Prevalence and associations of respiratory-related leg movements: The MrOS sleep study

Sayaka Aritake, Terri Blackwell, Katherine W. Peters, Michael Rueschman, Daniel Mobley, Michael G. Morrical, Samuel F. Platt, Thuy Tien L Dam, Susan Redline, John W. Winkelman

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Objectives: Obstructive respiratory events often terminate with an associated respiratory-related leg movement (RRLM). Such leg movements are not scored as periodic leg movements (periodic limb movements during sleep, PLMS), although the criteria for distinguishing RRLM from PLMS differ between the American Academy of Sleep Medicine (AASM) and the World Association of Sleep Medicine (WASM)/ International Restless Legs Syndrome Study Group (IRLSSG) scoring manuals. Such LMs may be clinically significant in patients with obstructive sleep apnea (OSA). The prevalence and correlation of RRLM in men with OSA were examined. Methods: A case-control sample of 575 men was selected from all men with an apnea-hypopnea index (AHI, ≥3% desaturation criteria) ≥ 10 and good data from piezoelectric leg movement sensors at the first in-home sleep study in the MrOS cohort (mean age = 76.8 years). Sleep studies were rescored for RRLMs using five different RRLM definitions varying in both latency of leg movement onset from respiratory event termination and duration of the leg movement. The quartile of RRLM% (the number of RRLM/the number of hypopneas + apneas) was derived. Results: The nonparametric densities of RRLM% were most influenced by alterations in the latency rather than the duration of the LM. The most liberal RRLM definition (latency 0-5 s, duration 0.5-10 s) led to a median RRLM% of 23.4 (interquartile range 12.41, 37.12) in this sample. The average AHI and arousal index increased as the quartile of RRLM% increased, as well as the prevalence of chronic obstructive pulmonary disease (COPD). The prevalence of those with a history of hypertension decreased as RRLM% increased. The non-Caucasian race was associated with lower RRLM%. Conclusion: Within an elderly sample with moderate to severe OSA, piezoelectric-defined RRLM% is associated with a number of sleep-related and demographic factors. Further study of the optimal definition, predictors, and consequences of RRLM is warranted.

Original languageEnglish
Pages (from-to)1236-1244
Number of pages9
JournalSleep Medicine
Volume16
Issue number10
DOIs
Publication statusPublished - 2015 Oct 1
Externally publishedYes

Fingerprint

Leg
Sleep
Obstructive Sleep Apnea
Apnea
Extremities
Medicine
Restless Legs Syndrome
Arousal
Chronic Obstructive Pulmonary Disease

Keywords

  • Cardiovascular disease
  • Hypertension
  • Leg movement
  • Obstructive sleep apnea
  • Respiratory-related events

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Aritake, S., Blackwell, T., Peters, K. W., Rueschman, M., Mobley, D., Morrical, M. G., ... Winkelman, J. W. (2015). Prevalence and associations of respiratory-related leg movements: The MrOS sleep study. Sleep Medicine, 16(10), 1236-1244. https://doi.org/10.1016/j.sleep.2015.06.012

Prevalence and associations of respiratory-related leg movements : The MrOS sleep study. / Aritake, Sayaka; Blackwell, Terri; Peters, Katherine W.; Rueschman, Michael; Mobley, Daniel; Morrical, Michael G.; Platt, Samuel F.; Dam, Thuy Tien L; Redline, Susan; Winkelman, John W.

In: Sleep Medicine, Vol. 16, No. 10, 01.10.2015, p. 1236-1244.

