plummer St., North Hills, CA 91343, USA;5. Geriatric Research, Education and Clinical Center, VA Greater Los Angeles Healthcare System, 16111 Plummer St., North Hills, CA 91343, USA;6. Department of Medicine, University of California, 650 Charles E. Young Dr. S., Los Angeles, CA 90024, USA;7. Department of Orthopaedic Surgery, Keck School of Medicine of USC, 1520 San Pablo, HCT Suite 2000, Los Angeles, CA 90033, USA;8. Division of Orthopaedic Surgery, Department of Surgery, University of Nevada School of Medicine, 2040 W Charleston Blvd, Suite 601, Las Vegas, NV 89102, USA;1. Division of Cardiovascular Diseases, Department of Medicine, Mayo Clinic, Rochester, MN, USA;2. Hypertension Unit, Department of Hypertension and Diabetology, Medical University of Gdansk, Gdansk, Poland;3. Pfizer Global Research & Development, Pfizer Inc., Groton, CT, USA;1. Department of Neurology, Kaohsiung Chang Gung Memorial Hospital and College of Medicine, Chang Gung University, Kaohsiung City, Taiwan;2. Department of Clinical Forensic Medicine, Kaohsiung Medical University Hospital and College of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan;1. Department of Neurology, Toho University Omori Medical Center, Tokyo, Japan;2. Department of Neurology, Mishuku Hospital, Tokyo, Japan |
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| Abstract: | ObjectiveThe aim of this study was to evaluate quantitatively the presence and the characteristics of periodic leg movements during sleep (PLMS) in a group of consecutive patients presenting with daytime impairment related to insomnia of unknown etiology and whose polysomnographic features differ from those of healthy individuals only for a significantly increased arousal index in NREM sleep.MethodsWe recruited 20 consecutive adult patients with insomnia according to the ICSD-2 criteria, 20 patients with RLS, and 12 age-matched normal controls. The time structure of their polysomnographically recorded leg movements during sleep was analyzed by means of an approach particularly able to consider their periodicity.ResultsA subgroup of 12 patients with a relatively high number of periodic LM activity was detected with a statistically based approach using two indexes: total LM index and Periodicity index. This subgroup had high PLMS index, Periodicity index was also high and PLMS showed a progressive decrease during the night, being highest in the first hours of sleep. The characteristics of PLMS were identical within this insomnia subgroup and RLS patients.ConclusionsPLMS was a common finding in our patients with insomnia and a detailed analysis of their periodicity revealed that a subgroup of these patients had to be finally diagnosed with Periodic Limb Movement Disorder.SignificancePolysomnography with the subsequent analysis of PLMS periodicity is able to differentiate between insomnia patient subgroups. |
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