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Heart Rate and Blood Pressure Changes Associated with Periodic Limb Movements

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Abstract

Periodic limb movements in sleep (PLMS) are known to be associated with significant heart rate (HR) variability (HRV) and PLMS with arousals are associated with a higher degree of autonomic activation. PLMS are also known to be associated with statistically significant transient rises in systolic and diastolic blood pressure (BP). Such repetitive abnormal HR and BP rises can play a role in increased cardiovascular risk in restless legs syndrome (RLS) patients with PLMS thus making PLMS a potential and an emerging cardiovascular and cerebrovascular risk factor. Hypertension, heart disease and stroke are suspected to be potential effects of PLMS. PLMS are embedded in the general sleep oscillatory pattern involving not only the motor system but also the autonomic function, cortical electroencephalographic (EEG) activities, the respiratory system, and several other functions too. This chapter will review the present data available to establish the complex relationship of PLMS with HR and BP.

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References

  1. Walters AS, Rye DB. Review of the relationship of restless legs syndrome and periodic limb movements in sleep to hypertension, heart disease, and stroke. Sleep. 2009;32:589–97.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Winkelman JW, Cunningham S. Autonomic consequences of periodic leg movements of sleep. Sleep. 1998;21(suppl):S67.

    Google Scholar 

  3. Sforza E, Nicolas A, Lavigne G, Gosselin A, Petit D, Montplaisir J. EEG and cardiac activation during periodic leg movements in sleep: support for a hierarchy of arousal responses. Neurology. 1999;52:786–91.

    Article  CAS  PubMed  Google Scholar 

  4. Ferri R, Zucconi M, Rundo F, Spruyt K, Manconi M, Ferini-Strambi L. Heart rate and spectral EEG changes accompanying periodic and nonperiodic leg movements during sleep. Clin Neurophsiol. 2007;118:438–48.

    Article  Google Scholar 

  5. Sforza E, Juony C, Ibanez V. Time-dependent variation in cerebral and autonomic activity during periodic leg movements in sleep: implications for arousal mechanisms. Clin Neurophysiol. 2002;113:883–91.

    Article  PubMed  Google Scholar 

  6. Gosselin N, Lanfranchi P, Michaud M, Fantini L, Carrier J, Lavigne G, Montplaisir J. Age and gender effects on heart rate activation associated with periodic leg movements in patients with restless legs syndrome. Clin Neurophysiol. 2003;114:2188–95.

    Article  CAS  PubMed  Google Scholar 

  7. Ferrillo F, Beelke M, Canovaro P, Watanabe T, Aricò D, Rizzo P, Garbarino S, Nobili L, De Carli F. Changes in cerebral and autonomic activity heralding periodic limb movements in sleep. Sleep Med. 2004;5:407–12.

    Article  PubMed  Google Scholar 

  8. Sforza E, Pichot V, Barthelemy JC, Haba-Rubio J, Roche F. Cardiovascular variability during periodic leg movements: a spectral analysis approach. ClinNeurophysiol. 2005;116:1096–104.

    Google Scholar 

  9. Guggisberg AG, Hess CW, Mathis J. The significance of the sympathetic nervous system in the pathophysiology of periodic leg movements in sleep. Sleep. 2007;30:755–66.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Ferri R, Zucconi M, Rye D. Heart rate changes accompanying periodic leg movements during sleep in narcoleptic patients. Sleep. 2011;34:409–10.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Lavoie S, de Bilbao F, Haba-Rubio J, Ibanez V, Sforza E. Influence of sleep stage and wakefulness on spectral EEG activity and heart rate variations around periodic leg movements. Clin Neurophysiol. 2004;115:2236–46.

    Article  PubMed  Google Scholar 

  12. Lugaresi E, Coccagna G, Mantovani M, Lebrun R. Some periodic phenomena arising during drowsiness and sleep in man. Electroencephalogr Clin Neurophysiol. 1972;32:701–5.

    Article  CAS  PubMed  Google Scholar 

  13. Ali NJ, Davies RJO, Fleetham JA, Stradling JR. Periodic movements of the legs during sleep associated with rises in systemic blood pressure. Sleep. 1991;14:163–5.

    CAS  PubMed  Google Scholar 

  14. Pennestri MH, Montplaisir J, Colombo R, Lavigne G, Lanfranchi PA. Nocturnal blood pressure changes in patients with restless legs syndrome. Neurology. 2007;68:1213–8.

    Article  CAS  PubMed  Google Scholar 

  15. Siddiqui F, Strus J, Ming X, Lee IA, Chokroverty S, Walters AS. Rise of blood pressure with periodic limb movements in sleep and wakefulness. Clin Neurophysiol. 2007;118:1923–30.

