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논문KCI 등재

주기성 사지운동장애와 사망률

Periodic Limb Movement Disorder and Mortality

최재원
대한수면의학회 (Korean Academy of Sleep Medicine)|2023.06|수면정신생리 (Sleep Medicine and Psychophysiology)|제30권 제1호|pp. 3-8|DOI 10.14401/KASMED.2023.30.1.3

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참고문헌

키워드

Mortality사망률Cardiovascular disease심혈관계 질환Periodic limb movement disorder주기성 사지운동장애
주제분류정신과학

초록

PLMS는 비교적 흔한 현상이지만 수면다원검사를 통해서 만 확인할 수 있고, PLMD는 RLS 등의 수면장애가 배제되 어야만 진단할 수 있어 유병률이 높지 않고, RLS는 임상증 상만으로도 진단을 내릴 수 있는 유병률이 높은 질환이기 때문에 많은 사망률 관련 연구들이 RLS만 또는 RLS/PLMS 를 대상으로 하고 있다. 하지만 최근 많은 연구들에서 RLS 증상을 조정한 후에도 PLMS 자체의 빈도 증가가 여러 질환 의 이환율 및 사망률 증가와 연관이 있다는 결과를 보이고 있다. 이는 RLS와 PLMS 가 많은 부분에서 공통된 변인을 가지고 있지만 수면 중 움 직임이라는 생리적인 반응이 여러 메커니즘을 통해 직접적 으로 신체에 영향을 미치는 것이 이환율과 사망률을 증가 시키는데 더 중요하다고 할 수 있다. PLMI를 감소시키는 치료가 심혈관계질환의 이환율과 사망률을 감소시킨다는 증거는 부족한 상태이다. 이환율과 사망률 증가와 관련된 교감신경의 활성도, 혈압, 심박수, 인 슐린 감수성, 포도당 내성과 같은 측정 가능한 중간 생리학적인자에 대한 소규모 무작위 임상 시험 등의 연구가 앞으로 필요하다. 이러한 연구가 PLMS 감소와 함께 중간 생리학적 인자의 개선을 입증한다면 향후 대규모 결과 연구에 대한 이론적 근거를 제공할 수 있을 것이다.

Abstract

Periodic limb movement disorder (PLMD) is a sleep-related movement disorder characterized by involuntary, rhythmic limb movements during sleep. While PLMD itself is not considered life-threatening, its association with certain underlying health conditions raises concerns about mortality risks. PLMD has been found to be associated with cardiovascular diseases such as hypertension and cardiovascular disease. The fragmented sleep caused by the repetitive limb movements and associated arousals may contribute to sympathetic activation, chronic sleep disruption, sleep deprivation, and subsequent cardiovascular problems, which can increase mortality risks. The comorbidities and health factors commonly associated with PLMD, such as obesity, diabetes, and chronic kidney disease, may also contribute to increased mortality risks. PLMD is often observed alongside other neurological disorders, including restless legs syndrome (RLS) and Parkinson's disease. The presence of PLMD in these conditions may exacerbate the underlying health issues and potentially contribute to higher mortality rates. Further research is needed to elucidate the specific mechanisms linking PLMD to mortality risks and to develop targeted interventions that address these risks.

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