nach oben

Erschienen in:

01.12.2018 | Sleep Breathing Physiology and Disorders • Original Article

Basal sympathetic predominance in periodic limb movements in sleep after continuous positive airway pressure

verfasst von: Meng-Ni Wu, Chiou-Lian Lai, Ching-Kuan Liu, Chen-Wen Yen, Li-Min Liou, Cheng-Fang Hsieh, Ming-Ju Tsai, Sharon Chia-Ju Chen, Chung-Yao Hsu

Erschienen in: Sleep and Breathing | Ausgabe 4/2018

Einloggen, um Zugang zu erhalten

Abstract

Purpose

This study investigated the basal autonomic regulation in patients with obstructive sleep apnea (OSA) showing periodic limb movements in sleep (PLMS) emerging after therapy with continuous positive airway pressure (CPAP).

Methods

Data of patients with OSA undergoing a first polysomnography for diagnosis and a second polysomnography for therapy with CPAP were reviewed. Patients with OSA showing PLMS on the first polysomnography were excluded. By using heart rate variability analysis, epochs without any sleep events and continuous effects from the second polysomnography were retrospectively analyzed.

Results

Of 125 eligible patients, 30 with PLMS after therapy with CPAP (PLMS group) and 30 not showing PLMS on both polysomnography (non-PLMS group) were randomly selected for the analysis. No significant differences in the demographic characteristics and variables of polysomnographies were identified between the groups. Although one trend of low root mean square of successive differences (RMSSD) between intervals of adjacent normal heart beats (NN intervals) in the PLMS group was observed, patients in the PLMS group had significantly low normalized high-frequency (n-HF) and high-frequency (HF) values, but high normalized low frequency (n-LF) and high ratio of LF to HF (LF/HF ratio). After adjustment for confounding variables, PLMS on the second polysomnography was significantly associated with RMSSD (β = − 6.7587, p = 0.0338), n-LF (β = 0.0907, p = 0.0148), n-HF (β = − 0.0895, p = 0.0163), log LF/HF ratio (β = 0.4923, p = 0.0090), and log HF (β = − 0.6134, p = 0.0199).

Conclusions

Patients with OSA showing PLMS emerging after therapy with CPAP may have a basal sympathetic predominance with potential negative cardiovascular effects.

Nur mit Berechtigung zugänglich

Hornyak M, Feige B, Riemann D, Voderholzer U (2006) Periodic leg movements in sleep and periodic limb movement disorder: prevalence, clinical significance and treatment. Sleep Med Rev 10(3):169–177. https://doi.org/10.1016/j.smrv.2005.12.003 CrossRefPubMed

Warnes H, Dinner DS, Kotagal P, Burgess RC (1993) Periodic limb movements and sleep apnoea. J Sleep Res 2(1):38–44. https://doi.org/10.1111/j.1365-2869.1993.tb00059.x CrossRefPubMed

Baran AS, Richert AC, Douglass AB, May W, Ansarin K (2003) Change in periodic limb movement index during treatment of obstructive sleep apnea with continuous positive airway pressure. Sleep 26(6):717–720CrossRef

Aritake-Okada S, Namba K, Hidano N, Asaoka S, Komada Y, Usui A, Matsuura M, Inoue Y (2012) Change in frequency of periodic limb movements during sleep with usage of continuous positive airway pressure in obstructive sleep apnea syndrome. J Neurol Sci 317(1-2):13–16. https://doi.org/10.1016/j.jns.2012.03.013 CrossRefPubMed

Shamsuzzaman AS, Gersh BJ, Somers VK (2003) Obstructive sleep apnea: implications for cardiac and vascular disease. JAMA 290(14):1906–1914. https://doi.org/10.1001/jama.290.14.1906 CrossRefPubMed

Koo BB, Blackwell T, Ancoli-Israel S, Stone KL, Stefanick ML, Redline S, Osteoporotic Fractures in Men Study G (2011) Association of incident cardiovascular disease with periodic limb movements during sleep in older men: outcomes of sleep disorders in older men (MrOS) study. Circulation 124(11):1223–1231. https://doi.org/10.1161/CIRCULATIONAHA.111.038968 CrossRefPubMedPubMedCentral

Walters AS, Rye DB (2009) Review of the relationship of restless legs syndrome and periodic limb movements in sleep to hypertension, heart disease, and stroke. Sleep 32(5):589–597. https://doi.org/10.1093/sleep/32.5.589 CrossRefPubMedPubMedCentral

Boulos MI, Murray BJ, Muir RT, Gao F, Szilagyi GM, Huroy M, Kiss A, Walters AS, Black SE, Lim AS, Swartz RH (2017) Periodic limb movements and white matter hyperintensities in first-ever minor stroke or high-risk transient ischemic attack. Sleep 40(3). https://doi.org/10.1093/sleep/zsw080

Aurora RN, Kristo DA, Bista SR, Rowley JA, Zak RS, Casey KR, Lamm CI, Tracy SL, Rosenberg RS, American Academy of Sleep M (2012) The treatment of restless legs syndrome and periodic limb movement disorder in adults—an update for 2012: practice parameters with an evidence-based systematic review and meta-analyses: an American Academy of Sleep Medicine clinical practice guideline. Sleep 35:1039–1062. https://doi.org/10.5665/sleep.1988 CrossRefPubMedPubMedCentral

10.

