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Positional Obstructive Sleep Apnea and Periodic Limb Movements During Sleep: A Large Multicenter Study

신현우|박찬순|강윤진|소재현|윤원혁
대한이비인후과학회 (Korean Society of Otorhinolaryngology-Head and Neck Surgery)|2024.08|Clinical and Experimental Otorhinolaryngology|제17권 제3호|pp. 217-225|DOI 10.21053/ceo.2024.00034

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키워드

Supine PositionObstructive Sleep ApneaSleep Apnea SyndromesPeriodic Limb Movement DisorderExcessive Sleep-Related Periodic Leg Move- ments

초록

Objectives. The relationships among positional obstructive sleep apnea (POSA), obstructive sleep apnea (OSA), and peri- odic limb movements during sleep (PLMS) remain unclear. We investigated these relationships with respect to the se- verity of OSA and explored the underlying mechanisms. Methods. We retrospectively reviewed 6,140 eligible participants who underwent full-night diagnostic polysomnography at four clinical centers over a 5-year period, utilizing event-synchronized analysis. We evaluated the periodic limb move- ment index (PLMI) and the periodic limb movement with arousal index (PLMAI). The impacts of POSA on the PLMI, PLMAI, and PLMS were analyzed in relation to the severity of OSA. Results. The mean PLMI, the mean PLMAI, and the prevalence of PLMS were significantly lower in participants with se- vere OSA compared to the mild and moderate OSA groups. The mean PLMI among those with mild OSA exceeded that of control participants. Furthermore, the mean PLMI (4.8±12.7 vs. 2.6±9.8 events/hr, P <0.001), the mean PLMAI (0.9±3.7 vs. 0.5±3.3 events/hr, P <0.001), and the prevalence of PLMS (11% vs. 5.3%, P <0.001) were higher in patients with POSA than in those with non-positional OSA. This PLMS finding was particularly pronounced among those with severe OSA (odds ratio [OR], 1.554; 95% confidence interval [CI], 1.065–2.267) and was less evi- dent in the mild (OR, 0.559; 95% CI, 0.303–1.030) and moderate (OR, 1.822; 95% CI, 0.995–3.339) groups. Conclusion. Patients with POSA, especially those with severe OSA, exhibit a comparatively high prevalence of PLMS. In cases involving prominent PLMS, the diagnosis and treatment of POSA and OSA should be considered.

Abstract

Objectives. The relationships among positional obstructive sleep apnea (POSA), obstructive sleep apnea (OSA), and peri- odic limb movements during sleep (PLMS) remain unclear. We investigated these relationships with respect to the se- verity of OSA and explored the underlying mechanisms. Methods. We retrospectively reviewed 6,140 eligible participants who underwent full-night diagnostic polysomnography at four clinical centers over a 5-year period, utilizing event-synchronized analysis. We evaluated the periodic limb move- ment index (PLMI) and the periodic limb movement with arousal index (PLMAI). The impacts of POSA on the PLMI, PLMAI, and PLMS were analyzed in relation to the severity of OSA. Results. The mean PLMI, the mean PLMAI, and the prevalence of PLMS were significantly lower in participants with se- vere OSA compared to the mild and moderate OSA groups. The mean PLMI among those with mild OSA exceeded that of control participants. Furthermore, the mean PLMI (4.8±12.7 vs. 2.6±9.8 events/hr, P <0.001), the mean PLMAI (0.9±3.7 vs. 0.5±3.3 events/hr, P <0.001), and the prevalence of PLMS (11% vs. 5.3%, P <0.001) were higher in patients with POSA than in those with non-positional OSA. This PLMS finding was particularly pronounced among those with severe OSA (odds ratio [OR], 1.554; 95% confidence interval [CI], 1.065–2.267) and was less evi- dent in the mild (OR, 0.559; 95% CI, 0.303–1.030) and moderate (OR, 1.822; 95% CI, 0.995–3.339) groups. Conclusion. Patients with POSA, especially those with severe OSA, exhibit a comparatively high prevalence of PLMS. In cases involving prominent PLMS, the diagnosis and treatment of POSA and OSA should be considered.

참고문헌 (51)

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