title: Periodic limb movements are associated with vasomotor symptoms.
abstract: OBJECTIVE
  Periodic limb movements (PLMs) are characterized by involuntary movements of the lower extremity during sleep. The etiology of PLM has been suggested to involve the dopaminergic system which, in turn, can be modulated by estrogen. It is currently unknown whether PLMs are associated with the menopausal transition and/or concomitant vasomotor symptoms. The aim of the present study was to examine if objectively diagnosed PLMs (with and without arousals) are more common in postmenopausal women or in women with vasomotor symptoms. A secondary aim was to analyze the influence of PLMs on self-reported HRQoL.
  
  
  METHODS
  A community-based sample of 348 women underwent full-night polysomnography. PLMs (index > 15) and associated arousals (PLM arousal index > 5) were evaluated according to AASM scoring rules. Health-related quality of life was measured using the SF-36 questionnaire. The occurrence of peri- and postmenopausal symptoms were evaluated by a questionnaire and plasma levels of follicle stimulating hormone (FSH) were measured.
  
  
  RESULTS
  After adjusting for confounding factors, vasomotor symptoms remained a significant explanatory factor for the occurrence of PLMs (adj. OR 1.86, 95% CI 1.03-3.37). In women with PLM arousals, adjusted OR for vasomotor symptoms was 1.61, 95% CI 0.76-3.42. PLMs did not seem to affect HRQoL.
  
  
  CONCLUSIONS
  We found that clinically significant PLMs, but not PLM with arousals, were more common among women with vasomotor symptoms, even after controlling for confounding factors. Menopausal status per se, as evidenced by FSH in the postmenopausal range, was not associated with PLMs.
authors.affiliation: Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden ; Center for Clinical Research Dalarna, Falun, Sweden.
authors.forename: Jan
authors.initials: J
authors.lastname: Wesström
authors.affiliation: Sleep Disorder Department, Capio, Örebro, Sweden.
authors.forename: Jan
authors.initials: J
authors.lastname: Ulfberg
authors.affiliation: Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
authors.forename: Inger
authors.initials: I
authors.lastname: Sundström-Poromaa
authors.affiliation: Department of Medical Sciences, Respiratory Medicine and Allergology, Uppsala University, Uppsala, Sweden.
authors.forename: Eva
authors.initials: E
authors.lastname: Lindberg
mesh_terms: D000328:Adult; D000368:Aged; D001143:Arousal; D005260:Female; D019584:Hot Flashes / Q000150:complications* / Q000503:physiopathology; D006801:Humans; D008875:Middle Aged; D020189:Nocturnal Myoclonus Syndrome / Q000150:complications* / Q000503:physiopathology; D016017:Odds Ratio; D017698:Postmenopause; D017697:Premenopause; D011795:Surveys and Questionnaires; D013546:Sweating; D013548:Sweden; D014666:Vasomotor System / Q000503:physiopathology*; D055815:Young Adult
keywords: Periodic limb movements; menopause; women