Higher Prevalence of Periodic Limb Movements of Sleep in Patients with History of Stroke

Coelho, Fernando Morgadinho Santos; Georgsson, Hlynur; Narayansingh, Marc; Swartz, Richard H.; Murray, Brian J.

doi:10.5664/jcsm.27930

Cited by 38 publications

(20 citation statements)

References 13 publications

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“…Although PLMS occur in approximately 80% of RLS sufferers, it occurs in several other conditions and often in the elderly without RLS symptoms. 5,11,[33][34][35] A single measurement of PLMS at baseline does not account for night-to-night variability and changes in PLMS over time.…”

Section: Discussionmentioning

confidence: 99%

“…[4][5][6][7][8] The importance of PLMS has been highlighted by recent investigations supporting a relationship between PLMS, cardiovascular disease, and autonomic activation. [9][10][11] Because of the high prevalence of PLMS in the elderly, it has been argued that PLMS may not be a risk factor for disease, but rather a marker of aging or other health attributes.…”

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confidence: 99%

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Periodic Leg Movements Are Associated with Reduced Sleep Quality in Older Men: The MrOS Sleep Study

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et al. 2013

Journal of Clinical Sleep Medicine

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Periodic Leg Movements Are Associated with Reduced Sleep Quality in Older Men: The MrOS Sleep Study

Claman

Ewing

Redline

et al. 2013

Journal of Clinical Sleep Medicine

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“…With regard to chronicity (time since stroke), 7 [ 21 , 23 , 26 – 30 ] out of the 15 studies examined sleep in the first 16 days post stroke. In one study, chronicity was not reported [ 22 ]. The remaining studies covered a diverse range of chronicity often within the same study, with one study collating the data acquired between 8 days and 1 year [ 25 ] post stroke; one for 8 to 35 days [ 31 ] one for 2 days to 3 weeks [ 32 ]; one for 3 months to 1 year [ 33 ]; and 3 for chronicities greater than 1 month [ 24 , 34 , 35 ].…”

Section: Resultsmentioning

confidence: 99%

“…The remaining studies covered a diverse range of chronicity often within the same study, with one study collating the data acquired between 8 days and 1 year [ 25 ] post stroke; one for 8 to 35 days [ 31 ] one for 2 days to 3 weeks [ 32 ]; one for 3 months to 1 year [ 33 ]; and 3 for chronicities greater than 1 month [ 24 , 34 , 35 ]. We further noted that only 4 studies [ 22 , 23 , 27 , 31 ] specified the medication status of patients and controls, while 9 [ 21 , 24 , 25 , 28 – 30 , 33 – 35 ] did not report this type of information at all. Another 2 [ 26 , 32 ] were conducted in participants free of medication for the study period.…”

Section: Resultsmentioning

confidence: 99%

Polysomnographic Characteristics of Sleep in Stroke: A Systematic Review and Meta-Analysis

et al. 2016

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BackgroundResearch on sleep after stroke has focused mainly on sleep disordered breathing. However, the extend to which sleep physiology is altered in stroke survivors, how these alterations compare to healthy volunteers, and how sleep changes might affect recovery as well as physical and mental health has yet to be fully researched. Motivated by the view that a deeper understanding of sleep in stroke is needed to account for its role in health and well-being as well as its relevance for recovery and rehabilitation, we conducted a systematic review and meta-analysis of polysomnographic studies comparing stroke to control populations.MethodMedline and PsycInfo databases were searched using "stroke" and words capturing polysomnographic parameters as search terms. This yielded 1692 abstracts for screening, with 15 meeting the criteria for systematic review and 9 for meta-analysis. Prisma best practice guidelines were followed for the systematic review; the Comprehensive Meta-Analysis software was used for random effects modelling.ResultsThe meta-analysis revealed that patients with stroke have poorer sleep than controls. Patients had lower sleep efficiency (mean 75% vs 84%), shorter total-sleep-time (309.4 vs 340.3 min) and more wake-after-sleep-onset (97.2 vs 53.8 min). Patients also spend more time in stage 1 (13% vs 10%) and less time in stage 2 sleep (36% vs 45%) and slow-wave-sleep (10% vs 12%). No group differences were identified for REM sleep. The systematic review revealed a strong bias towards studies in the early recovery phase of stroke, with no study reporting specifically on patients in the chronic state. Moreover, participants in the control groups included community samples as well as other patients groups.ConclusionsThese results indicate poorer sleep in patients with stroke than controls. While strongly suggestive in nature, the evidence base is limited and methodologically diverse, and hands a clear mandate for further research. A particular need regards polysomnographic studies in chronic community-dwelling patients compared to age-matched individuals.

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“…Periodic limb movements (PLM) during sleep (PLMS) involve spontaneous and repetitive flexion of the ankle, knee, and hip during sleep, and are present in 90% of patients with restless legs syndrome (RLS). 1 Increased risks of cardiovascular disease 2 and stroke 3 have been reported in patients with RLS, with sympathetic hyperactivity widely suggested as the underlying mechanism. 4 Indeed, PLMS have been associated with increased heart rate 5 and blood pressure 6 during sleep, and are frequently present in patients with daytime hypertension.…”

Section: Introductionmentioning

confidence: 99%

Spontaneous Low-Frequency Cerebral Hemodynamics Oscillations in Restless Legs Syndrome with Periodic Limb Movements During Sleep: A Near-Infrared Spectroscopy Study

et al. 2016

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Background and PurposePeriodic limb movements (PLM) during sleep (PLMS) are associated with cortical and cardiovascular activation. Changes in cerebral hemodynamics caused by cortical activity can be measured using near-infrared spectroscopy (NIRS). We investigated oscillatory components of cerebral hemodynamics during PLM and different sleep stages in restless legs syndrome (RLS) patients with PLMS.MethodsFour female RLS patients with PLMS, and four age- and sex-matched normal controls were included. PLM and sleep stages were scored using polysomnography, while the spontaneous cerebral hemodynamics was measured by NIRS. The phase and amplitude of the cerebral oxyhemoglobin concentration [HbO] and the deoxyhemoglobin concentration [Hb] low-frequency oscillations (LFOs) were evaluated during each sleep stage [waking, light sleep (LS; stages N1 and N2), slow-wave sleep (stage N3), and rapid eye movement (REM) sleep]. In RLS patients with PLMS, the cerebral hemodynamics during LS was divided into LS with and without PLM.ResultsThe cerebral hemodynamics activity varied among the different sleep stages. There were changes in phase differences between [HbO] and [Hb] LFOs during the different sleep stages in the normal controls but not in the RLS patients with PLMS. The [HbO] and [Hb] LFO amplitudes were higher in the patient group than in controls during both LS with PLM and REM sleep.ConclusionsThe present study has demonstrated the presence of cerebral hemodynamics disturbances in RLS patients with PLMS, which may contribute to an increased risk of cerebrovascular events.

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Higher Prevalence of Periodic Limb Movements of Sleep in Patients with History of Stroke

Cited by 38 publications

References 13 publications

Periodic Leg Movements Are Associated with Reduced Sleep Quality in Older Men: The MrOS Sleep Study

Periodic Leg Movements Are Associated with Reduced Sleep Quality in Older Men: The MrOS Sleep Study

Polysomnographic Characteristics of Sleep in Stroke: A Systematic Review and Meta-Analysis

Spontaneous Low-Frequency Cerebral Hemodynamics Oscillations in Restless Legs Syndrome with Periodic Limb Movements During Sleep: A Near-Infrared Spectroscopy Study

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