Sleep Medicine and Psychophysiology (수면정신생리)

KOREAN ACADEMY OF SLEEP MEDICINE (대한수면의학회)
권호 표지
DOI QR코드

DOI QR Code

The Clinical Significance of Periodic Limb Movements During Sleep in Various Sleep Disorders

다양한 수면장애의 주기성사지운동증의 임상적 의의

  • So-Jin Lee (Department of Psychiatry, Gyeongsang National University School of Medicine)
  • 이소진 (경상국립대학교 의과대학 정신건강의학교실)
  • Received : 2023.05.29
  • Accepted : 2023.06.29
  • Published : 2023.06.30
Download PDF
⟨ Previous Next ⟩

Abstract

Periodic limb movements during sleep (PLMS) are prevalent in various sleep disorders, such as restless legs syndrome (RLS), periodic limb movements disorder, obstructive sleep apnea (OSA), REM sleep behavior disorder (RBD), and narcolepsy. PLMS has been hypothesized to be related to the decline of dopaminergic transmission. In RLS, PLMS is suggested to be related to iron deficiency and symptom severity. PLMD is a rare sleep disorder, and the role of PLMS in PLMD has not been clearly investigated yet. PLMS in OSA, which remain after proper PAP therapy, may need further management. The clinical relevance of PLMS in RBD and narcolepsy have not been investigated thoroughly and need further studies. Whether PLMS are to be considered as a mere symptom of individual sleep disorders or not can be elucidated through studies investigating the efficacy of therapeutic approaches to reduce PLMS in various sleep disorders.

