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Obstructive sleep apnea and periodic limb movement in children: is there really an association?
Sleep Med
January 2024
Pediatrics Department, Health Research Institute-Fundación Jiménez Díaz University Hospital, Universidad Autónoma de Madrid (IIS-FJD, UAM), 28040, Madrid, Spain; Sleep Unit, Health Research Institute-Fundación Jiménez Díaz University Hospital, Universidad Autónoma de Madrid (IIS-FJD, UAM), 28040, Madrid, Spain; Health Research Institute-Fundación Jiménez Díaz University Hospital, Universidad Autónoma de Madrid (IIS-FJD, UAM), 28040, Madrid, Spain. Electronic address:
Purpose: Periodic limb movements (PLMs) can be found isolated or related to other sleep disorders, as Obstructive Sleep Apnea (OSA). Nevertheless, this association was described before the proposal for modification of the World Association of Sleep Medicine (WASM), which incorporated major changes modifying the definition of respiratory-related leg movements (RRLM) so that the relationship between OSA and PLM could be affected.
Methods: A total of 131 PSG were studied (children with ages from 5 to 12 years old), all referred because of a suspicion of sleep-disordered breathing (65 children were diagnosed of OSA, and 66 presented snoring but no sleep apnea).
The accuracy and difference of scoring rules and methods to score respiratory event-related leg movements in obstructive sleep apnea patients.
Sleep Med
August 2023
Department of Otorhinolaryngology-Head and Neck Surgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea. Electronic address:
Objective: To compare manual scoring: 1) to the American Academy of Sleep Medicine (AASM) auto-scoring rules. 2) to the AASM and World Association of Sleep Medicine (WASM) rules, and evaluate the accuracy of the AASM and WASM for respiratory event-related limb movements (RRLM) in diagnostic and continuous positive airway pressure (CPAP) titration polysomnography (PSG).
Methods: We retrospectively, re-scored diagnostic and CPAP titration PSGs of 16 patients with obstructive sleep apnea (OSA), using manual re-scoring by the AASM (mAASM) and WASM (mWASM) criteria for RRLM, periodic limb movements during sleep (PLMS), and limb movements (LM), which were compared to auto-scoring by the AASM (aAASM).
Different scoring rules for respiratory event-related leg movements: effects on the prevalence of periodic limb movements during sleep and their association with depressive symptoms in patients with obstructive sleep apnea.
Sleep Med
September 2021
Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Background: We compared the prevalence of periodic leg movements during sleep (PLMS) according to two different scoring rules of the American Academy of Sleep Medicine (AASM) 2012 and World Association of Sleep Medicine (WASM) 2016 and determined their association with depressed mood in patients with obstructive sleep apnea (OSA).
Methods: PLMS, defined as a periodic leg movements index of >15, were diagnosed on a diagnostic and continuous positive airway pressure (CPAP) titration polysomnography using the AASM 2012 and WASM 2016 rules. The Beck Depression Inventory (BDI) and Epworth Sleepiness Scale (ESS) were used, and multiple regression analyses were performed.
Sleep-related leg movements in obstructive sleep apnea: definitions, determinants, and clinical consequences.
Sleep Med
November 2020
Center for Sleep and Wake Disorders, Haaglanden Medical Center, The Hague, the Netherlands; Department of Neurology, Haaglanden Medical Center, The Hague, the Netherlands.
Study Objectives: To investigate (1) the effect of different scoring rules on leg movement (LM) classification in patients with obstructive sleep apnea (OSA); (2) determinants of respiratory event related leg movements (rLM); and (3) to relate LM parameters to clinical outcomes.
Methods: (1) LM classification was compared between the World Association of Sleep Medicine (WASM) 2006 and the WASM 2016 rules in 336 participants with apnea hypopnea index (AHI) ≥ 5; (2) determinants and features of rLM were investigated with logistic mixed regression in 172 participants with AHI ≥ 10 and respiratory disturbance index (RDI) ≥ 15, and (3) LM parameters were compared for patients with and without cardiovascular events and related to continuous positive airway pressure (CPAP) adherence.
Results: WASM-2016 scoring significantly reduced periodic limb movements of sleep (PLMS) frequency in OSA participants even when only considering the new periodicity criteria.
Effects of new PLM scoring rules on PLM rate in relation to sleep and resting wake for RLS and healthy controls.
Sleep Breath
March 2021
Christopher J Earley. Richard P Allen. Department of Neurology, School of Med., Johns Hopkins University, Baltimore, MD, USA.
Purpose: This study evaluates the differences in periodic leg movement (PLM) rates for Restless Legs Syndrome (RLS) and healthy controls when using the updated PLM scoring criteria developed by IRLSSG in 2016 versus the prior PLM scoring criteria developed by IRLSSG in 2006. Four major problems with the prior standards had been objectively identified, i.e.
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