Journal of Sleep Medicine

Korean Sleep Research Society (대한수면연구학회)
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Difference in Sleep Characteristics between Restless Leg Syndrome With and Without Periodic Limb Movement during Wakefulness

각성 중 주기성사지운동 여부에 따른 하지불안증후군 환자의 수면 특성 차이에 대한 비교연구

  • Shin, Yu Yong (Department of Neurology, Kyung Hee University Hospital at Gangdong) ;
  • Byun, Jung-Ick (Department of Neurology, Kyung Hee University Hospital at Gangdong) ;
  • Shin, Won Chul (Department of Neurology, Kyung Hee University Hospital at Gangdong)
  • 신유용 (강동경희대학교병원 신경과) ;
  • 변정익 (강동경희대학교병원 신경과) ;
  • 신원철 (강동경희대학교병원 신경과)
  • Received : 2018.11.19
  • Accepted : 2018.12.13
  • Published : 2018.12.31
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Abstract

Objectives: Restless leg syndrome (RLS) is a common sensorimotor disorder and is frequently associated with periodic limb movement in sleep (PLMS). Also about one third of patient with RLS have periodic limb movement during wakefulness (PLMW). However there is little research on the correlation between PLMW and RLS. We aimed to evaluate difference in sleep characteristics between patients with RLS with PLMW and those without PLMW. Methods: Our study included twenty eight RLS patients. Subjects underwent suggested immobilization test (SIT) prior to one full-night polysomnography study. Patients were classified into two groups according to the presence of PLMW based on SIT-PLMW index. Polysomnographic findings, subjective sleep quality, and hematologic results were analyzed and compared between the two groups. Results: Mean age of patient with frequent PLMW (SIT-PLMW ${\geq}40/hr$) was significantly higher. RLS patients with frequent PLMW were also significantly related to insomnia severity. The PLMS index was higher in patients with PLMW and showed a significant correlation with the PLMW index. Conclusions: PLMW influence sleep quality such as insomnia and is correlated with movement during sleep.

