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. 2007 Dec;30(12):1779-85.
doi: 10.1093/sleep/30.12.1779.

Time structure analysis of leg movements during sleep in REM sleep behavior disorder

Mauro Manconi  1 , Raffaele Ferri, Marco Zucconi, Maria Livia Fantini, Giuseppe Plazzi, Luigi Ferini-Strambi
Affiliations

Time structure analysis of leg movements during sleep in REM sleep behavior disorder

Mauro Manconi et al. Sleep. 2007 Dec.

Abstract

Study objectives: To compare the time structure of leg movements (LM) during sleep of patients with rapid eye movement (REM) sleep behavior disorder (RBD) with that of patients with restless legs syndrome (RLS) or control subjects.

Design: The polysomnographically recorded tibialis anterior activity during sleep was analyzed by means of a new approach able to consider duration, intermovement interval, sleep stage and time of night distribution, and periodicity.

Patients and participants: Twenty patients with idiopathic RBD, 37 with idiopathic RLS and 14 age-matched control subjects were consecutively recruited.

Measurements and results: Most patients with RBD (85%) presented periodic leg movements during sleep (PLMS). PLMS occurred more frequently during non-REM sleep in patients with RLS and during REM sleep in patients with RBD. PLMS were shorter in duration, less often bilateral, and with a higher intermovement interval in patients with RBD compared to those with RLS. The number of PLMS decreased across the night in patients with RBD and in those with RLS, but not in control subjects. In all subjects, LM periodicity clearly depended on sleep state, with higher values during non-REM than during REM sleep. Patients with RBD showed a lower LM periodicity, compared with patients with RLS, in each of the sleep states.

Conclusions: Significant differences, together with some similarities in LM time structure, were observed between patients with RBD and those with RLS; for this reason, our approach seems to indicate that their phenotype might be dependent on 2 factors: disease and sleep stage.

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Figures

Figure 1
Figure 1
Comparison between the distribution of inter-leg-movement intervals in controls, patients with rapid eye movement (REM) sleep behavior disorder (RBD) and patients with restless legs syndrome (RLS); values are shown as mean and standard error (whiskers).
Figure 2
Figure 2
Comparison between the distribution of number of periodic limb movements per hour of sleep (PLMS; first 8 hours shown) in normal control subjects and patients with rapid eye movement (REM) sleep behavior disorder (RBD) or restless legs syndrome (RLS). The results of the statistical analysis of the differences between RBD and RLS or controls is shown at the top of each histogram bar (P values; NS = not significant). All values are shown as mean and standard error (whiskers). NREM refers to non-rapid eye movement sleep.
Figure 3
Figure 3
Periodicity index in controls, patients with rapid eye movement (REM) sleep behavior disorder (RBD), and patients with restless legs syndrome (RLS); values are shown as mean (black-filled squares) and 95% confidence intervals (whiskers). Individual values are also shown (circles). NREM refers to non-rapid eye movement sleep.
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