Bilateral leg movements during sleep: detailing their structure and features in normal controls and in patients with restless legs syndrome.

Objective: The aim of this study was to analyze statistically the number of single leg movements (LMs) forming bilateral LMs during sleep, along with their combined duration, to eventually provide evidence-based data for the adjustment of the current scoring rules defining bilateral LMs.

Methods: Polysomnographic recordings of 111 untreated patients with RLS with a median age of 56.0 years, along with 42 normal controls with a mean age of 60.

Intervening Leg Movements Disrupt PLMS Sequences.

Study Objectives: Periodic leg movements during sleep (PLMS) occur within a subject as a series with a remarkably stable period defined by the intermovement interval (IMI). Sometimes a non-PLMS movement occurs intervening between two PLMS. PLMS scoring rules totally ignore these intervening leg movements (iLM).

Periodic leg movements during sleep: phenotype, neurophysiology, and clinical significance.

Periodic leg movements during sleep (PLMS) are the most important objective finding in restless legs syndrome (RLS). During the last decade, PLMS have been very important for the assessment and comprehension of their pathophysiological correlates, which have been paralleled by the emergence of new computer-assisted and data-driven rules for their identification, scoring, and analysis. The present article focused on the most relevant PLMS-related findings of the last decade, and sought to provide a coherent and comprehensive overview on this enigmatic motor phenomenon.

Sequence analysis of leg movements during sleep with different intervals (<10, 10-90 and >90 s) in restless legs syndrome.

The aim of this study was to define the time structure of leg movements during sleep occurring with an intermovement interval (onset-to-onset) shorter than 10 s in patients with restless legs syndrome and controls, and to compare it to the structure of movements with intervals of 10-90 s or >90 s. Polysomnographic recordings of 141 untreated patients and 68 age-matched normal controls were analysed. All movements were detected and classified into three categories, separated by intervals of <10, 10-90 or >90 s.

Quantifying Leg Movement Activity During Sleep.

Currently, 2 sets of similar rules for recording and scoring leg movement (LM) exist, including periodic LM during sleep (PLMS) and periodic LM during wakefulness. The former were published in 2006 by a task force of the International Restless Legs Syndrome Study Group, and the second in 2007 by the American Academy of Sleep Medicine. This article reviews the basic recording methods, scoring rules, and computer-based programs for PLMS.

World Association of Sleep Medicine (WASM) 2016 standards for recording and scoring leg movements in polysomnograms developed by a joint task force from the International and the European Restless Legs Syndrome Study Groups (IRLSSG and EURLSSG).

This report presents the results of the work by a joint task force of the International and European Restless Legs Syndrome Study Groups and World Association of Sleep Medicine that revised and updated the current standards for recording and scoring leg movements (LM) in polysomnographic recordings (PSG). First, the background of the decisions made and the explanations of the new rules are reported and then specific standard rules are presented for recording, detecting, scoring and reporting LM activity in PSG. Each standard rule has been classified with a level of evidence.

Defining morphology of periodic leg movements in sleep: an evidence-based definition of a minimum window of sustained activity.

Objective: Current standard guidelines for scoring periodic leg movements (PLM) define the start and end of a movement but fail to explicitly specify the movement morphology necessary to classify an EMG event as a PLM, rather than some other muscle event. This is currently left to the expert visual scorer to determine. This study aimed to define this morphology to provide a consistent standard for visual scoring and to improve automatic periodic leg movements in sleep scoring.

Diagnostic accuracy of the standard and alternative periodic leg movement during sleep indices for restless legs syndrome.

Objective: To evaluate the diagnostic accuracy of the standard periodic leg movement during sleep (PLMS) index, a recently introduced alternative one, and the periodicity index (PI) for restless legs syndrome (RLS).

Subjects And Methods: A total of 107 patients with RLS were retrospectively identified and included (47 males and 60 females, mean age 56.9 years), along with 48 normal controls (24 males and 24 females, mean age 52.

Japanese version of the Munich Parasomnia Screening: translation and linguistic validation of a screening instrument for parasomnias and nocturnal behaviors.

Objective: There is no broad screening instrument that can comprehensively assess parasomnias and sleep-related movement disorders listed in the International Classification of Sleep Disorders. The aim of this study was to develop the Japanese version of the Munich Parasomnia Screening (MUPS), a screening instrument for parasomnias and nocturnal behaviors, which was developed and validated at the Max Planck Institute of Psychiatry.

Methods: A multi-step translation methodology consisting of forward translation, back translation, expert review, and cognitive debriefing interviews was performed between June and November 2011.

Putting the periodicity back into the periodic leg movement index: an alternative data-driven algorithm for the computation of this index during sleep and wakefulness.

Objective: To evaluate an alternative index for periodic leg movements during sleep (PLMS) and wakefulness (PLMW) expected to be similar to the standard index when leg movement activity is genuinely periodic, but significantly lower when periodicity is low.

Subjects And Methods: One-hundred-and-seven subjects with restless legs syndrome (RLS) were retrospectively identified and included (47 males, 60 females, mean age 56.9 years), along with 63 controls (33 males, 30 females, 42.

A Data-Driven Analysis of the Rules Defining Bilateral Leg Movements during Sleep.

Study Objectives: The aim of this study was to describe and analyze the association between bilateral leg movements (LMs) during sleep in subjects with restless legs syndrome (RLS), in order to eventually support or challenge the current scoring rules defining bilateral LMs.

Methods: Polysomnographic recordings of 100 untreated patients with RLS (57 women and 43 males, mean age 57 y) were included. In each recording, we selected as reference all LMs that occurred during sleep and that were separated from another ipsilateral LM by at least 10 sec of EMG inactivity.