Keywords

References

  1. Cho YW, Shin WC, Yun CH, et al. Epidemiology of restless legs syndrome in Korean adults. Sleep 2008;31:219-223. https://doi.org/10.1093/sleep/31.2.219
  2. Allen RP, Picchietti D, Hening WA, Trenkwalder C, Walters AS, Montplaisi J. Restless legs syndrome: diagnostic criteria, special considerations, and epidemiology. A report from the restless legs syndrome diagnosis and epidemiology workshop at the National Institutes of Health. Sleep Med 2003;4:101-119. https://doi.org/10.1016/S1389-9457(03)00010-8
  3. Allen RP, Earley CJ. Restless legs syndrome: a review of clinical and pathophysiologic features. J Clin Neurophysiol 2001;18:128-147. https://doi.org/10.1097/00004691-200103000-00004
  4. Montplaisir J, Boucher S, Poirier G, Lavigne G, Lapierre O, Lesperance P. Clinical, polysomnographic, and genetic characteristics of restless legs syndrome: a study of 133 patients diagnosed with new standard criteria. Mov Disord 1997;12:61-65. https://doi.org/10.1002/mds.870120111
  5. Ferri R, Manconi M, Lanuzza B, et al. Age-related changes in periodic leg movements during sleep in patients with restless legs syndrome. Sleep Med 2008;9:790-798. https://doi.org/10.1016/j.sleep.2007.08.020
  6. Eun MY, Seok HY, Kim JB, Jung KY. Comparison of sleep quality and polysomnographic findings in patients with RLS according to the presence of periodic limb movements during sleep. J Korean Sleep Res Soc 2011;8:4-8. https://doi.org/10.13078/jksrs.11002
  7. Garcia-Borreguero D, Larrosa O, de la Llave Y, Granizo JJ, Allen R. Correlation between rating scales and sleep laboratory measurements in restless legs syndrome. Sleep Med 2004;5:561-565. https://doi.org/10.1016/j.sleep.2004.08.003
  8. Hornyak M, Hundemer HP, Quail D, Riemann D, Voderholzer U, Trenkwalder C. Relationship of periodic leg movements and severity of restless legs syndrome: a study in unmedicated and medicated patients. Clin Neurophysiol 2007;118:1532-1537. https://doi.org/10.1016/j.clinph.2007.04.001
  9. Lee HB, Song ML, Koo BB, Cho YW. Mood symptoms and restless legs syndrome without periodic limb movements during sleep: is it a clinical subtype? J Neuropsychiatry Clin Neurosci 2017;29:52-59. https://doi.org/10.1176/appi.neuropsych.15090228
  10. Ferri R, Manconi M, Plazzi G, et al. Leg movements during wakefulness in restless legs syndrome: time structure and relationships with periodic leg movements during sleep. Sleep Med 2012;13:529-535. https://doi.org/10.1016/j.sleep.2011.08.007
  11. Montplaisir J, Boucher S, Nicolas A, et al. Immobilization tests and periodic leg movements in sleep for the diagnosis of restless leg syndrome. Mov Disord 1998;13:324-329. https://doi.org/10.1002/mds.870130220
  12. American Academy of Sleep Medicine. International classification of sleep disorders. 3rd ed. Darien: American Academy of Sleep Medicine, 2014.
  13. Sohn SI, Kim DH, Lee MY, Cho YW. The reliability and validity of the Korean version of the Pittsburgh Sleep Quality Index. Sleep Breath 2012;16:803-812. https://doi.org/10.1007/s11325-011-0579-9
  14. Cho YW, Song ML, Morin CM. Validation of a Korean version of the insomnia severity index. J Clin Neurol 2014;10:210-215. https://doi.org/10.3988/jcn.2014.10.3.210
  15. Cho YW, Lee JH, Son HK, Lee SH, Shin C, Johns MW. The reliability and validity of the Korean version of the Epworth sleepiness scale. Sleep Breath 2011;15:377-384. https://doi.org/10.1007/s11325-010-0343-6
  16. Sung HM, Kim JB, Park YN, Bai DS, Lee SH, Ahn HN. A study on the reliability and the validity of Korean version of the Beck Depression Inventory-II(BDI-II). J Korean Soc Biol Ther Psychiatry 2008;14:201-212.
  17. Michaud M, Paquet J, Lavigne G, Desautels A, Montplaisir J. Sleep laboratory diagnosis of restless legs syndrome. Eur Neurol 2002;48:108-113. https://doi.org/10.1159/000062996
  18. Garcia-Borreguero D, Kohnen R, Boothby L, Tzonova D, Larrosa O, Dunkl E. Validation of the multiple suggested immobilization test: a test for the assessment of severity of restless legs syndrome (Willis-Ekbom disease). Sleep 2013;36:1101-1109. https://doi.org/10.5665/sleep.2820
  19. Shin JW, Koo YS, Lee BU, et al. Prevalence and characteristics of periodic limb movements during sleep in Korean adult patients with restless legs syndrome. J Clin Sleep Med 2016;12:1089-1097. https://doi.org/10.5664/jcsm.6042
  20. Nicolas A, Michaud M, Lavigne G, Montplaisir J. The influence of sex, age and sleep/wake state on characteristics of periodic leg movements in restless legs syndrome patients. Clin Neurophysiol 1999;110:1168-1174. https://doi.org/10.1016/S1388-2457(99)00033-4
  21. Broman JE, Mallon L, Hetta J. Restless legs syndrome and its relationship with insomnia symptoms and daytime distress: epidemiological survey in Sweden. Psychiatry Clin Neurosci 2008;62:472-475. https://doi.org/10.1111/j.1440-1819.2008.01825.x
  22. Ulfberg J, Bjorvatn B, Leissner L, et al. Comorbidity in restless legs syndrome among a sample of Swedish adults. Sleep Med 2007;8:768-772. https://doi.org/10.1016/j.sleep.2006.11.015
  23. Ferri R, Zucconi M, Manconi M, Plazzi G, Bruni O, Ferini-Strambi L. New approaches to the study of periodic leg movements during sleep in restless legs syndrome. Sleep 2006;29:759-769.
  24. Allen RP, Barker PB, Horska A, Earley CJ. Thalamic glutamate/glutamine in restless legs syndrome: increased and related to disturbed sleep. Neurology 2013;80:2028-2034. https://doi.org/10.1212/WNL.0b013e318294b3f6
  25. Winkelman JW, Bogan RK, Schmidt MH, Hudson JD, DeRossett SE, Hill-Zabala CE. Randomized polysomnography study of gabapentin enacarbil in subjects with restless legs syndrome. Mov Disord 2011;26:2065-2072. https://doi.org/10.1002/mds.23771
  26. Akpinar S. Restless legs syndrome treatment with dopaminergic drugs. Clin Neuropharmacol 1987;10:69-79. https://doi.org/10.1097/00002826-198702000-00007
  27. Brodeur C, Montplaisir J, Godbout R, Marinier R. Treatment of restless legs syndrome and periodic movements during sleep with L-dopa: a double-blind, controlled study. Neurology 1988;38:1845-1848. https://doi.org/10.1212/WNL.38.12.1845
  28. Montplaisir J, Lorrain D, Godbout R. Restless legs syndrome and periodic leg movements in sleep: the primary role of dopaminergic mechanism. Eur Neurol 1991;31:41-43.
  29. Yokota T, Hirose K, Tanabe H, Tsukagoshi H. Sleep-related periodic leg movements (nocturnal myoclonus) due to spinal cord lesion. J Neurol Sci 1991;104:13-18. https://doi.org/10.1016/0022-510X(91)90210-X
  30. Ruottinen HM, Partinen M, Hublin C, et al. An FDOPA PET study in patients with periodic limb movement disorder and restless legs syndrome. Neurology 2000;54:502-504. https://doi.org/10.1212/WNL.54.2.502