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Basal sympathetic predominance in periodic limb movements in sleep with obstructive sleep apnea
Author(s) -
Wu MengNi,
Lai ChiouLian,
Liu ChingKuan,
Yen ChenWen,
Liou LiMin,
Hsieh ChengFang,
Tsai MingJu,
Chen Sharon C.J.,
Hsu ChungYao
Publication year - 2015
Publication title -
journal of sleep research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.297
H-Index - 117
eISSN - 1365-2869
pISSN - 0962-1105
DOI - 10.1111/jsr.12314
Subject(s) - obstructive sleep apnea , polysomnography , heart rate variability , epworth sleepiness scale , medicine , pittsburgh sleep quality index , cardiology , confounding , sleep (system call) , basal (medicine) , anesthesia , apnea , physical therapy , heart rate , insomnia , sleep quality , blood pressure , psychiatry , operating system , computer science , insulin
Summary Because the impact of periodic limb movements in sleep ( PLMS ) is controversial, no consensus has been reached on the therapeutic strategy for PLMS in obstructive sleep apnea ( OSA ). To verify the hypothesis that PLMS is related to a negative impact on the cardiovascular system in OSA patients, this study investigated the basal autonomic regulation by heart rate variability ( HRV ) analysis. Sixty patients with mild‐to‐moderate OSA who underwent polysomnography ( PSG ) and completed sleep questionnaires were analysed retrospectively and divided into the PLMS group ( n = 30) and the non‐ PLMS group ( n = 30). Epochs without any sleep events or continuous effects were evaluated using HRV analysis. No significant difference was observed in the demographic data, PSG parameters or sleep questionnaires between the PLMS and non‐ PLMS groups, except for age. Patients in the PLMS group had significantly lower normalized high frequency (n‐ HF ), high frequency ( HF ), square root of the mean of the sum of the squares of difference between adjacent NN intervals ( RMSSD ) and standard deviation of all normal to normal intervals index ( SDNN ‐I), but had a higher normalized low frequency (n‐ LF ) and LF / HF ratio. There was no significant difference in the Epworth Sleepiness Scale, the Pittsburgh Sleep Quality Index, the Short‐Form 36 and the Hospital Anxiety and Depression Scale between the two groups. After adjustment for confounding variables, PLMS remained an independent predictor of n‐ LF ( β = 0.0901, P = 0.0081), LF / HF ratio ( β = 0.5351, P = 0.0361), RMSSD ( β = −20.1620, P = 0.0455) and n‐ HF ( β = −0.0886, P = 0.0134). In conclusion, PLMS is related independently to basal sympathetic predominance and has a potentially negative impact on the cardiovascular system of OSA patients.