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Clinical characteristics of periodic limb movements during sleep categorized by continuous positive airway pressure titration polysomnography in patients with obstructive sleep apnea

  • Sleep Breathing Physiology and Disorders • Original Article
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Abstract

Purpose

The presence of periodic limb movements during sleep (PLMS) varies among patients with obstructive sleep apnea (OSA) undergoing treatment with continuous positive airway pressure (CPAP). The factors associated with this variation are unknown.

Methods

PLMS were defined as a periodic leg movements index of > 15/h. Patients with OSA and PLMS were categorized into four groups depending on diagnostic and CPAP titration polysomnography (PSG). A multinomial logistic regression analysis was performed using a non-PLMS group as the reference category.

Results

This study included 861 patients with OSA who underwent a full-night CPAP titration PSG. The proportions of the subjects with PLMS on both PSGs (persistent PLMS), those with CPAP-emergent PLMS, and those with CPAP-resolved PLMS were 12.9%, 9.2%, and 3.9%, respectively. Compared with the non-PLMS group, the persistent group was more likely to be of older age and male sex and has a higher body mass index and restless legs syndrome (RLS). Patients in the CPAP-emergent group were also older and more likely to have RLS as well as more severe apnea. Patients in the CPAP-resolved group were more likely to be women, of older age, have a higher body mass index, but less severe apnea.

Conclusions

PLMS elicited by CPAP are more likely to occur in older patients with more severe sleep apnea and comorbid RLS, whereas OSA patients in which PLMS resolve after CPAP are more likely to be women and have milder sleep apnea. Persistent PLMS share clinical characteristics with PLMS in general population.

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Authors and Affiliations

  1. Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, Republic of Korea

    Sang-Ahm Lee, Soo Jeong Kim, So Young Lee & Hyo Jae Kim

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  1. Sang-Ahm Lee
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  2. Soo Jeong Kim
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  3. So Young Lee
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Contributions

Conceptualization: Sang-Ahm Lee; Methodology: Sang-Ahm Lee; Writing—Original draft preparation: Sang-Ahm Lee; Reviewing, Editing, and Supervision: Sang-Ahm Lee; Data curation: Hyo Jae Kim, Soo Jeong Kim, and So Young Lee; Formal analysis: Hyo Jae Kim.

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Correspondence to Sang-Ahm Lee.

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This retrospective chart review study involving human participants was in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The Human Investigation Committee (IRB) of Asan Medical Center approved this study.

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This was a retrospective study based on records, and formal consent was not required.

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The authors declare no competing interests.

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Lee, SA., Kim, S.J., Lee, S.Y. et al. Clinical characteristics of periodic limb movements during sleep categorized by continuous positive airway pressure titration polysomnography in patients with obstructive sleep apnea. Sleep Breath 26, 251–257 (2022). https://doi.org/10.1007/s11325-021-02387-z

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  • DOI: https://doi.org/10.1007/s11325-021-02387-z

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