0678 Contactless 3D Detection Of Leg Movements In Sleep

Journal of Clinical Sleep Medicine, 2006

To determine the prevalence, risk factors, and impact on daytime sleepiness and hypertension of periodic leg movements of sleep (PLMS) with associated arousals in patients with obstructive sleep apnea (OSA). Methods: A single-center retrospective case series of 798 consecutive patients who underwent diagnostic overnight polysomnography for suspected OSA. We performed discriminant function analysis using clinical and polysomnographic variables to examine the relationship between PLMS (periodic leg movement arousal index ≥ 5 per hour) and potential risk factors, including OSA. Results: Mean ± SD age was 50 ± 12 years, body mass index 32 ± 8 kg/m 2 , Epworth Sleepiness Scale (ESS) score 11 ± 5, and apnea-hypopnea index 31 ± 26 per hour. Sixty-eight percent were men, 30% had systemic hypertension, and 19% were smokers. Ninety-two percent had OSA (apnea-hypopnea index ≥ 5); 47% had PLMS; 44% had both OSA and PLMS; and among patients with OSA, 48% had PLMS. Significant predictors of PLMS, in order of importance, were number of predisposing medical conditions, age, number of predisposing medications, obesity, and OSA. Medical conditions that significantly predicted PLMS were depression, fibromyalgia, and diabetes mellitus. The ESS score and hypertension status were no different between those with both OSA and PLMS and those with OSA alone. Conclusions: One in 2 patients investigated for OSA has PLMS. Risk factors for PLMS include preexisting medical conditions-particularly depression, fibromyalgia, and diabetes mellitus-increasing age, predisposing medications, obesity, and OSA. The combination of OSA and PLMS results in no greater subjective daytime sleepiness or prevalence of hypertension than OSA alone.

Somnologie - Schlafforschung und Schlafmedizin, 2008

Introduction: Insufficient sleep during polysomnography can produce poor quality studies or incomplete CPAP titrations. Non-benzodiazepines improve sleep without disrupting sleep architecture or exacerbating sleep-disordered breathing and should improve polysomnographic quality. Methods: Prospective, double-blinded, placebo-controlled trial assessing quality of polysomnography with eszopiclone premedication. We compared sleep latency, efficiency, sleep time and AHI between eszopiclone 3mg or matching placebo. We compared rates of inadequate studies between groups, defined as insufficient sleep time (<120 minutes or sleep efficiencies <70%) or incomplete CPAP titrations (>5 events/hour on the highest CPAP or complete intolerance).

Sleep, 2017

Study Objectives: Both restless legs syndrome (RLS) and periodic leg movements in sleep (PLMS) may be associated with incident cardiovascular disease (CVD). However, the individual contributions of these factors to adverse CVD outcomes are unknown. Methods: During the MrOS Sleep Study, 2823 men (mean age = 76.3 years) participated in a comprehensive sleep assessment from 2000 to 2002. RLS was identified by self-report of a physician diagnosis of RLS. A periodic limb movement of sleep index (PLMI) was derived from unattended in-home polysomnography. Incident cardiovascular events were centrally adjudicated during 8.7 ± 2.6 years of follow-up. The primary outcome was all-cause CVD; secondary outcomes included incident myocardial infarction (MI) and cerebrovascular disease. Cox proportional hazards regression models were adjusted for multiple covariates, including PLMI, to examine if there were independent associations of RLS and PLMI to the outcomes. Results: Physician-diagnosed RLS was reported by 2.2% and a PLMI ≥ 15 was found in 59.6% of men. RLS was not associated with the composite CVD outcome. RLS was significantly associated with incident MI (Hazard ratio [HR] = 2.02, 95% CI, 1.04-3.91) even after adjustment for multiple covariates. Results were only modestly attenuated when PLMI was added to the model. PLMI also was found to predict incident MI (per SD increase in PLMI, HR = 1.14, 95% CI, 1.00-1.30, p = .05), and was materially unchanged after addition of RLS. Conclusions: The independent risk that RLS confers for MI suggests a role for non-PLMS factors such as sleep disturbance, shared genetic factors, or PLMindependent sympathetic hyperactivity.

