Periodic Leg Movements Are Associated with Reduced Sleep Quality in Older Men: The MrOS Sleep Study
Periodic Leg Movements Are Associated with Reduced Sleep Quality in Older Men: The MrOS Sleep Study
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DOI：
10.5664/jcsm.3146
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发表时间：
2013-01-01
影响因子：
4.3
通讯作者：
Stone, Katie L.
中科院分区：
文献类型：
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作者：
Claman, David M.;Ewing, Susan K.;Stone, Katie L.
研究目的：睡眠中周期性肢体运动(PLMS)在老年人中很常见。之前的一项大型多导睡眠图(PSG)研究了PLMS与睡眠结构和睡眠唤醒的关系，发现腿部运动在老年女性中很常见，而与EEG唤醒相关的PLMS与睡眠障碍的标志有强烈和一致的关联。由于男性和女性的睡眠不同，我们现在调查了大量基于社区的老年男性样本中PLMS和PSG睡眠质量指数之间的关联。设计：观察性研究，横断面分析。背景：参与骨质疏松性男性骨折(MROS)研究的六个临床地点。参与者：2872名社区居住的老年男性(平均年龄76.4岁)，他们在2003-2005年完成了居家PSG。干预：N/A。测量和结果：在家中进行PSG检查，包括双侧腿部活动的测量。计算每小时睡眠中腿部活动的总数(PLMI)和每小时睡眠中引起脑电唤醒的腿部运动次数(PLMA)。PLMI+gt；=5例(70.8%)，PLMA>；=5例(27.4%)。使用线性回归模型检验PLMS作为预测因子与睡眠结构、觉醒指数和睡眠效率作为结果之间的关系。PLMI(>；=65.1)和PLMA(>；=6.8)的最高五分位数与睡眠结构指数的相关性最大；PLMA的影响程度更大。经过多因素调整后，PLMA较高的参与者的唤醒指数较小，但显著较高，睡眠效率较低，第一阶段和第二阶段睡眠的百分比较高，而第三-第四阶段睡眠和快速眼动睡眠的百分比较低(p<；0.01)。PLMI值的增加与更高的唤醒指数、更高的2期睡眠百分比和更低的3-4期睡眠百分比(p<；0.0001)类似，但与1期、快速眼动睡眠或睡眠效率的增加无关。PLMI和PMLA都与Epworth嗜睡量表测量的主观嗜睡性无关。结论：这项研究表明，周期性腿部运动在社区老年男性中非常常见，无论相关的唤醒情况如何，都与睡眠更轻、更零碎的证据有关。
Study Objectives: Periodic limb movements in sleep (PLMS) are common in the elderly. A previous large polysomnographic (PSG) study examining the relationship of PLMS to sleep architecture and arousals from sleep in women found that leg movements were common in elderly women, and PLMS which were associated with EEG arousals had a strong and consistent association with markers of disturbed sleep. Since sleep differs in men and women, we now investigate the association between PLMS and PSG indices of sleep quality in a large community-based sample of older men.Design: Observational study, cross-sectional analyses.Setting: Six clinical sites participating in the Osteoporotic Fractures in Men (MrOS) Study.Participants: 2,872 older community-dwelling men (mean age 76.4 years) who completed in-home PSG from 2003-2005. Interventions: N/A.Measurements and Results: In-home PSG was performed which included bilateral measurement of leg movements. The total number of leg movements per hour of sleep (PLMI) and the number of leg movements causing EEG-documented arousals per hour of sleep (PLMA) were computed. A PLMI >= 5 (70.8%) and PLMA >= 5 (27.4%) were both prevalent. Linear regression models were used to examine the relationship between PLMS as predictors and sleep architecture, arousal index, and sleep efficiency as outcomes. The highest quintiles of PLMI (>= 65.1) and PLMA (>= 6.8) showed the largest association with indices of sleep architecture; PLMA showed a larger magnitude of effect. After multivariate adjustment, participants with a higher PLMA had a small but significantly higher arousal index, lower sleep efficiency, higher percentages of stages 1 and 2 sleep, and lower percentages of stage 3-4 and REM sleep (p < 0.01). An increased PLMI was similarly associated with a higher arousal index, higher percentage of stage 2 sleep, and lower percentage of stage 3-4 (p < 0.0001), but not with an increase in stage 1, REM sleep, or sleep efficiency. Neither PLMI nor PMLA was associated with subjective sleepiness measured by the Epworth Sleepiness Scale.Conclusions: This study demonstrated that periodic leg movements are very common in older community-dwelling men and regardless of associated arousals, are associated with evidence of lighter and more fragmented sleep.