scholarly journals Periodic limb movements during REM sleep in multiple sclerosis: a previously undescribed entity

2015 ◽  
pp. 2323 ◽  
Author(s):  
Christian Veauthier ◽  
Gunnar Gaede ◽  
Helena Radbruch ◽  
Joern-Peter Sieb ◽  
Klaus-Dieter Wernecke ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Rem Sleep ◽  
Periodic Limb Movements ◽  
Limb Movements

523 Characteristics of Patients with REM Sleep without Atonia/Periodic Limb Movements of Sleep without Dream Enactment Behaviors

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A206-A206
Author(s):  
Lina Barker ◽  
Maja Tippmann-Peikert
Keyword(s):  
Rem Sleep ◽  
Psychiatric Diagnosis ◽  
Neurological Disorders ◽  
Rem Sleep Behavior Disorder ◽  
Control Group ◽  
Periodic Limb Movements ◽  
Limb Movements ◽  
Sleep Behavior ◽  
Rem Sleep Without Atonia ◽  
Antidepressant Use

Abstract Introduction While REM sleep without atonia (RSWA) in REM sleep behavior disorder (RBD) is associated with male sex, age greater than or equal to 50 years, alpha-synucleinopathies, and narcolepsy, the characteristics of patients with RSWA/persistent periodic limb movements of sleep in REM sleep (RSWA/PLMS-REM) without dream enactment behaviors are unexplored. The aim of this study was to compare the demographics, comorbidities, and concomitant medication use between RSWA/PLMS-REM patients and non-RSWA/non-PLMS-REM controls. Based on anecdotal clinical observations, we hypothesized that these patients are more commonly young, women, have psychiatric or neurological diseases, and use antidepressants. Methods We conducted a retrospective review of the Mayo Clinic electronic medical record to identify all patients with RSWA/PLMS-REM between November 2018 and November 2020. After excluding all patients with RBD, restless legs syndrome, narcolepsy, and RSWA/non-PLMS-REM, we identified 27 patients. All in-lab polysomnograms (PSGs) were reviewed to calculate the periodic limb movement index per hour of REM sleep (REM-PLMI). We also identified a control group of 15 individuals without RSWA, reviewed their PSGs, and calculated the REM-PLMI. Results The mean REM-PLMI of patients with RSWA was 64 +/- 8.3 (standard error of mean (SEM)) per hour versus 1 +/- 0.6 (SEM) per hour in non-RSWA controls (p < 0.001). Patients with RSWA/PLMS-REM and non-RSWA controls had similar age and gender, 62 +/- 3 (SEM) versus 58 +/- 3 (SEM) years and 81% versus 87% men, respectively. However, psychiatric diagnosis, neurological disorders, and antidepressants use were more common among RSWA/PLMS-REM patients compared to non-RSWA controls with p = 0.0002, p = 0.0035 and p = 0.0074 respectively (Fisher’s Exact Test). Conclusion Psychiatric diagnosis, neurological disorders, and antidepressant use are more common among RSWA/PLMS-REM patients compared to non-RSWA/non-PLMS-REM controls. Further research to determine the implications of a diagnosis of RSWA/PLMS-REM for the future development of alpha-synucleinopathies are needed and currently ongoing. Support (if any):

519 Restless Legs and Periodic Limb Movements in 86 patients with Multiple Sclerosis

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A205-A205
Author(s):  
Davide Sparasci ◽  
Raffaele Ferri ◽  
Anna Castelnovo ◽  
Claudio Gobbi ◽  
Chiara Zecca ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Diagnostic Criteria ◽  
Large Population ◽  
Female Gender ◽  
Clinical Findings ◽  
Periodic Limb Movements ◽  
Limb Movements ◽  
Cross Sectional ◽  
Restless Legs ◽  
Maintenance Of Wakefulness Test

Abstract Introduction The aim of this study was to assess the prevalence of restless legs syndrome (RLS), periodic limb movements during sleep (PLMS) and their overlap in a large population of patients with multiple sclerosis (MS), and to compare clinical and paraclinical findings between patients with and without RLS/PLMS. Methods In this cross–sectional, observational, instrumental study, eighty-six patients (M/F: 27/59; mean age 48.0 ± 10.8 years) with a diagnosis of MS underwent a structured telephone interview assessing the five standard diagnostic criteria for RLS. Seventy-six participants underwent Video-polysomnography and Maintenance of Wakefulness Test (MWT). Instrumental and clinical findings were subsequently statistically compared to investigate their association with RLS and PLMS index (PLMSI). Results RLS and PLMS (PLMSI ≥15/h) prevalence in patients with MS was of 31.4% and 31.6% respectively. Among patients with RLS, 37.5% had a PLMSI ≥15/h. In the group with PLMS, 37.5% met all diagnostic criteria for RLS. No differences were found between patients with and without RLS (F = 0.99, p = 0.45), and between patients with and without a PLMSI ≥15/hour (F = 0.32 p = 0.94) on the pool of clinical and instrumental variables. Conclusion RLS is highly prevalent and severe in patients with MS. The prevalence of PLMS is comparable to the general population. The low percentage of patients with RLS having a high PLMSI, together with the absence of correlation between RLS and female gender and older age, support the existence of a distinct symptomatic form of RLS in MS. Support (if any):

Periodic limb movements both in non-REM and REM sleep: Relationships between cerebral and autonomic activities

2009 ◽  
Vol 120 (7) ◽  
pp. 1282-1290 ◽  
Author(s):  
M. Allena ◽  
C. Campus ◽  
E. Morrone ◽  
F. De Carli ◽  
S. Garbarino ◽  
...  
Keyword(s):  
Rem Sleep ◽  
Periodic Limb Movements ◽  
Limb Movements