Murase K, Hitomi T, Hamada S, Azuma M, Toyama Y, Harada Y, Tanizawa K, Handa T, Yoshimura C, Oga T, Mishima M, Chin K (2014) The additive impact of periodic limb movements during sleep on inflammation in patients with obstructive sleep apnea. Ann Am Thorac Soc 11(3):375–382. https://doi.org/10.1513/AnnalsATS.201306-144OC CrossRefPubMed

11.

MN W, Lai CL, Liu CK, Yen CW, Liou LM, Hsieh CF, Tsai MJ, Chen SC, Hsu CY (2015) Basal sympathetic predominance in periodic limb movements in sleep with obstructive sleep apnea. J Sleep Res 24(6):722–729. https://doi.org/10.1111/jsr.12314 CrossRef

12.

Heart rate variability: standards of measurement, physiological interpretation and clinical use. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology (1996). Circulation 93:1043–1065

13.

Dekker JM, Crow RS, Folsom AR, Hannan PJ, Liao D, Swenne CA, Schouten EG (2000) Low heart rate variability in a 2-minute rhythm strip predicts risk of coronary heart disease and mortality from several causes: the ARIC study. Atherosclerosis Risk In Communities. Circulation 102(11):1239–1244. https://doi.org/10.1161/01.CIR.102.11.1239 CrossRefPubMed

14.

Liao D, Cai J, Rosamond WD, Barnes RW, Hutchinson RG, Whitsel EA, Rautaharju P, Heiss G (1997) Cardiac autonomic function and incident coronary heart disease: a population-based case-cohort study. The ARIC study. Atherosclerosis Risk in Communities Study. Am J Epidemiol 145(8):696–706. https://doi.org/10.1093/aje/145.8.696 CrossRefPubMed

15.

Tsuji H, Larson MG, Venditti FJ Jr, Manders ES, Evans JC, Feldman CL, Levy D (1996) Impact of reduced heart rate variability on risk for cardiac events. The Framingham Heart Study. Circulation 94(11):2850–2855. https://doi.org/10.1161/01.CIR.94.11.2850 CrossRefPubMed

16.

Aydin M, Altin R, Ozeren A, Kart L, Bilge M, Unalacak M (2004) Cardiac autonomic activity in obstructive sleep apnea: time-dependent and spectral analysis of heart rate variability using 24-hour Holter electrocardiograms. Tex Heart Inst J 31(2):132–136PubMedPubMedCentral

17.

Gula LJ, Krahn AD, Skanes A, Ferguson KA, George C, Yee R, Klein GJ (2003) Heart rate variability in obstructive sleep apnea: a prospective study and frequency domain analysis. Ann Noninvasive Electrocardiol 8(2):144–149. https://doi.org/10.1046/j.1542-474X.2003.08209.x CrossRefPubMed

18.

Ferrillo F, Beelke M, Canovaro P, Watanabe T, Arico D, Rizzo P, Garbarino S, Nobili L, De Carli F (2004) Changes in cerebral and autonomic activity heralding periodic limb movements in sleep. Sleep Med 5(4):407–412. https://doi.org/10.1016/j.sleep.2004.01.008 CrossRefPubMed

19.

Guggisberg AG, Hess CW, Mathis J (2007) The significance of the sympathetic nervous system in the pathophysiology of periodic leg movements in sleep. Sleep 30(6):755–766. https://doi.org/10.1093/sleep/30.6.755 CrossRefPubMedPubMedCentral

20.

Manconi M, Ferri R, Zucconi M, Clemens S, Rundo F, Oldani A, Ferini-Strambi L (2011) Effects of acute dopamine-agonist treatment in restless legs syndrome on heart rate variability during sleep. Sleep Med 12(1):47–55. https://doi.org/10.1016/j.sleep.2010.03.019 CrossRefPubMed

21.

Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research. The Report of an American Academy of Sleep Medicine Task Force (1999). Sleep 22:667–689

22.

Manconi M, Zavalko I, Fanfulla F, Winkelman JW, Fulda S (2015) An evidence-based recommendation for a new definition of respiratory-related leg movements. Sleep 38:295–304. https://doi.org/10.5665/sleep.4418 CrossRefPubMedPubMedCentral

23.