    Article  PubMed  Google Scholar 

  16. Pennestri MH, Montplaisir J, Fradette L, Lavigne G, Colombo R, Lanfranchi PA. Blood pressure changes associated with periodic leg movements during sleep in healthy subjects. Sleep Med. 2013;14:555–61.

    Article  PubMed  Google Scholar 

  17. Manconi M, Ferri R, Zucconi M, et al. Effects of acute dopamine-agonist treatment in restless legs syndrome on heart rate variability during sleep. Sleep Med. 2011;12:47–55.

    Article  PubMed  Google Scholar 

  18. Ferri R. Two legs, one heart, one sleeping brain. Sleep Med. 2006;7:299–300.

    Article  PubMed  Google Scholar 

  19. Ferri R. The time structure of leg movement activity during sleep: the theory behind the practice. Sleep Med. 2012;13:433–41.

    Article  PubMed  Google Scholar 

  20. Yang CK, Jordan AS, White DP, Winkelman JW. Heart rate response to respiratory events with or without leg movements. Sleep. 2006;29:553–6.

    Article  PubMed  Google Scholar 

  21. Manconi M, Zavalko I, Bassetti CL, Colamartino E, Pons M, Ferri R. Respiratory-related leg movements and their relationship with periodic leg movements during sleep. Sleep. 2014;37(3):497–504.

    PubMed  PubMed Central  Google Scholar 

  22. Fulda S, Zavalko I, Ferri R, Manconi M. Respiratory-related leg movements: What is the evidence behind the results? Sleep. 2013;35(suppl):A241–2.

    Google Scholar 

  23. Trotti LM, Rye DB, De Staercke C, Hooper WC, Quyyumi A, Bliwise DL. Elevated C-reactive protein is associated with severe periodic leg movements of sleep in patients with restless legs syndrome. Brain Behav Immun. 2012;26:1239–43.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Siddiqui F, Strus J, Sun YJ, Walters AS. No significant difference in cytokine levels in patients with restless legs syndrome versus controls - preliminary data. Sleep Med. 2007;8:98–9.

    Article  PubMed  Google Scholar 

  25. Bekci TT, Kayrak M, Kiyici A, Ari H, Teke T, Maden E, Akilli H. The relation between Lp-PLA2 levels with periodic limb movements. Sleep Breath. 2012;16:117–22.

    Article  PubMed  Google Scholar 

  26. Li Y, Walters AS, Chiuve SE, Rimm EB, Winkelman JW, Gao X. Prospective study of restless legs syndrome and coronary heart disease among women. Circulation. 2012;126:1689–94.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Espinar-Sierra J, Vela-Bueno A, Luque-Otero M. Periodic leg movements in sleep in essential hypertension. Psychiatry Clin Neurosci. 1997;51:103–7.

    Article  CAS  PubMed  Google Scholar 

  28. Billars L, Hicks A, Bliwise D, Sigmundsson T, Sigurdsson A, Kristjansson K, Gulcher J, Stefansson K, Rye D. Hypertension risk and PLMS in restless legs syndrome. Sleep. 2007;30:A297–8.

    Google Scholar 

  29. Hanly PJ, Zuberi-Khokhar N. Periodic limb movements during sleep in patients with congestive heart failure. Chest. 1996;109:1497–502.

    Article  CAS  PubMed  Google Scholar 

  30. Javaheri S. Sleep disorders in systolic heart failure: a prospective study of 100 male patients. The final report. Int J Cardiol. 2006;106:21–8.

    Article  PubMed  Google Scholar 

  31. Skomro R, Silva R, Alves R, Figueiredo A, Lorenzi-Filho G. The prevalence and significance of periodic leg movements during sleep in patients with congestive heart failure. Sleep Breath. 2009;13:43–7.

    Article  PubMed  Google Scholar 

  32. Benz RL, Pressman MR, Hovick ET, Peterson DD. Potential novel predictors of mortality in end-stage renal disease patients with sleep disorders. Am J Kidney Dis. 2000;35:1052–60.

    Article  CAS  PubMed  Google Scholar 

  33. Yumino D, Wang H, Floras JS, Newton GE, Mak S, Ruttanaumpawan P, Parker JD, Bradley TD. Relation of periodic leg movements during sleep and mortality in patients with systolic heart failure. Am J Cardiol. 2011;107:447–51.

    Article  PubMed  Google Scholar 

  34. Kang SY, Sohn YH, Lee IK, Kim JS. Unilateral periodic limb movement in sleep after supratentorial cerebral infarction. Parkinsonism Relat Disord. 2004;10:429–31.

