| Positional obstructive sleep apnea and periodic limb movement during sleep: A large multi-center study |
Jae Hyun Soh1
, Yun Jin Kang2
, Won-Hyuck Yoon3
, Chan-Soon Park4
, Hyun-Woo Shin3,5,6,7,8,9
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1Seoul National University College of Medicine, Seoul, Korea
2Department of Otorhinolaryngology-Head and Neck Surgery, Soonchunhyang University College of Medicine, Cheonan, Korea
3OUaR LaB, Inc., Seoul, Korea
4Department of Otorhinolaryngology-Head and Neck Surgery, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
5Department of Pharmacology, Seoul National University College of Medicine, Seoul, Korea
6Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Korea
7Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
8Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul, Korea
9Sensory Organ Research Institute, Seoul National University College of Medicine, Seoul, Korea |
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Received: January 30, 2024; Revised: April 4, 2024 Accepted: April 29, 2024. Published online: May 2, 2024.
*Jae Hyun Soh and Yun Jin Kang contributed equally to this work. |
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| ABSTRACT |
Objectives
The relationships among positional obstructive sleep apnea (POSA), obstructive sleep apnea (OSA), and periodic limb movement during sleep (PLMS) are unclear. We analyzed these relationships according to OSA severity and explored the underlying mechanisms.
Methods
We retrospectively reviewed 6,140 eligible participants who underwent full-night diagnostic polysomnography in four clinical centers over a period of 5 years with eventsynchronized analysis. The PLMS index (PLMI) and periodic limb movements with arousal index (PLMAI) were evaluated. The effects of POSA on the PLMI, PLMAI, and PLMS were analyzed according to OSA severity.
Results
The mean PLMI and PLMAI, as well as PLMS prevalence, were significantly lower in those with severe OSA than in those with mild and moderate OSA. The mean PLMI was higher in mild OSA group than in control group. The mean PLMI (4.80 ± 12.71 vs. 2.59 ± 9.82 events/h, p < 0.001) and PLMAI (0.89 ± 3.66 vs. 0.53 ± 3.33 events/h, p < 0.001), and the prevalence of PLMS (11% vs. 5.3%, p < 0.001) were higher in patients with POSA than patients with non-POSA. This trend was particularly marked in severe OSA group (OR 1.55, 95%CI [1.07–2.27]) and less so in mild (OR 0.56, 95%CI [0.30–1.03]) and moderate (OR 1.82, 95%CI [0.99–3.34]) OSA groups.
Conclusion
The POSA group tended to have a higher prevalence of PLMS, particularly in those with severe OSA. If PLMS is prominent, diagnosis and treatment of POSA and OSA may be considered. |
| Keywords:
Sleep apnea, Obstructive; Sleep Apnea Syndromes; Periodic Limb Movement Disorder; Sleep-Related Periodic Leg Movements, Excessive; Supine Position |
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