Research output: Contribution to journalArticle

Aritake, S, Blackwell, T, Peters, KW, Rueschman, M, Mobley, D, Morrical, MG, Platt, SF, Dam, TTL, Redline, S & Winkelman, JW 2015, 'Prevalence and associations of respiratory-related leg movements: The MrOS sleep study', Sleep Medicine, vol. 16, no. 10, pp. 1236-1244. https://doi.org/10.1016/j.sleep.2015.06.012
Aritake S, Blackwell T, Peters KW, Rueschman M, Mobley D, Morrical MG et al. Prevalence and associations of respiratory-related leg movements: The MrOS sleep study. Sleep Medicine. 2015 Oct 1;16(10):1236-1244. https://doi.org/10.1016/j.sleep.2015.06.012
Aritake, Sayaka ; Blackwell, Terri ; Peters, Katherine W. ; Rueschman, Michael ; Mobley, Daniel ; Morrical, Michael G. ; Platt, Samuel F. ; Dam, Thuy Tien L ; Redline, Susan ; Winkelman, John W. / Prevalence and associations of respiratory-related leg movements : The MrOS sleep study. In: Sleep Medicine. 2015 ; Vol. 16, No. 10. pp. 1236-1244.
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abstract = "Objectives: Obstructive respiratory events often terminate with an associated respiratory-related leg movement (RRLM). Such leg movements are not scored as periodic leg movements (periodic limb movements during sleep, PLMS), although the criteria for distinguishing RRLM from PLMS differ between the American Academy of Sleep Medicine (AASM) and the World Association of Sleep Medicine (WASM)/ International Restless Legs Syndrome Study Group (IRLSSG) scoring manuals. Such LMs may be clinically significant in patients with obstructive sleep apnea (OSA). The prevalence and correlation of RRLM in men with OSA were examined. Methods: A case-control sample of 575 men was selected from all men with an apnea-hypopnea index (AHI, ≥3{\%} desaturation criteria) ≥ 10 and good data from piezoelectric leg movement sensors at the first in-home sleep study in the MrOS cohort (mean age = 76.8 years). Sleep studies were rescored for RRLMs using five different RRLM definitions varying in both latency of leg movement onset from respiratory event termination and duration of the leg movement. The quartile of RRLM{\%} (the number of RRLM/the number of hypopneas + apneas) was derived. Results: The nonparametric densities of RRLM{\%} were most influenced by alterations in the latency rather than the duration of the LM. The most liberal RRLM definition (latency 0-5 s, duration 0.5-10 s) led to a median RRLM{\%} of 23.4 (interquartile range 12.41, 37.12) in this sample. The average AHI and arousal index increased as the quartile of RRLM{\%} increased, as well as the prevalence of chronic obstructive pulmonary disease (COPD). The prevalence of those with a history of hypertension decreased as RRLM{\%} increased. The non-Caucasian race was associated with lower RRLM{\%}. Conclusion: Within an elderly sample with moderate to severe OSA, piezoelectric-defined RRLM{\%} is associated with a number of sleep-related and demographic factors. Further study of the optimal definition, predictors, and consequences of RRLM is warranted.",
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AU - Mobley, Daniel

AU - Morrical, Michael G.

AU - Platt, Samuel F.

AU - Dam, Thuy Tien L

AU - Redline, Susan

AU - Winkelman, John W.

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N2 - Objectives: Obstructive respiratory events often terminate with an associated respiratory-related leg movement (RRLM). Such leg movements are not scored as periodic leg movements (periodic limb movements during sleep, PLMS), although the criteria for distinguishing RRLM from PLMS differ between the American Academy of Sleep Medicine (AASM) and the World Association of Sleep Medicine (WASM)/ International Restless Legs Syndrome Study Group (IRLSSG) scoring manuals. Such LMs may be clinically significant in patients with obstructive sleep apnea (OSA). The prevalence and correlation of RRLM in men with OSA were examined. Methods: A case-control sample of 575 men was selected from all men with an apnea-hypopnea index (AHI, ≥3% desaturation criteria) ≥ 10 and good data from piezoelectric leg movement sensors at the first in-home sleep study in the MrOS cohort (mean age = 76.8 years). Sleep studies were rescored for RRLMs using five different RRLM definitions varying in both latency of leg movement onset from respiratory event termination and duration of the leg movement. The quartile of RRLM% (the number of RRLM/the number of hypopneas + apneas) was derived. Results: The nonparametric densities of RRLM% were most influenced by alterations in the latency rather than the duration of the LM. The most liberal RRLM definition (latency 0-5 s, duration 0.5-10 s) led to a median RRLM% of 23.4 (interquartile range 12.41, 37.12) in this sample. The average AHI and arousal index increased as the quartile of RRLM% increased, as well as the prevalence of chronic obstructive pulmonary disease (COPD). The prevalence of those with a history of hypertension decreased as RRLM% increased. The non-Caucasian race was associated with lower RRLM%. Conclusion: Within an elderly sample with moderate to severe OSA, piezoelectric-defined RRLM% is associated with a number of sleep-related and demographic factors. Further study of the optimal definition, predictors, and consequences of RRLM is warranted.

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