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Type: Journal article
Title: Non-REM sleep instability in children with restless sleep disorder
Author: DelRosso, L.
Hartmann, S.
Baumert, M.
Bruni, O.
Ruth, C.
Ferri, R.
Citation: Sleep Medicine, 2020; 75:276-281
Publisher: Elsevier
Issue Date: 2020
ISSN: 1389-9457
Statement of
Lourdes M. DelRosso, Simon Hartmann, Mathias Baumert, Oliviero Bruni, Chris Ruth, Raffaele Ferri
Abstract: Study objectives: Restless sleep disorder (RSD) is a newly recognized condition characterized by motor movements involving large muscle groups with frequent repositioning or bed sheets disruption. We analyzed cyclic alternating pattern (CAP) in these children, a marker of sleep instability that might be associated with the motor episodes of RSD and may play a role in their daytime symptoms. Methods: Polysomnographic recordings from thirty-eight children who fulfilled RSD diagnostic criteria (23 boys and 15 girls), 23 children with restless legs syndrome (RLS, 18 boys and 5 girls) and 19 controls (10 boys and 9 girls) were included. For CAP analysis, a previously developed, highly precise automated system, based on a deep learning recurrent neural network, was used. Results: Age and gender were not statistically different between groups. RSD patients showed a lower percentage of A3 CAP subtypes than controls (median 9.8 vs. 18.2, p = 0.0089), accompanied by shorter duration of the B phase of the CAP cycle (median 28.2 vs. 29.8 in controls, 30.2 in RLS, p = 0.005) and shorter CAP cycle duration than both controls and RLS subjects (median 33.8 vs. 35.0 in controls, 35.8 in RLS, p = 0.002). Finally, RSD children also showed a longer duration of CAP cycle sequences, when compared to controls (median 172.7 vs. 141.9, p = 0.0063). Conclusions: In conclusion, our study indicates that NREM sleep EEG shows an increased instability in RSD; these findings add to the current knowledge on the mechanisms of this newly recognized sleep disorder and suggest that sleep instability might be a favoring mechanism for the emergence of the motor episodes characterizing RSD.
Keywords: Cyclic alternating pattern; restless legs syndrome; restless sleep disorder; NREM sleep instability
Rights: © 2020 Elsevier B.V. All rights reserved.
DOI: 10.1016/j.sleep.2020.07.033
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