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. 2024 Apr;33(2):e14012.
doi: 10.1111/jsr.14012. Epub 2023 Aug 19.

The relationship between periodic limb movement during sleep and dyslipidaemia in patients with obstructive sleep apnea

Andras Bikov  1   2 , Sebastien Bailly  3 , Dries Testelmans  4   5 , Francesco Fanfulla  6 , Athanasia Pataka  7 , Izolde Bouloukaki  8 , Holger Hein  9 , Zoran Dogas  10 , Ozen K Basoglu  11 , Richard Staats  12   13 , Gianfranco Parati  14   15 , Carolina Lombardi  14   15 , Ludger Grote  16   17 , Stefan Mihaicuta  18 ; ESADA study group
Collaborators, Affiliations
Free article

The relationship between periodic limb movement during sleep and dyslipidaemia in patients with obstructive sleep apnea

Andras Bikov et al. J Sleep Res. 2024 Apr.
Free article

Abstract

Periodic limb movements during sleep and obstructive sleep apnea are both associated with increased sympathetic tone, and have been proposed as risk factors for heart diseases and, in particular, cardiovascular disease. As sympathetic system activation may lead to dyslipidaemia, periodic limb movements during sleep could be an additional risk factor for cardiovascular disease in patients with obstructive sleep apnea. The aim of the study was to determine whether the presence of periodic limb movements during sleep affects serum lipid levels in obstructive sleep apnea. Total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, non- high-density lipoprotein cholesterol and triglyceride levels were investigated in 4138 patients with obstructive sleep apnea in the European Sleep Apnea Database (ESADA) cohort, divided into those with periodic limb movements during sleep index ≥ 15 per hr (n = 628) and controls (n = 3510). ANCOVA adjusted for age, sex, body mass index, apnea-hypopnea index, alcohol intake, smoking status, diabetes, insomnia and study site was used to assess differences in lipids between periodic limb movements during sleep and controls. Patients with periodic limb movements during sleep (24% female, 54.4 ± 12.1 years, body mass index 31.9 ± 5.8 kg m-2 , apnea-hypopnea index 36.7 ± 25.4 per hr) had higher triglyceride (1.81 ± 1.04 versus 1.69 ± 0.90 mmol L-1 , p = 0.002) and lower high-density lipoprotein cholesterol (1.19 ± 0.34 versus 1.24 ± 0.37 mmol L-1 , p = 0.002) levels, whilst there was no difference in either total cholesterol (4.98 ± 1.10 versus 4.94 ± 1.07 mmol L-1 ), low-density lipoprotein cholesterol (3.04 ± 0.96 versus 2.98 ± 0.98 mmol L-1 ) or non- high-density lipoprotein cholesterol (3.78 ± 1.10 versus 3.70 ± 1.05 mmol L-1 ) concentrations (all p > 0.05). The results remained unchanged after most sensitivity analyses. Patients with obstructive sleep apnea with periodic limb movements during sleep had more prevalent cardiovascular disease (11% versus 6%, p < 0.01). Periodic limb movements during sleep in obstructive sleep apnea is associated with dyslipidaemia independently of important confounders. Our results highlight periodic limb movements during sleep as an additional risk factor for cardiovascular disease in obstructive sleep apnea.

Keywords: apnea; cardiovascular disease; lipids; sleep.

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References

REFERENCES

    1. Al-Alawi, A., Mulgrew, A., Tench, E., & Ryan, C. F. (2006). Prevalence, risk factors and impact on daytime sleepiness and hypertension of periodic leg movements with arousals in patients with obstructive sleep apnea. Journal of Clinical Sleep Medicine, 2(3), 281-287.
    1. Bauer, A., Cassel, W., Benes, H., Kesper, K., Rye, D., Sica, D., Winkelman, J. W., Bauer, L., Grieger, F., Joeres, L., Moran, K., Schollmayer, E., Whitesides, J., Carney, H. C., Walters, A. S., Oertel, W., & Trenkwalder, C. (2016). Rotigotine's effect on PLM-associated blood pressure elevations in restless legs syndrome: An RCT. Neurology, 86(19), 1785-1793. https://doi.org/10.1212/wnl.0000000000002649
    1. Bikov, A., Meszaros, M., & Schwarz, E. I. (2021). Coagulation and fibrinolysis in obstructive sleep Apnoea. International Journal of Molecular Sciences, 22(6), 2834. https://doi.org/10.3390/ijms22062834
    1. Budhiraja, R., Javaheri, S., Pavlova, M. K., Epstein, L. J., Omobomi, O., & Quan, S. F. (2020). Prevalence and correlates of periodic limb movements in OSA and the effect of CPAP therapy. Neurology, 94(17), e1820-e1827. https://doi.org/10.1212/wnl.0000000000008844
    1. Chervin, R. D. (2001). Periodic leg movements and sleepiness in patients evaluated for sleep-disordered breathing. American Journal of Respiratory and Critical Care Medicine, 164(8 Pt 1), 1454-1458. https://doi.org/10.1164/ajrccm.164.8.2011062

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