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Abstract
Objectives
The aim of this study was to examine the differences in subjective sleep quality and objective sleep parameters between groups with different severities of limb movements during sleep in elderly persons with sleep complaints.
Methods
We recruited adult subjects with sleep complaints from four areas in Gangwon-do. Nocturnal polysomnography studies were conducted for 159 subjects at Kangwon National University Hospital. A total of 72 subjects older than 60 years were finally selected, and we classified them into three groups according to the limb movement index (LMI) : 29 subjects with LMI below 15, 21 subjects with LMI between 15 and 44, and 22 subjects with LMI above 44.
Results
The proportion of existing restless legs syndrome (RLS) symptoms differed between the three groups, but was not statistically significant (p=0.051). No difference in nocturnal sleep parameters was observed between the three groups. In the total group, the limb movement arousal index showed positive correlation with respiratory arousal index (r=0.252, p<0.05).
Conclusion
In elderly persons with sleep complaints, a greater LMI severity was associated with a tendency of higher comorbidity of RLS. Frequent arousals due to limb movements were not associated with a greater severity of limb movements during sleep severity, but with increased arousals due to respiratory events.
Figures and Tables
Table 1
Demographic factors and the scores of KESS and PSQI in three different LMI subgroups
*: p<0.05, †: Analysis of variance, ‡: Chi-square test, §: Analysis of covariance controlling for Apnea Hypopnea index, ∥: Number of subjects with restless legs syndrome versus subjects without restless legs syndrome, ¶: One subject with missing data was excluded. LMI : Limb movement index, KESS : Korean version of Epworth Sleepiness Scale, PSQI : Pittsburgh Sleep Quality Index, SD : Standard deviation, RLS : Restless legs syndrome
Table 2
Nocturnal sleep parameters in three different LMI subgroups
*: p<0.05 (analysis of covariance controlling for Apnea Hypopnea index). LMI : Limb movement index, TST : Total sleep time, SE : Sleep efficiency, WASO : Wake after sleep onset, SL : Sleep latency, REML : REM latency, N1 : Stage 1 sleep, N2 : Stage 2 sleep, N3 : Slow wave sleep, REMS : Rapid eye movement sleep, SD : Standard deviation
Table 3
Sleep breathing disorder related parameters and arousal indices in three different LMI subgroups
*: p<0.05 (analysis of covariance controlling for Apnea Hypopnea index). LMI : Limb movement index, AHI : Apnea hypopnea index, ODI : Oxygen desaturation index, LOS : Lowest oxygen saturation, RST : Relative snoring time, RAI : Respiratory arousal index, LMAI : Limb movement arousal index, SAI : Spontaneous arousal index, TAI : Total arousals index, SD : Standard deviation
Table 4
Correlations of sleep breathing disorder related parameters with arousal indices
*: p<0.05, **: p<0.01 (Pearson correlation analysis). LMI : Limb movement index, AHI : Apnea hypopnea index, ODI : Oxygen desaturation index, LOS : Lowest oxygen saturation, RAI : Respiratory arousal index, LMAI : Limb movement arousal index, SAI : Spontaneous arousal index, TAI : Total arousal index
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