Journal of Clinical Sleep Medicine, 2013

Study Objectives: Periodic limb movements in sleep (PLMS) are common in the elderly. A previous large polysomnographic (PSG) study examining the relationship of PLMS to sleep architecture and arousals from sleep in women found that leg movements were common in elderly women, and PLMS which were associated with EEG arousals had a strong and consistent association with markers of disturbed sleep. Since sleep differs in men and women, we now investigate the association between PLMS and PSG indices of sleep quality in a large community-based sample of older men. Design: Observational study, cross-sectional analyses. Setting: Six clinical sites participating in the Osteoporotic Fractures in Men (MrOS) Study. Participants: 2,872 older community-dwelling men (mean age 76.4 years) who completed in-home PSG from 2003-2005. Interventions: N/A. Measurements and Results: In-home PSG was performed which included bilateral measurement of leg movements. The total number of leg movements per hour of sleep (PLMI) and the number of leg movements causing EEG-documented arousals per hour of sleep (PLMA) were computed. A PLMI ≥ 5 (70.8%) and PLMA ≥ 5 (27.4%) were both prevalent. Linear regression models were used to examine the relationship between PLMS as predictors and sleep architecture, arousal index, and sleep effi ciency as outcomes. The highest quintiles of PLMI (≥ 65.1) and PLMA (≥ 6.8) showed the largest association with indices of sleep architecture; PLMA showed a larger magnitude of effect. After multivariate adjustment, participants with a higher PLMA had a small but signifi cantly higher arousal index, lower sleep effi ciency, higher percentages of stages 1 and 2 sleep, and lower percentages of stage 3-4 and REM sleep (p < 0.01). An increased PLMI was similarly associated with a higher arousal index, higher percentage of stage 2 sleep, and lower percentage of stage 3-4 (p < 0.0001), but not with an increase in stage 1, REM sleep, or sleep effi ciency. Neither PLMI nor PMLA was associated with subjective sleepiness measured by the Epworth Sleepiness Scale. Conclusions: This study demonstrated that periodic leg movements are very common in older community-dwelling men and regardless of associated arousals, are associated with evidence of lighter and more fragmented sleep.

Sleep, 2006

Several studies have demonstrated a positive correlation between periodic leg movements during sleep (PLMS) and age in healthy subjects. However, little is known about periodic leg movements during wakefulness (PLMW) in this population. Although the definitions of PLMS and PLMW specify a typical intermovement interval of 20 to 40 seconds, scoring criteria allow an intermovement interval of 4 to 90 seconds. The aim of the present study was to look at the prevalence and interval distribution of PLMS and PLMW in relationship with age in a population of healthy subjects. Periodic leg movements were recorded during 1 night. Sleep laboratory, Hôpital du Sacré-Coeur de Montréal. Sixty-seven healthy subjects aged between 5 and 76 years (32 F, 35 M). N/A. The presence of PLMS was rare before the age of 40, but then the index increased dramatically. PLMW index was higher in younger subjects compared with middle-aged subjects. Interval histograms of PLMS did not revealed a clear peak in younge...

Journal of Medical Screening, 2013

Sleep, 2007

study objectives: To examine the association between sleep-disordered breathing (SDB) and subjective measures of daytime sleepiness, sleep quality, and sleep-related quality of life in a large cohort of community-dwelling older men and to determine whether any association remained after adjustment for sleep duration. Design: Cross-sectional. The functional outcome measures of interest were daytime sleepiness (Epworth Sleepiness Scale, ESS), sleep-related symptoms (Pittsburgh Sleep Quality Index, PSQI), and sleep-related quality of life (Functional Outcomes of Sleep Questionnaire, FOSQ). Analysis of variance and adjusted regression analyses examined the association between these outcome measures and SDB severity and actigraphy-determined total sleep time (TST). We then explored whether associations with SDB were confounded by sleep duration by adjusting models for TST. setting: Community-based sample in home and research clinic settings. Participants: Two-thousand eight-hundred forty-nine older men from the multicenter Osteoporotic Fractures in Men Study that began in 2000. All participants underwent in-home polysomnography for 1 night and wrist actigraphy for a minimum of 5 consecutive nights. interventions: N/A. measurements and results: Participants were aged 76.4 ± 5.5 years and had an apnea-hypopnea index (AHI) of 17.0 ± 15.0. AHI and TST were weakly correlated. ESS scores individually were modestly associated with AHI and TST, but the association with AHI was attenuated by adjustment for TST. PSQI and FOSQ scores were largely not associated with measures of SDB severity but were modestly associated with TST. conclusions: Daytime sleepiness, nighttime sleep disturbances, and sleep-related quality of life were modestly associated with TST. After adjustment for TST, there was no independent association with SDB severity. These results underscore the potential differences in SDB functional outcomes in older versus young and middle-aged adults.

