Periodic leg movements and sleepiness in patients evaluated for sleep-disordered breathing
Periodic leg movements and sleepiness in patients evaluated for sleep-disordered breathing
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DOI：
10.1164/ajrccm.164.8.2011062
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发表时间：
2001-10-15
影响因子：
24.7
通讯作者：
Chervin, RD
中科院分区：
文献类型：
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作者：
Chervin, RD
大多数多导睡眠图是因为怀疑睡眠呼吸障碍（SDB）而进行的，但睡眠期间的周期性腿部运动（PLMS）是常见的偶然发现，其意义尚不清楚。在1,124例疑似或确诊SDB的成人患者的临床系列研究中，我们测试了周期性腿部运动的速率与一个重要结果（白天嗜睡的严重程度）之间的关联。通过多次睡眠潜伏期测试对所有受试者的客观嗜睡进行评估，通过自我评定对873名受试者的问题嗜睡进行评估，通过埃普沃思嗜睡量表对201名受试者的主观睡眠倾向进行评估。腿部运动增加与客观嗜睡减少相关（p = 0.03），但解释的方差不到1%。当对夜间觉醒进行评分时（n = 321名受试者），与觉醒相关的腿部运动率预测客观嗜睡较少（p = 0.008）;没有觉醒的腿部运动率预测不了任何东西。腿部运动的频率与主观问题嗜睡或睡眠倾向无关。我们认为这是偶然的。睡眠期间的周期性腿部运动与白天过度嗜睡无关，因此似乎不太可能导致该问题。增加的困倦可能会减少每次腿部运动时唤醒的可能性。
Most polysomnograms are performed because sleep-disordered breathing (SDB) is suspected, but periodic leg movements during sleep (PLMS) are frequent incidental findings, and their significance is not well understood. In a clinical series of 1,124 adult patients with suspected or confirmed SDB, we tested for an association between the rate of periodic leg movements and one important outcome, the severity of daytime sleepiness. Objective sleepiness was assessed by the Multiple Sleep Latency Test in all subjects, problem sleepiness by self-rating in 873, and subjective sleep propensity by the Epworth Sleepiness Scale in 201. Increased leg movements were associated with decreased objective sleepiness (p = 0.03) but explained less than 1% of the variance. When nocturnal arousals were scored (n = 321 subjects), rates of leg movements associated with arousals predicted less objective sleepiness (p = 0.008); rates of leg movements without arousals predicted nothing. The rates of leg movements showed no association with subjective problem sleepiness or sleep propensity. We conclude that incidental. periodic leg movements during sleep are not associated with excessive daytime sleepiness, and therefore appear unlikely to contribute to this problem. Increased sleepiness may reduce the likelihood of arousal with each leg movement.