The prevalence and significance of periodic leg movements during sleep in patients with congestive heart failure.
OBJECTIVE
The aim of this study was to evaluate (1) the prevalence of periodic leg movements during sleep (PLMs) in a consecutive sample of congestive heart failure (CHF) outpatients; (2) the presence of correlation between PLMs, subjective daytime sleepiness, and sleep architecture; and (3) the heart rate response to PLMs in CHF.


METHODS
Seventy-nine [50 men, age 59 +/- 11 years, body mass index (BMI) 26 +/- 5 kg/m(2)] consecutive adult stable outpatients with CHF [left ventricular ejection fraction (LVEF) 36 +/- 6%] were prospectively evaluated. The patients underwent assessment of echocardiography, sleepiness (Epworth Scale), and overnight in-lab polysomnography.


RESULTS
Fifteen patients (19%) had PLM index >5. These subjects were similar in sex distribution, BMI, subjective somnolence, LVEF, and apnea-hypopnea index (AHI), but were significantly older than subjects without PLMs. Sleep architecture was similar in subjects with and without PLMs. There was a small but significant elevation of heart rate after PLMs (80.1 +/- 9.4 vs. 81.5 +/- 9.2; p < 0.001). The cardiac acceleration was also present in absence of electroencephalogram activation.


CONCLUSIONS
The prevalence of PLMs in consecutive sample of adult CHF outpatients was 19%. There were no differences in subjective daytime sleepiness, sleep architecture, AHI, and severity of CHF in subjects with and without PLMs. PLMs caused a small but statistically significant cardiac acceleration.
Skomro
Robert
R
University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
Silva
Rogerio
R
Alves
Rosana
R
Figueiredo
Adelaide
A
Lorenzi-Filho
Geraldo
G
D015992:Body Mass Index; D006970:Disorders of Excessive Somnolence / Q000175:diagnosis / Q000453:epidemiology; D004452:Echocardiography; D005260:Female; D006333:Heart Failure / Q000453:epidemiology*; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D020189:Nocturnal Myoclonus Syndrome / Q000175:diagnosis / Q000453:epidemiology*; D017286:Polysomnography; D015995:Prevalence; D011446:Prospective Studies; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000453:epidemiology; D012894:Sleep Stages / Q000502:physiology; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000453:epidemiology