Subjective sleep dysfunction and insomnia symptoms in Parkinson's disease: Insights from a cross-sectional evaluation of the French CoPark cohort.

Introduction: Twenty-seven to 80% of patients with Parkinson's Disease (PD) complain of subjective sleep dysfunction and insomnia symptoms. Our aim is to describe the prevalence and features of subjective sleep dysfunction and insomnia symptoms in patients with PD compared to other patients.

Methods: Cross-sectional analysis of 636 adult PD patients compared to 143 age and sex-matched non-PD control patients consulting their general practitioners.

The Role of Periodic Limb Movements During Sleep in Restless Legs Syndrome: A Selective Update.

Periodic leg movements during sleep (PLMS) are a highly active research topic and accumulating recent evidence has led to reevaluation of key aspects on the role of PLMS in restless legs syndrome (RLS). This article summarizes the recent developments in 3 areas: the relationship of PLMS to cortical arousals in patients with RLS, the differential effect of dopaminergic and non-dopaminergic treatment on PLMS, and the possible emergence of PLMS as a sleep-related cardiovascular risk factor.

Neurology and psychiatry: waking up to opportunities of sleep. : State of the art and clinical/research priorities for the next decade.

In recent years, evidence has emerged for a bidirectional relationship between sleep and neurological and psychiatric disorders. First, sleep-wake disorders (SWDs) are very common and may be the first/main manifestation of underlying neurological and psychiatric disorders. Secondly, SWDs may represent an independent risk factor for neuropsychiatric morbidities.

Reduced sleep quality and depression associate with decreased quality of life in patients with pituitary adenomas.

Objectives: Several studies reported decreased quality of life (QoL) and sleep as well as increased rates of depression for patients with pituitary adenomas. Our aim was to explore to what extent differences in depression and sleep quality contribute to differences in QoL between patients with pituitary adenomas and controls.

Design: A cross-sectional case-control study.

Distinctive features of NREM parasomnia behaviors in parkinson's disease and multiple system atrophy.

Objective: To characterize parasomnia behaviors on arousal from NREM sleep in Parkinson's Disease (PD) and Multiple System Atrophy (MSA).

Methods: From 30 patients with PD, Dementia with Lewy Bodies/Dementia associated with PD, or MSA undergoing nocturnal video-polysomnography for presumed dream enactment behavior, we were able to select 2 PD and 2 MSA patients featuring NREM Parasomnia Behviors (NPBs). We identified episodes during which the subjects seemed to enact dreams or presumed dream-like mentation (NPB arousals) versus episodes with physiological movements (no-NPB arousals).

An Evidence-based Analysis of the Association between Periodic Leg Movements during Sleep and Arousals in Restless Legs Syndrome.

Study Objectives: To analyze statistically the association between periodic leg movements during sleep (PLMS) and arousals, in order to eventually support or challenge the current scoring rules and to further understand their reciprocal influence.

Setting: Sleep research center.

Patients: Twenty untreated consecutive patients with restless legs syndrome (RLS) (13 women and 7 males, mean age 60.

An evidence-based recommendation for a new definition of respiratory-related leg movements.

Study Objectives: Current sleep scoring rules exclude leg movements that occur near respiratory events from being scored as periodic leg movements during sleep (PLMS) but differ in whether they exclude leg movements occurring at the end (WASM/ IRLSSG) or during a respiratory event (AASM). The aim of the present study was to describe the distribution of leg movements in relation to respiratory events and to contribute to an evidence-based rule for the identification and scoring of respiratory-related leg movements (RRLMs).

Design: Retrospective chart review and analysis of polysomnographic recordings.

Increased electroencephalographic high frequencies during the sleep onset period in patients with restless legs syndrome.

Study Objectives: To analyze the electroencephalographic (EEG) spectral content in untreated patients with restless legs syndrome (RLS) during the sleep onset period (SOP) and during the quiet wakefulness preceding sleep, in order to test the hypothesis that a state of hyperarousal might be present during the SOP with RLS.

Setting: Sleep Research Centre.

Patients: Twenty-seven untreated consecutive patients with RLS (mean age = 53.

Respiratory-related leg movements and their relationship with periodic leg movements during sleep.

Study Objectives: To describe the time structure of leg movements (LM) in obstructive sleep apnea (OSA) syndrome, in order to advance understanding of their clinical significance.

Location: Sleep Research Centre, Oasi Institute (IRCCS), Troina, Italy.

Setting: Sleep laboratory.

Longitudinal polysomnographic assessment from acute to subacute phase in infratentorial versus supratentorial stroke.

Background: Regulation of sleep and sleep-related breathing resides in different brain structures. Vascular lesions can be expected to differ in their consequences on sleep depending on stroke topography. However, studies addressing the differences in sleep and sleep-related breathing depending on stroke topography are scarce.

High-density electroencephalography as an innovative tool to explore sleep physiology and sleep related disorders.

High density EEG represents a promising tool to achieve new insights regarding sleep physiology and pathology. It combines the advantages of an EEG technique as an optimal temporal resolution with the spatial resolution of the neuroimaging. So far its application in sleep research contributed to better characterize some of the peculiar microstructural figures of sleep such as spindles and K-complexes, and to understand the fundamental relationships between sleep and synaptic plasticity, learning and consciousness.

Pediatric insomnia: clinical, diagnosis, and treatment.

Pediatric insomnia is an extrinsic sleep disorder subdivided into two categories: behavioral insomnia and insomnia related to medical, neurological, and psychiatric diseases. This review will cover several types of insomnia, comorbidities and specific pediatric therapies according to clinical characteristics and age. Behavioral insomnia should be differentiated from pediatric insomnia due to medical conditions, mostly occurring during the first year of life.