SLEEP Advances, 2021

Introduction Co-morbid insomnia and sleep apnoea (COMISA) is a highly prevalent and debilitating condition. Previous studies have investigated associations between insomnia and mortality, and OSA and mortality, but not COMISA. Thus, this study investigated associations between OSA, insomnia and COMISA on mortality and cardiovascular event risks. Methods Sleep Heart Health Study data (n = 5803) were used to identify people with insomnia defined as difficulties falling asleep, maintaining sleep, and/or early morning awakenings from sleep at least 5 times a month and daytime impairment. OSA was defined as an apnoea-hypopnoea index ≥15 events/h. COMISA was defined if both conditions were present. Cox proportional hazard models were used to determine the association between COMISA and all-cause mortality (n = 1210) and cardiovascular events (N = 1243) over 15 years of follow-up. Results This analysis included 5236 participants. 2504 (47.8%) did not have insomnia/OSA, 374 (7.1%) had insom...

herkules.oulu.fi

The prevalence of self-reported obstructive sleep apnea syndrome (OSAS), habitual snoring (HS), daytime sleepiness (DS) and restless legs syndrome (RLS), and their associations with cardiovascular risk factors and depressive symptoms as well as the natural course and associated factors of habitual snoring and restless legs syndrome over a ten-year period were studied. Two different birth cohorts in Northern Finland were investigated. In the Oulu 35 longitudinal research programme study subjects participated in two subsequent surveys conducted in 1996-1998 and 2007-2008 (61-63 and 72-73 years old subjects, respectively). The Oulu 45 study population was examined in 2001-2002 (56-57 years old subjects). The data were gathered by questionnaires, as well as laboratory and clinical measurements. In the Oulu35 study, of the 831 baseline participants, 593 (73%) participated in the first followup in 1996-1998 and 457 (55%) participated in both follow-up studies. In the Oulu 45 study, the target population comprised 1 332 subjects, 995 (75%) of whom participated. The prevalence of OSAS was 8% in the 56-57 year-old population, 4% in the 61-63 year old population, and 3% in the 72-73 year old population. These figures were 31%, 26% and 19% for HS, 16%, 9% and 11% for DS, and 18%, 21% and 15% for RLS, respectively. In a ten-year period, half of those who snored in 1996-1998 stopped snoring, and half of those who suffered from restless legs 3-7 nights/week in 1996-98 suffered from this syndrome less than once a week in 2007-2008. The 10-year incidence of new cases of both HS and RLS was 7%. In subjects aged 56-57 and 61-63, the components of the metabolic syndrome and depressive symptoms associated with OSAS and HS, while in the follow-up study, the role of these associations diminished. Male gender was the strongest predictor of the new cases of HS, while depressive symptoms and waist circumference predicted the permanence or incidence of HS. Depressive symptoms, DS and, weakly, waist circumference were associated with RLS in both the 56-57 year-old and in 61-63 year-old populations. Depressive symptoms were also predictive of the permanence and incidence of new RLS cases. Waist circumference also predicted new cases of RLS in the 72-73 year-old population. Sleep disorders were quite common in 56-73 year-old subjects and their prevalence seemed to diminish as subjects aged. The components of metabolic syndrome associated with sleep disorders in middle-aged subjects, but these associations lost their significance in older age groups. Depressive symptoms predicted incidence of restless legs syndrome.

Indian Journal of Sleep Medicine

A questionnaire based survey was conducted to determine the prevalence of common sleep-related disorders in the elderly population of Delhi. The study population included in this analysis comprised 1240 grandparents of school-going children. The overall prevalence of SDB was 10.3%.; (9.9% in males and 10.8% in female subjects) It was found to correlate with increasing BMI (p< 0.064) The overall prevalence of snoring was found to be 41.4% (Males=41.6%, Females =41.2%). It correlated positively with body mass index (BMI) (p<0.033), age (p<0.076), and excessive daytime sleepiness (p<0.036). Habitual snoring was found to be prevalent in 27.2% of the elderly subjects and was found to correlate with BMI (p<0.03), and rising socio-economic strata (p<0.014). Approximately 41.5% of the elderly population was seen to suffer from excessive daytime sleepiness. It correlated significantly with lower socio-economic strata The overall prevalence of symptoms suggestive of restless leg syndrome was 14.3%. It was found to correlate significantly with BMI (p<0.018), and female gender (p<0.052) The overall prevalence of sleepwalking in the elderly population studied was 6.9%. It was found to correlate negatively with increasing BMI (p<0.041) and age and positively with rising socio-economic strata (p<0.076). The prevalence of nightmares in the elderly population studied was 21.7%. It was found to correlate inversely with age (p<0.019). Bruxism was observed to be present in 9.2% of the elderly population studied. It correlated significantly with rising socio-economic strata (p<0.017) and snoring (p<0.002). Approximately 8% of the entire elderly study population admitted that they consumed sleeping pills. Its use correlated with rising socio-economic strata (p<0.033) and symptoms suggestive of disorders of initiation & maintenance of sleep (DIMS) (p<0.072).