Restless Legs Syndrome and Periodic Limb Movements in 86 patients with Multiple Sclerosis

SLEEP ◽  
2021 ◽  
Author(s):  
Davide Sparasci ◽  
Raffaele Ferri ◽  
Anna Castelnovo ◽  
Silvia Miano ◽  
Kosuke Tanioka ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Restless Legs Syndrome ◽  
Sleep Onset ◽  
Female Gender ◽  
Clinical Findings ◽  
Periodic Limb Movements ◽  
Limb Movements ◽  
Cross Sectional ◽  
Restless Legs ◽  
Maintenance Of Wakefulness Test

Abstract Study Objectives To assess the frequency of restless legs syndrome (RLS), periodic limb movements during sleep (PLMS) and their overlap in a large sample of patients with multiple sclerosis (MS). To compare clinical and paraclinical findings among four sub-groups of patients: RLS–/PLMS– (patients without RLS and PLMS), RLS+/PLMS– (patients with RLS and without PLMS), RLS–/PLMS (patients without RLS and with PLMS), RLS+/PLMS+ (patients with both RLS and PLMS). Methods In this cross–sectional, observational, instrumental study, eighty-six patients (M/F: 27/59; mean age 48.0 ± 10.8 years) with a diagnosis of MS underwent a telephone interview assessing the five standard diagnostic criteria for RLS. Seventy-six participants underwent polysomnography (PSG) and maintenance of wakefulness test. Instrumental and clinical findings were subsequently statistically compared to investigate their association with RLS and PLMS index (PLMSI). Results RLS and PLMS (PLMSI ≥15/h) frequency in patients with MS was of 31.4% and 31.6% respectively. Among patients with RLS, 37.5% had a PLMSI ≥15/h. RLS–/PLMS+ group showed higher wake after sleep onset (p = 0.01), stage shifts per hour (p = 0.03), increased stage N1 (p = 0.03) and reduction in stage N3 (p = 0.01) compared to RLS–/PLMS–. RLS had no influence on clinical and PSG parameters (p = 0.45). Conclusions RLS is highly frequent in patients with MS. The frequency of PLMS is comparable to the general population. The low percentage of patients with RLS having a high PLMSI, together with the absence of correlation between RLS and female gender and older age, support the existence of a distinct symptomatic form of RLS in MS.

Hypnic Headache - the First German Cases Including Polysomnography

Cephalalgia ◽  
2003 ◽  
Vol 23 (1) ◽  
pp. 20-23 ◽  
Author(s):  
S Evers ◽  
A Rahmann ◽  
S Schwaag ◽  
P Lüdemann ◽  
I-W Husstedt
Keyword(s):  
Oxygen Saturation ◽  
Rem Sleep ◽  
Periodic Limb Movements ◽  
Limb Movements ◽  
Hypnic Headache ◽  
Oxygen Inhalation

We report the first four German cases of hypnic headache according to the criteria suggested in the literature. Furthermore, we present the results of polysomnography in two theses cases with hypnic headache occurring during REM sleep. In one case, hypnic headache was also associated with periodic limb movements. Although mean nocturnal oxygen saturation was decreased in another patient, nightly oxygen inhalation did not result in an improvement of the headache.

scholarly journals 1128 Sleep Apnea and Periodic Limb Movements are Highly Prevalent in Patients With Multiple Sclerosis

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A429-A430
Author(s):  
M Palotai ◽  
H L Weiner ◽  
T Chitnis ◽  
J F Duffy ◽  
C R Guttmann
Keyword(s):  
Multiple Sclerosis ◽  
Sleep Apnea ◽  
Prospective Study ◽  
Sleep Disordered Breathing ◽  
Periodic Limb Movements ◽  
Naval Research ◽  
Limb Movements ◽  
Portable Monitor ◽  
Respiratory Event ◽  
Disordered Breathing

Abstract Introduction The pathogenesis of multiple sclerosis (MS)-related fatigue is multi-factorial, including neurogenic, inflammatory, endocrine, metabolic, mood, as well as sleep disorder-related mechanisms. The confounding effect of sleep disorders on the association between fatigue and neurodegenerative changes in the brain has not been investigated. Our objectives were to assess the prevalence of sleep apnea and periodic limb movements in the framework of a prospective study which investigates the neurogenic causation of treatment-resistant fatigue in MS. Methods MS patients enrolled in a National MS Society-funded prospective study (grant identifier RG-1501-03141) underwent a one-night at-home sleep test (HST) using a NOX T3 portable monitor. HST recordings were scored by a registered polysomnographic technologist. Respiratory Event (REI) and Periodic Limb Movement (PLMI) Indices were calculated for each patient. Results Out of 36 patients, 7 (20%) had mild (REI=5-14), 1 (3%) had moderate (REI=15-29), and 1 (3%) had severe sleep-disordered breathing (REI≥30). Fourteen (42%) of the patients had mild (PLMI=5-24), 4 (11%) had moderate (PLMI=25-49), and 7 (19%) had severe periodic limb movements (PLMI≥50). Overall, 81% of the patients had at least mild sleep-disordered breathing and/or periodic limb movements. Conclusion Sleep abnormalities (i.e., sleep apnea and periodic limb movements) are highly prevalent in patients with MS. We plan to compare the MRI exams of subgroups of MS patients with fatigue, to test the hypothesis that fronto-striatal circuitry is more affected by lesions in patients without sleep apnea compared to those with sleep apnea. Support This investigation was supported by a grant from the National Multiple Sclerosis Society (grant identifier RG-1501-03141). The home sleep test equipment was provided by a DURIP grant from the Office of Naval Research (grant N00014-15-1-2917).

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