McCall WV, Haponik E (1993) Relationship of nasal continuous positive airway pressure to periodic limb movement disorder in a patient without sleep apnea. Chest 103(5):1609–1611. https://doi.org/10.1378/chest.103.5.1609 CrossRefPubMed

24.

Guerrero ML, Kim D, Rupp TL, Balkin TJ (2010) Oral appliance titration in patients with obstructive sleep apnea induces the appearance of periodic limb movements. Sleep Breath 14(4):359–363. https://doi.org/10.1007/s11325-009-0321-z CrossRefPubMed

25.

Fry JM, DiPhillipo MA, Pressman MR (1989) Periodic leg movements in sleep following treatment of obstructive sleep apnea with nasal continuous positive airway pressure. Chest 96(1):89–91. https://doi.org/10.1378/chest.96.1.89 CrossRefPubMed

26.

Exar EN, Collop NA (2001) The association of upper airway resistance with periodic limb movements. Sleep 24(2):188–192. https://doi.org/10.1093/sleep/24.2.188 CrossRefPubMed

27.

Siddiqui F, Strus J, Ming X, Lee IA, Chokroverty S, Walters AS (2007) Rise of blood pressure with periodic limb movements in sleep and wakefulness. Clin Neurophysiol 118(9):1923–1930. https://doi.org/10.1016/j.clinph.2007.05.006 CrossRefPubMed

28.

Ross AJ, Yang H, Larson RA, Carter JR (2014) Sleep efficiency and nocturnal hemodynamic dipping in young, normotensive adults. Am J Physiol Regul Integr Comp Physiol 307(7):R888–R892. https://doi.org/10.1152/ajpregu.00211.2014 CrossRefPubMed

29.

Hornyak M, Kopasz M, Feige B, Riemann D, Voderholzer U (2005) Variability of periodic leg movements in various sleep disorders: implications for clinical and pathophysiologic studies. Sleep 28(3):331–335PubMed

30.

Ferri R, Fulda S, Manconi M, Hogl B, Ehrmann L, Ferini-Strambi L, Zucconi M (2013) Night-to-night variability of periodic leg movements during sleep in restless legs syndrome and periodic limb movement disorder: comparison between the periodicity index and the PLMS index. Sleep Med 14(3):293–296. https://doi.org/10.1016/j.sleep.2012.08.014 CrossRefPubMed

Titel: Basal sympathetic predominance in periodic limb movements in sleep after continuous positive airway pressure
verfasst von: Meng-Ni Wu
Chiou-Lian Lai
Ching-Kuan Liu
Chen-Wen Yen
Li-Min Liou
Cheng-Fang Hsieh
Ming-Ju Tsai
Sharon Chia-Ju Chen
Chung-Yao Hsu
Publikationsdatum: 01.12.2018
Verlag: Springer International Publishing
Erschienen in: Sleep and Breathing / Ausgabe 4/2018
Print ISSN: 1520-9512
Elektronische ISSN: 1522-1709
DOI: https://doi.org/10.1007/s11325-018-1620-z

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Neu im Fachgebiet Innere Medizin

24.04.2024 | DGIM 2024 | Kongressbericht | Nachrichten

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Basal sympathetic predominance in periodic limb movements in sleep after continuous positive airway pressure

Abstract

Purpose

Methods

Results

Conclusions

Leitlinien kompakt für die Innere Medizin

Neu im Fachgebiet Innere Medizin

Metformin rückt in den Hintergrund

Myokarditis nach Infekt – richtig schwierig wird es bei Profisportlern

Thrombophiliescreening – Wenn, dann richtig und nur bei therapeutischer Konsequenz

Bei Senioren mit Prostatakarzinom auf Anämie achten!

Update Innere Medizin

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusions

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 4/2018

Obesity modulates the association between sleep apnea treatment and CHI3L1 levels but not CHIT1 activity in moderate to severe OSA: an observational study

Drug-induced sleep endoscopy: the effect of different passive maneuvers on the distribution of collapse patterns of the upper airway in obstructive sleep apnea patients

Towards a prediction model for drug-induced sleep endoscopy as selection tool for oral appliance treatment and positional therapy in obstructive sleep apnea

Effect of semi-rapid maxillary expansion in children with obstructive sleep apnea syndrome: 5-month follow-up study

Improved follow-up by peripheral arterial tonometry in CPAP-treated patients with obstructive sleep apnea and persistent excessive daytime sleepiness

Addition of frontal EEG to adult home sleep apnea testing: does a more accurate determination of sleep time make a difference?

Leitlinien kompakt für die Innere Medizin

Neu im Fachgebiet Innere Medizin

Metformin rückt in den Hintergrund

Myokarditis nach Infekt – richtig schwierig wird es bei Profisportlern

Thrombophiliescreening – Wenn, dann richtig und nur bei therapeutischer Konsequenz

Bei Senioren mit Prostatakarzinom auf Anämie achten!

Update Innere Medizin