    Article  PubMed  Google Scholar 

  35. Lee JS, Lee PH, Huh K. Periodic limb movements in sleep after a small deep subcortical infarct. Mov Disord. 2005;20:260–1.

    Article  PubMed  Google Scholar 

  36. Anderson KN, Bhatia KP, Losseff NA. A case of restless legs syn-drome in association with stroke. Sleep. 2005;28:147–8.

    PubMed  Google Scholar 

  37. Benbir G, Karadeniz D. Periodic leg movements in sleep in patients with supratentorial cerebral infarction. Acta Neurol Belg. 2012;112:27–32.

    Article  PubMed  Google Scholar 

  38. Coelho FM, Georgsson H, Narayansingh M, Swartz RH, Murray BJ. Higher prevalence of periodic limb movements of sleep in patients with history of stroke. J Clin Sleep Med. 2010;6:428–30.

    PubMed  PubMed Central  Google Scholar 

  39. Walters AS, Moussouttas M, Siddiqui F, Silveira DC, Fuentes K, Wang L, Berger K. Prevalence of stroke in restless legs syndrome: initial results point to the need for more sophisticated studies. Open Neurol J. 2010;4:73–7.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Terzano MG, Mancia D, Salati MR, Costani G, Decembrino A, Parrino L. The cyclic alternating pattern as a physiologic component of normal NREM sleep. Sleep. 1985;8:137–45.

    Article  CAS  PubMed  Google Scholar 

  41. Parrino L, Ferri R, Bruni O, Terzano MG. Cyclic alternating pattern (CAP): the marker of sleep instanbility. Sleep Med Rev. 2012;16:27–45.

    Article  PubMed  Google Scholar 

  42. Brown LK, Heffner JE, Obbens EA. Transverse myelitis associated with restless legs syndrome and periodic movements of sleep responsive to an oral dopaminergic agent but not to intrathecal baclofen. Sleep. 2000;23:591–4.

    Article  CAS  PubMed  Google Scholar 

  43. Lee MS, Choi YC, Lee SH, Lee SB. Sleep-related periodic leg movements associated with spinal cord lesions. Mov Disord. 1996;11:719–22.

    Article  CAS  PubMed  Google Scholar 

  44. Nogues M, Cammarota A, Leiguarda R, Rivero A, Pardal A, Encabo H. Periodic limb movements in syringomyelia and syringobulbia. Mov Disord. 2000;15:113–9.

    Article  CAS  PubMed  Google Scholar 

  45. Salminen AV, Manconi M, Rimpilä V, Luoto TM, Koskinen E, Ferri R, Öhman J, Polo O. Disconnection between periodic leg movements and cortical arousals in spinal cord injury. J Clin Sleep Med. 2013;9:1207–9.

    PubMed  PubMed Central  Google Scholar 

  46. Raggi A, Ferri R. Sleep disorders in neurodegenerative diseases. Eur J Neurol. 2010;17:1326–38.

    Article  CAS  PubMed  Google Scholar 

  47. Manconi M, Ferri R, Zucconi M, Bassetti C, Fulda S, Aricò D, Ferini-Strambi L. Dissociation of periodic leg movements from arousals in restless legs syndrome. Ann Neurol. 2012;71:834–44.

    Article  PubMed  Google Scholar 

  48. Ferri R, Manconi M, Aricò D, Punjabi NM, Zucconi M. Experimentally induced arousals do not elicit periodic leg motor activity during sleep in normal subjects. Sleep Med. 2013;14:85–90.

    Article  PubMed  Google Scholar 

  49. Winkelman JW, Shahar E, Sharief I, Gottlieb DJ. Association of restless legs syndrome and cardiovascular disease in the sleep heart health study. Neurology. 2008;70:35–42.

    Article  PubMed  Google Scholar 

  50. Saletu M, Anderer P, Saletu B, Hauer C, Mandl M, Semler B, Saletu-Zyhlarz G. Sleep laboratory studies in periodic limb movement disorder (PLMD) patients as compared with normals and acute effects of ropinirole. Hum Psychopharmacol. 2001;16:177–87.

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Raffaele Ferri .

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Ferri, R., Siddiqui, F. (2017). Heart Rate and Blood Pressure Changes Associated with Periodic Limb Movements. In: Manconi, M., García-Borreguero, D. (eds) Restless Legs Syndrome/Willis Ekbom Disease. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-6777-3_7

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  • DOI: https://doi.org/10.1007/978-1-4939-6777-3_7

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