Objective Sleep Quality in Subjects with Restless Legs Syndrome versus with Psychophysiological Insomnia: Polysomnography and Cardiopulmonary Coupling Analysis
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Objectives: To compare the sleep quality in the view of polysomnography (PSG) and cardiopulmonary coupling (CPC) analysis in subjects with restless legs syndrome (RLS) versus with psychophysiological insomnia (PPI). Methods: The PSG data of 109 subjects with RLS and 86 with PPI (apnea-hypopnea index <5 /h) were collected. All subjects reported sleep onset and maintenance insomnia. CPC parameters were obtained using CPC analyzer in RemLogic. Sleep spectrogram by CPC analyses categorized sleep as “stable” [high-frequency coupling (HFC), 0.1–0.4 Hz] and “unstable” [low-frequency coupling (LFC), 0.1–0.01 Hz], independent of sleep stages. We compared PSG and CPC parameters between two groups and performed correlation analyses to find the PSG parameters to affect CPC parameters. Results: In PSG parameters, subjects with PPI showed significantly longer sleep latency (14.2±20.06 vs. 27.5±34.96, p<0.001), and decreased sleep efficiency (SE, 80.5±14.96 vs. 76.5±14.45, p=0.009) than RLS. CPC parameters were not significantly different between groups. In both groups HFC was positively correlated with total sleep time and SE and was negatively associated with time of wake after sleep onset in both groups. Meanwhile, very LFC showed the opposite results to HFC with the same PSG parameters. Conclusions: Although subjects with RLS or PPI present sleep onset and maintenance insomnia, objective sleep quality was worse in PPI than RLS. It suggests that CPC as a factor to differentiate sleep quality between the RLS and the PPI has a limited role.
Abstract
Objectives: To compare the sleep quality in the view of polysomnography (PSG) and cardiopulmonary coupling (CPC) analysis in subjects with restless legs syndrome (RLS) versus with psychophysiological insomnia (PPI). Methods: The PSG data of 109 subjects with RLS and 86 with PPI (apnea-hypopnea index <5 /h) were collected. All subjects reported sleep onset and maintenance insomnia. CPC parameters were obtained using CPC analyzer in RemLogic. Sleep spectrogram by CPC analyses categorized sleep as “stable” [high-frequency coupling (HFC), 0.1–0.4 Hz] and “unstable” [low-frequency coupling (LFC), 0.1–0.01 Hz], independent of sleep stages. We compared PSG and CPC parameters between two groups and performed correlation analyses to find the PSG parameters to affect CPC parameters. Results: In PSG parameters, subjects with PPI showed significantly longer sleep latency (14.2±20.06 vs. 27.5±34.96, p<0.001), and decreased sleep efficiency (SE, 80.5±14.96 vs. 76.5±14.45, p=0.009) than RLS. CPC parameters were not significantly different between groups. In both groups HFC was positively correlated with total sleep time and SE and was negatively associated with time of wake after sleep onset in both groups. Meanwhile, very LFC showed the opposite results to HFC with the same PSG parameters. Conclusions: Although subjects with RLS or PPI present sleep onset and maintenance insomnia, objective sleep quality was worse in PPI than RLS. It suggests that CPC as a factor to differentiate sleep quality between the RLS and the PPI has a limited role.
참고문헌 (19)
- Thomas RJ, "Differentiating obstructive from central and complex sleep apnea using an automated electrocardiogram-based method", Sleep, 30, pp.1756~1769 (2007)
- Allen RP, "Restless legs syndrome: diagnostic criteria, special considerations, and epidemiology. A report from the restless legs syndrome diagnosis and epidemiology workshop at the National Institutes of Health", Sleep Med, 4, pp.101~119 (2003)
- American Academy of Sleep Medicine, "The international classification of sleep disorders: diagnostic and coding manual", American Academy of Sleep Medicine, ~ (2005)
- Walters AS, "Validation of the International Restless Legs Syndrome Study Group rating scale for restless legs syndrome", Sleep Med, 4, pp.121~132 (2003)
- A manual of standardized terminology, techniques and scoring systems for sleep stages of human subjects, "Rechtschaffen A", Brain Information Service, 1968
- Iber C, "The AASM Manual for the Scoring of Sleep and Associated Events: rules terminology and technical specifications", American Academy of Sleep Medicine, ~ (2007)
- "EEG arousals: scoring rules and examples: a preliminary report from the Sleep Disorders Atlas Task Force of the American Sleep Disorders Association", Sleep, 15, pp.173~184 (1992)
- Thomas RJ, "An electrocardiogram-based technique to assess cardiopulmonary coupling during sleep", Sleep, 28, pp.1151~1161 (2005)
- AASM, "International Classification of Sleep Disorders", American Academy of Sleep Medicine, ~ (2014)
- Ulfberg J, "Prevalence of restless legs syndrome among men aged 18 to 64 years: an association with somatic disease and neuropsychiatric symptoms", Mov Disord, 16, pp.1159~1163 (2001)
- Ulfberg J, "Restless Legs Syndrome among working-aged women", Eur Neurol, 46, pp.17~19 (2001)
- Cho YW, "Epidemiology of restless legs syndrome in Korean adults", Sleep, 31, pp.219~223 (2008)
- Montplaisir J, "Clinical, polysomnographic, and genetic characteristics of restless legs syndrome: a study of 133 patients diagnosed with new standard criteria", Mov Disord, 12, pp.61~65 (1997)
- Hornyak M, "Polysomnography findings in patients with restless legs syndrome and in healthy controls : a comparative observational study", Sleep, 30, pp.861~865 (2007)
- Montplaisir J, "The treatment of the restless leg syndrome with or without periodic leg movements in sleep", Sleep, 15, pp.391~395 (1992)
- Garcia-Borreguero D, "Correlation between rating scales and sleep laboratory measurements in restless legs syndrome", Sleep Med, 5, pp.561~565 (2004)
- Geyer JD, "Sleep education for paradoxical insomnia", Behav Sleep Med, 9, pp.266~272 (2011)
- Kryger MH, "Principles and Practice of Sleep Medicine", pp.2011, Saunders
- Schramm PJ, "Quantitative measurement of sleep quality using cardiopulmonary coupling analysis : a retrospective comparison of individuals with and without primary insomnia", Sleep Breath, 17, pp.713~721 (2013)