Periodic limb movements during sleep are associated with cardiovascular diseases: A systematic review and meta‐analysis

Huang, Tien‐Chi; Tseng, Ping‐Tao; Wu, Meng‐Ni; Stubbs, Brendon; Carvalho, André F.; Lin, Pao‐Yen; Chen, Yen‐Wen; Chen, Tien‐Yu; Hsu, Chung‐Yao

doi:10.1111/jsr.12720

Cited by 25 publications

(12 citation statements)

References 34 publications

(77 reference statements)

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“…When RLS symptom duration was analyzed in a prospective study of 70,977 women free from coronary heart disease at baseline and followed for 6 years, patients with symptoms lasting for at least 3 years showed an increased risk of coronary heart disease (multivariable‐adjusted HR,1.80; 95% CI, 1.07–3.01) 93 . Lastly, a systematic review and meta‐analysis including cross‐sectional and prospective studies on PLMS found a significantly elevated prevalence of coronary artery disease (odds ratio, 1.56; 95% CI, 1.2–2.1) and cardiovascular disease in the study population (odds ratio, 1.27; 95% CI, 1.1–1.5) 94 …”

Section: Resultsmentioning

confidence: 95%

“…93 Lastly, a systematic review and meta-analysis including cross-sectional and prospective studies on PLMS found a significantly elevated prevalence of coronary artery disease (odds ratio, 1.56; 95% CI, 1.2-2.1) and cardiovascular disease in the study population (odds ratio, 1.27; 95% CI, 1.1-1.5). 94 RLS may favor cardiovascular disease through autonomic changes, modifying cardiovagal control, specific to arterial baroreflex, leading to greater peripheral vascular resistance and sympathetic overactivity [95][96][97] and ultimately increasing cardiovascular disease prevalence. 95 A recent cross-sectional study of a large population-based cohort of health outcomes in the Canadian general population aged 45 to 85 years found that the mean carotid intima-media thickness, an objective measure of atherosclerosis, was higher in the group of patients with probable RLS (0.755 ± 0.17; n = 2047) in comparison with a control group (0.736 ± 0.17; n = 24257) with an adjusted mean difference of 0.016 (95% CI, 0.008-0.024).…”

Section: Restless Legs Syndrome and Periodic Leg Movements Of Sleep (Rls-plms)mentioning

confidence: 99%

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Cardiac Involvement in Movement Disorders

Rossi

Wainsztein

Merello

2021

Movement Disord Clin Pract

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BackgroundBackground: Several conditions represented mainly by movement disorders are associated with cardiac disease, which can be overlooked in clinical practice in the context of a prominent primary neurological disorder. Objectives Objectives: To review neurological conditions that combine movement disorders and primary cardiac involvement. Methods Methods: A comprehensive and structured literature search following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria was conducted to identify disorders combining movement disorders and cardiac disease. ResultsResults: Some movement disorders are commonly or prominently associated with cardiac disease. Neurological and cardiac symptoms may share underlying physiopathological mechanisms in diseases, such as Friedreichʼs ataxia and Wilsonʼs disease, and in certain metabolic disorders, including Refsum disease, Gaucher disease, a congenital disorder of glycosylation, or cerebrotendinous xanthomatosis. In certain conditions, such as Sydenhamʼs chorea or dilated cardiomyopathy with ataxia syndrome (ATX-DNAJC19), heart involvement can present early in the course of disease, whereas in others such as Friedreichʼs ataxia or Refsum disease, cardiac symptoms tend to present in later stages. In another 68 acquired or inherited conditions, cardiac involvement or movement disorders are seldom reported. Conclusions Conclusions: As cardiac disease is part of the phenotypic spectrum of several movement disorders, heart involvement should be carefully investigated and increased awareness of this association encouraged as it may represent a leading cause of morbidity and mortality.Cardiac abnormalities may be a significant source of morbidity and premature mortality [1][2][3][4] and can occur in numerous neurological diseases, manifesting as cardiomyopathy, arrhythmias, conduction defects, structural malformations, coronary disease, valvulopathies, or cardiac autonomic dysfunction. In neurological conditions mainly manifested by movement disorders, cardiac disease can be a frequent and predominant clinical feature, or only be reported in isolated cases, and can be of early presentation, or occur only during later stages of disease. 5,6 In diseases such as Friedreichʼs ataxia (FRDA), where the need for heart monitoring is well established, a cross-sectional healthcare resource study revealed that recommended annual cardiac evaluations had not been conducted in up to 23% of patients with FRDA in the United States and 14% in Canada. 7 These figures may be even higher in other parts of the world.In this educational review, we describe and list movement disorders with cardiac involvement as part of the clinical picture. MethodsA comprehensive and structured search in PubMed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (http://www.prismastatement.org) was conducted.

