title: Change in frequency of periodic limb movements during sleep with usage of continuous positive airway pressure in obstructive sleep apnea syndrome.
abstract: Periodic limb movements during sleep (PLMS) sometimes newly appear on the night of continuous positive airway pressure (CPAP) titration in patients with obstructive sleep apnea syndrome (OSAS). To ascertain the incidence and causative factors of this phenomenon, we investigated differences in its prevalence and the factors associated with newly appeared and persistent PLMS on CPAP titration night. We retrospectively analyzed polysomnographic data of 997 consecutive OSAS outpatients who had undergone overnight CPAP titration. On the basis of changes in periodic limb movements index (PLMI) values (cut off level≥15/h) from baseline polysomnography (BPSG) to CPAP titration PSG, patients were assigned to one of four groups: persistent, CPAP-emergent, CPAP-disappeared, and non-PLMS. The rate of patients was 6.7% in the persistent group, 8.0% in the CPAP-emergent group, 4.0% in the CPAP-disappearance group, and 81.2% in the non-PLMS group. Multivariate logistic regression analysis revealed that a higher apnea-hypopnea index (AHI) on BPSG and ≥47years of age appeared to be associated with the CPAP-emergent group. The results suggest that elderly patients with higher AHI at BPSG may present with CPAP-emergent PLMS.
authors.affiliation: Department of Somnology, Tokyo Medical University, Tokyo 160-0023, Japan.
authors.forename: Sayaka
authors.initials: S
authors.lastname: Aritake-Okada
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Namba
authors.forename: Natsuki
authors.initials: N
authors.lastname: Hidano
authors.forename: Shoichi
authors.initials: S
authors.lastname: Asaoka
authors.forename: Yoko
authors.initials: Y
authors.lastname: Komada
authors.forename: Akira
authors.initials: A
authors.lastname: Usui
authors.forename: Masato
authors.initials: M
authors.lastname: Matsuura
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Inoue
mesh_terms: D000328:Adult; D045422:Continuous Positive Airway Pressure / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020189:Nocturnal Myoclonus Syndrome / Q000453:epidemiology / Q000503:physiopathology* / Q000628:therapy*; D012890:Sleep / Q000502:physiology*; D020181:Sleep Apnea, Obstructive / Q000453:epidemiology / Q000503:physiopathology* / Q000628:therapy*