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Periodic limb movements during sleep may reduce excessive daytime sleepiness in men with obstructive sleep apnea

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Abstract

Purpose

The impact of periodic limb movements during sleep (PLMS) on excessive daytime sleepiness (EDS) is controversial. We investigated the relationship between PLMS and EDS in men with obstructive sleep apnea (OSA).

Methods

This was a cross-sectional study of men with OSA. PLMS parameters were a PLM index (PLMI) > 15 per hour of sleep and a PLM-arousal index (PLMAI) > 5 per hour of sleep. The Epworth Sleepiness Scale (ESS) and the Beck Depression Inventory were used. EDS was defined as an ESS score ≥ 11. Multivariate logistic regression analysis was performed with adjustments for several covariates.

Results

Of 1111 men with OSA, 14.0% (n = 156) had a PLMI > 15/h, and 3.7% (n = 41) had a PLMAI > 5/h. EDS was noted in 39.5% (n = 439) of men. Men with a PLMI > 15/h were less likely to have EDS (odd ratio [OR], 0.598; 95% confidence interval [CI], 0.414–0.864; p = 0.006). This association remained significant after controlling for age, body mass index, depressive symptoms, total sleep time, and severity of OSA (OR, 0.675; 95% CI, 0.456–0.999; p = 0.049). Men with a PLMAI > 5/h were less likely to have EDS, but this result did not reach statistical significance (OR, 0.550; 95% CI, 0.273–1.109; p = 0.095).

Conclusions

PLMS defined as PLMI > 15/h are significantly and inversely associated with EDS in men with OSA, even after controlling for several confounding variables.

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Author information

Correspondence to Sang-Ahm Lee.

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The authors declare that they have no conflicts of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments, or comparable ethical standards.

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Kim, H.J., Lee, S. Periodic limb movements during sleep may reduce excessive daytime sleepiness in men with obstructive sleep apnea. Sleep Breath (2020). https://doi.org/10.1007/s11325-020-02024-1

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Keywords

  • Periodic limb movements during sleep
  • Obstructive sleep apnea
  • Excessive daytime sleepiness
  • Hyperarousal
  • Restless legs syndrome