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Section: Resultsmentioning

confidence: 95%

Section: Restless Legs Syndrome and Periodic Leg Movements Of Sleep (Rls-plms)mentioning

confidence: 99%

Cardiac Involvement in Movement Disorders

Rossi

Wainsztein

Merello

2021

Movement Disord Clin Pract

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“…It has long been known that periodic leg movements during sleep (PLMS) are accompanied by transient increases in heart rate (HR; Ferri et al., 2007; Winkelman, 1999) and blood pressure (Pennestri et al., 2007; Siddiqui et al., 2007). In recent years, an increasing number of reports have been published on cardiovascular correlates of PLMS (Huang et al., 2019). These correlates support the hypothesis that PLMS have long‐term consequences on health.…”

Section: Introductionmentioning

confidence: 99%

Heart rate changes associated with the different types of leg movements during sleep in children, adolescents and adults with restless legs syndrome

Ferri

Silvani

Mogavero

et al. 2021

Journal of Sleep Research

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The objective of this study was to describe in detail the heart rate changes accompanying short-interval leg movements during sleep, periodic leg movements during sleep, and isolated leg movements during sleep in children and adolescents with restless legs syndrome, and to compare them with the same findings in adults with restless legs syndrome. We analysed time series of R-R intervals synchronized to the onset of short-interval leg movements during sleep, periodic leg movements during sleep or isolated leg movements during sleep that entailed an arousal during nonrapid-eye-movement sleep. We assessed cardiac activation based on the heart rate changes with respect to baseline during non-rapid-eye-movement sleep without leg movements. All types of leg movements recorded during sleep were accompanied by important heart rate changes also in children, with an overall impact similar to that observed in adults. In all age groups, heart rate changes accompanying short-interval leg movements during sleep were constituted by a tachycardia, without a subsequent relative bradycardia, that was instead evident for periodic leg movements during sleep and isolated leg movements during sleep. Moreover, an age-related decline of the relative bradycardia following the heart rate increase, in association with periodic leg movements during sleep and isolated leg movements during sleep, was observed.Our findings show that important heart rate changes accompany all leg movements during sleep at all ages in restless legs syndrome, with significant age-related differences. This information represents an important contribution to the ongoing scientific debate on the possibility and opportunity to treat periodic leg movements during sleep. K E Y W O R D S adults, children, heart rate variability, periodic leg movements, restless legs syndrome, sleep leg movements How to cite this article: Ferri R, Silvani A, Mogavero MP, et al. Heart rate changes associated with the different types of leg movements during sleep in children, adolescents and adults with restless legs syndrome.

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“…www.nature.com/scientificreports www.nature.com/scientificreports/ there were significantly higher co-morbidity rates of coronary artery disease and cardiovascular diseases (CVD), but not acute myocardial infarction, in subjects with PLMS 22 . Meanwhile, these PLMS-related complications and/ or sequelae might also contribute to tinnitus formation 2,3,5-7 .…”

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confidence: 99%

Association of periodic limb movements during sleep and tinnitus in humans

Hwang

Chu

Hwang

et al. 2020

Sci Rep

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Both of periodic limb movements during sleep (pLMS) and tinnitus were related with dopaminergic system dysfunction. However, it was still unclear whether PLMS, one kind of sleep disturbances, was associated with chronic tinnitus or not. Thus, we aimed to investigate this issue in humans. Clinical and overnight polysomnographic data of 2849 adults from a community hospital during Nov. 2011 to Jun 2017 in Taiwan was collected retrospectively. The association of PLMS and chronic tinnitus was analyzed by Student's t-test, Pearson's Chi-Square test, and multivariate logistic regression. The results showed that the mean age was 50.6 years old (standard deviation, SD = 13.3, range = 18~91) for all subjects. There were 1886 subjects without tinnitus and 963 subjects with tinnitus in this study. The PLMS was not significantly different between subjects without tinnitus (mean = 1.0/h, SD = 3.5/h) and subjects with tinnitus mean = 1.1/h, SD = 3 .4/h) by Student's t-test. The severity of PLMS was not significantly between non-tinnitus and tinnitus subjects by Pearson's Chi-Square test. Multivariate logistic regression also showed that PLMS was not significantly associated with tinnitus after adjusting age, sex, subjective hearing loss, Parkinson's disease, and insomnia. In conclusion, PLMS was not associated with chronic tinnitus in humans.Tinnitus is a phantom auditory perception. There were many types of tinnitus, for example auditory tinnitus, somatic tinnitus, vascular origin tinnitus, muscular origin tinnitus, etc. And, the prevalence of tinnitus depends on the type and/or definition for it. A nationwide survey of South Korea reported that the prevalence of any tinnitus was 20.7% among adults aged 20 to 98 years 1 . The prevalence of all types of tinnitus was higher in women than in men, and it increased with age 1 . The contributing factors and/or etiologies of tinnitus were numerous, including hearing impairment, cardiometabolic disorders, sleep disturbances and sleep apnea, migraine, and non-migraine headache, etc. 2-4 . And, tinnitus often comorbided with other diseases, such as anxiety, depression, brain tumors or stroke, and some symptoms including irritability, inability to concentration, and sleep disturbances [5][6][7] .Dysfunction in the cochlea, and neural reorganization in the auditory and non-auditory cortices have been reported to be associated with auditory tinnitus 8 . In addition to neuroinflammation and/or oxidative stress damages 9-13 , increased expression of N-methyl D-aspartate (NMDA) receptor (NR) gene 14 , decreasedγ-amino butyric acid (GABA) receptor (GR) and cannabinoid receptor genes were found in the cochlea and some brain areas 9,15 . Increased expresssion of K + -Cl − cotransporter (KCC2) gene was also found in salicylate-induced tinnitus 16 . Besides, dysfunction of dopaminergic system was reported to be related with tinnitus formation 17,18 . On the other hand, the pathophysiology of periodic limb movements during sleep (PLMS) was reported to be related with dysfunction of dopaminergic sy...

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Periodic limb movements during sleep are associated with cardiovascular diseases: A systematic review and meta‐analysis

Cited by 25 publications

References 34 publications

Cardiac Involvement in Movement Disorders

Cardiac Involvement in Movement Disorders

Heart rate changes associated with the different types of leg movements during sleep in children, adolescents and adults with restless legs syndrome

Association of periodic limb movements during sleep and tinnitus in humans

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