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An evidence-based analysis of the association between periodic leg movements during sleep and arousals in restless legs syndrome

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dc.contributor.authorFerri, R.
dc.contributor.authorRundo, F.
dc.contributor.authorZucconi, M.
dc.contributor.authorManconi, M.
dc.contributor.authorBruni, O.
dc.contributor.authorFerini-Strambi, L.
dc.contributor.authorFulda, S.
dc.date.issued2015
dc.description.abstractSTUDY OBJECTIVES: To analyze statistically the association between periodic leg movements during sleep (PLMS) and arousals, in order to eventually support or challenge the current scoring rules and to further understand their reciprocal influence. SETTING: Sleep research center. PATIENTS: Twenty untreated consecutive patients with restless legs syndrome (RLS) (13 women and 7 males, mean age 60.9 y). METHODS: In each recording, we selected all PLMS/arousal pairs that met the following inclusion criteria: (a) PLMS events that were separated from another PLMS event (preceding or following) by at least 10 s of EMG inactivity; (b) arousal events separated from another arousal event (preceding or following) by at least 10 s of stable EEG baseline activity; (c) PLMS/arousal pairs were then selected among events identified according to the previous two criteria, when PLMS and arousals were separated (offset-to-onset) by no more than 10 s, regardless of which was first. MEASUREMENTS AND RESULTS: We selected a mean of 46.1 (SD 25.55) PLMS/arousal pairs per subject; in these pairs, average PLMS duration was 3.2 s (0.65) and average arousal duration was 6.5 s (0.92). Within these event pairs, the great majority (on average 98.4%, SD 3.88) was separated by less than 0.5 s (i.e., between the end of one event and the onset of the other, regardless of which was first). Arousal onsets preceded PLMS onset in 41.2% of pairs, while the opposite was true for the remaining 58.8% of pairs. A significant correlation between PLMS duration and arousal duration was also found (r = 0.447, P < 0.000001). CONCLUSION: The results of this study support the current rule for the definition of the association between periodic leg movements during sleep (PLMS) and arousals. The tight time relationship between PLMS and arousals and their correlated durations seem to indicate that both events might be regulated by a complex mechanism, rather than being connected by a simple reciprocal cause/effect relationship.
dc.description.statementofresponsibilityRaffaele Ferri, Francesco Rundo, Marco Zucconi, Mauro Manconi, Oliviero Bruni, Luigi Ferini-Strambi, Stephany Fulda
dc.identifier.citationSleep, 2015; 38(6):919-924
dc.identifier.doi10.5665/sleep.4740
dc.identifier.issn0161-8105
dc.identifier.issn1550-9109
dc.identifier.orcidFerri, R. [0000-0001-6937-3065]
dc.identifier.orcidBruni, O. [0000-0003-2207-1398]
dc.identifier.urihttp://hdl.handle.net/2440/96087
dc.language.isoen
dc.publisherAssociated Professional Sleep Societies
dc.rightsCopyright status unknown
dc.source.urihttps://doi.org/10.5665/sleep.4740
dc.subjectPLMS
dc.subjectarousals
dc.subjectperiodic leg movements during sleep
dc.subjectrestless legs syndrome
dc.subjectsleep scoring
dc.titleAn evidence-based analysis of the association between periodic leg movements during sleep and arousals in restless legs syndrome
dc.typeJournal article
pubs.publication-statusPublished

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