Keywords

References

  1. AASM. International classification of sleep disorders. Darien, IL, American Academy of Sleep Medicine;2014.
  2. Allen RP, Picchietti DL, Garcia-Borreguero D, Ondo WG, Walters AS, Winkelman JW, et al. Restless legs syndrome/Willis-Ekbom disease diagnostic criteria: updated International Restless Legs Syndrome Study Group (IRLSSG) consensus criteria-history, rationale, description, and significance. Sleep Medicine 2014;15:860-873. https://doi.org/10.1016/j.sleep.2014.03.025
  3. Association ASD, Committee DCS, Thorpy MJ. The international classification of sleep disorders: diagnostic and coding manual, American Sleep Disorders Association;1990.
  4. Baran AS, Richert AC, Douglass AB, May W, Ansarin K. Change in periodic limb movement index during treatment of obstructive sleep apnea with continuous positive airway pressure. Sleep 2003;26:717-720.
  5. Bastuji H, Garcia-Larrea L. Sleep/wake abnormalities in patients with periodic leg movements during sleep: factor analysis on data from 24-h ambulatory polygraphy. Journal of Sleep Research 1999;8:217-223. https://doi.org/10.1046/j.1365-2869.1999.00157.x
  6. Budhiraja R, Javaheri S, Pavlova MK, Epstein LJ, Omobomi O, Quan SF. Prevalence and correlates of periodic limb movements in OSA and the effect of CPAP therapy. Neurology 2020;94:e1820-e1827. https://doi.org/10.1212/WNL.0000000000008844
  7. Claman DM, Ewing SK, Redline S, Ancoli-Israel S, Cauley JA, Stone KL, et al. Periodic leg movements are associated with reduced sleep quality in older men: the MrOS Sleep Study. Journal of Clinical Sleep Medicine 2013;9:1109-1117. https://doi.org/10.5664/jcsm.3146
  8. Coleman R. Periodic movements in sleep (nocturnal myoclonus) and restless legs syndrome. Sleeping and waking disorders: indications and techniques 1982:Sp265-295.
  9. Crabtree VM, Ivanenko A, O'Brien LM, Gozal D. Periodic limb movement disorder of sleep in children. Journal of Sleep Research 2003;12:73-81. https://doi.org/10.1046/j.1365-2869.2003.00332.x
  10. Dauvilliers Y, Pennestri MH, Petit D, Dang-Vu T, Lavigne G, Montplaisir J. Periodic leg movements during sleep and wakefulness in narcolepsy. Journal of Sleep Research 2007;16:333-339. https://doi.org/10.1111/j.1365-2869.2007.00601.x
  11. Ferri R, Zucconi M, Manconi M, Bruni O, Ferini-Strambi L, Vandi S, et al. Different periodicity and time structure of leg movements during sleep in narcolepsy/cataplexy and restless legs syndrome. Sleep 2006;29:1587-1594. https://doi.org/10.1093/sleep/29.12.1587
  12. Garcia-Borreguero D, Larrosa O, de la Llave Y, Granizo JJ, Allen R. Correlation between rating scales and sleep laboratory measurements in restless legs syndrome. Sleep Medicine 2004;5:561-565. https://doi.org/10.1016/j.sleep.2004.08.003
  13. Hornyak M, Feige B, Riemann D, Voderholzer U. Periodic leg movements in sleep and periodic limb movement disorder: prevalence, clinical significance and treatment. Sleep Medicine Reviews 2006;10:169-177. https://doi.org/10.1016/j.smrv.2005.12.003
  14. Hornyak M, Hundemer HP, Quail D, Riemann D, Voderholzer U, Trenkwalder C. Relationship of periodic leg movements and severity of restless legs syndrome: a study in unmedicated and medicated patients. Clinical Neurophysiology 2007;118:1532-1537. https://doi.org/10.1016/j.clinph.2007.04.001
  15. Huang Z, Lobbezoo F, de Vries N, Aarab G, Hilgevoord AA. Temporal association between leg movements and respiratory events in patients with obstructive sleep apnea: description and differences between the AASM and WASM scoring criteria. Sleep and Breathing 2023:1-10.
  16. Kryger MH, Roth T, Goldstein CA. Kryger's Principles and Practice of Sleep Medicine, Elsevier Health Sciences;2021.
  17. Lee SA, Lee YS, Cho CW, Yang HR, Im K. Different scoring rules for respiratory event-related leg movements: effects on the prevalence of periodic limb movements during sleep and their association with depressive symptoms in patients with obstructive sleep apnea. Sleep Medicine 2021;85:204-210. https://doi.org/10.1016/j.sleep.2021.07.020
  18. Li X, Allen RP, Earley CJ, Liu H, Cruz TE, Edden RA, et al. Brain iron deficiency in idiopathic restless legs syndrome measured by quantitative magnetic susceptibility at 7 tesla. Sleep Medicine 2016;22:75-82. https://doi.org/10.1016/j.sleep.2016.05.001
  19. Lugaresi E, Coccagna G, Mantovani M, Lebrun R. Some periodic phenomena arising during drowsiness and sleep in man. Electroencephalography and Clinical Neurophysiology 1972;32:701-705. https://doi.org/10.1016/0013-4694(72)90106-X
  20. Manconi M, Ferri R, Zucconi M, Fantini ML, Plazzi G, Ferini-Strambi L. Time structure analysis of leg movements during sleep in REM sleep behavior disorder. Sleep 2007;30:1779-1785. https://doi.org/10.1093/sleep/30.12.1779
  21. Montplaisir J, Boucher S, Poirier G, Lavigne G, Lapierre O, Lesperance P. Clinical, polysomnographic, and genetic characteristics of restless legs syndrome: a study of 133 patients diagnosed with new standard criteria. Movement Disorders: Official Journal of the Movement Disorder Society 1997;12:61-65. https://doi.org/10.1002/mds.870120111
  22. Ohayon MM, Roth T. Prevalence of restless legs syndrome and periodic limb movement disorder in the general population. Journal of Psychosomatic Research 2002;53:547-554. https://doi.org/10.1016/S0022-3999(02)00443-9
  23. Picchietti D. Periodic limb movements in sleep: irrelevant epiphenomenon, marker for a potential problem, or a disorder? Journal of Clinical Sleep Medicine 2006;2:446-447. https://doi.org/10.5664/jcsm.26662
  24. Schipper MH, Alvarez-Estevez D, Jellema K, Verbraecken J, Fulda S, Rijsman RM. Sleep-related leg movements in obstructive sleep apnea: definitions, determinants, and clinical consequences. Sleep Medicine 2020;75:131-140. https://doi.org/10.1016/j.sleep.2020.06.004
  25. Shin JW, Koo YS, Lee BU, Shin WC, Lee SK, Cho YW, et al. Prevalence and characteristics of periodic limb movements during sleep in Korean adult patients with restless legs syndrome. Journal of Clinical Sleep Medicine 2016;12:1089-1097. https://doi.org/10.5664/jcsm.6042
  26. Symonds CP. Nocturnal myoclonus. Journal of Neurology, Neurosurgery, and Psychiatry 1953;16:166.
  27. Youngstedt SD, Kripke DF, Klauber MR, Sepulveda RS, Mason WJ. Periodic leg movements during sleep and sleep disturbances in elders. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 1998;53:M391-M394. https://doi.org/10.1093/gerona/53A.5.M391
  28. Zucconi M, Ferri R, Allen R, Baier PC, Bruni O, Chokroverty S, et al. The official World Association of Sleep Medicine (WASM) standards for recording and scoring periodic leg movements in sleep (PLMS) and wakefulness (PLMW) developed in collaboration with a task force from the International Restless Legs Syndrome Study Group (IRLSSG). Sleep Medicine 2006;7:175-184. https://doi.org/10.1016/j.sleep.2006.01.001