Periodic limb movements in sleep are followed by increases in EEG activity, blood pressure, and heart rate during sleep

Mariusz Sieminski,Jan Pyrzowski,Markku Partinen

doi:10.1007/s11325-017-1476-7

Mariusz Sieminski, Jan Pyrzowski + Show 1 more

Open Access

https://doi.org/10.1007/s11325-017-1476-7

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Journal: Sleep & Breathing	Publication Date: Feb 11, 2017
Citations: 41	License type: open-access

Affiliation: Gdańsk Medical University

Abstract

PurposePeriodic limb movements in sleep (PLMS) are related to arousal, sympathetic activation, and increases in blood pressure (BP), but whether they are part of the arousal process or causative of it is unclear. Our objective was to assess the temporal distribution of arousal-related measures around PLMS.MethodsPolysomnographic recordings of six patients with restless legs syndrome were analyzed. We analyzed 15 PLMS, plus three 5-s epochs before and after each movement, for every patient. Mean values per epoch of blood pressure (BP), heart rate (HR), and electroencephalographic (EEG) power were calculated. For each patient, six 5-s epochs of undisturbed sleep were analyzed as controls.ResultsAlpha + beta EEG power, systolic BP, and HR were significantly increased following PLMS. The EEG power and HR increases were noticed in the first epoch after PLMS, whereas that of systolic BP was observed in the second and third epochs following a PLMS. No significant changes occurred in the epochs of undisturbed sleep.ConclusionsThe results suggest that PLMS are followed by arousal-related nervous system events. Given the high frequency of PLMS throughout the night, they could be a potential risk factor for nocturnal arrhythmias and hypertension, in addition to causing sleep deprivation.

Highlights

Periodic limb movements in sleep (PLMS) are repetitive, stereotypical involuntary movements of the lower extremities that appear during sleep
The results suggest that PLMS are followed by arousal-related nervous system events
The aim of this study was to analyze the temporal distribution of changes in EEG activity, blood pressure (BP), and heart rate (HR) that precede and follow a PLMS, and to compare this to the course of such changes during sleep uninterrupted by leg movements

Summary

Introduction

Periodic limb movements in sleep (PLMS) are repetitive, stereotypical involuntary movements of the lower extremities that appear during sleep. A single movement may last from 0.5 to 10 s; the movements manifest in series of four or more single movements separated by intervals of 5 to 90 s [1] They are highly prevalent in patients with restless legs syndrome (RLS) [2], but are found in patients with narcolepsy [3], REM sleep behavior disorder [4], and insomnia [5]. Some PLMS are followed by arousals, defined as transient increases in higher frequency (fast) electroencephalographic (EEG) activity occurring with increases of sympathetic activity. These are called periodic limb movements with arousals (PLMA)

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