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Periodic limb movements in tetraplegia

Peters, AEJ, van Silfhout, L, Graco, M, Schembri, R, Thijssen, DHJ and Berlowitz, DJ (2017) Periodic limb movements in tetraplegia. JOURNAL OF SPINAL CORD MEDICINE, 41 (3). pp. 318-325. ISSN 1079-0268

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Objective: To establish the prevalence of Periodic Limb Movements during Sleep (PLMS) in patients with tetraplegia, controlling for obstructive sleep apnea. To explore whether demographic and injury characteristics affect PLMS.

Study Design: Retrospective cohorts.

Setting and Participants: One hundred seventy-three participants with acute (<12 months) and 92 with chronic (>12 months) tetraplegia who underwent full overnight diagnostic sleep studies.

Interventions and outcome measures: Two hundred sixty-two sleep study recordings were included. A randomly selected subgroup of 21 studies was assessed for PLM during wakefulness. Data were analysed according to the current American Academy of Sleep Medicine guidelines.

Results: Of the participants, 41.6% (43(15.7) years and 14.9% female) had a motor and sensory complete lesion. Sleep was poor with both OSA (87.8% with apnea hypopnoea index ≥ 5) and PLMS (58.4% with PLMS per hour PLMSI > 15) highly prevalent. There was no difference in the PLMSI between those with OSA (36.3(39.8)) or without (42.2(37.7), P = 0.42). PLMS were evident during REM and NREM sleep in all of the 153 patients with PLMSI > 15. All 21 participants in the subgroup of studies analysed for the PLM during quiet wakefulness, exhibited limb movements. None of the modelled variables (injury completeness, gender, OSA severity or time since injury) significantly predicted a PLMSI > 15 (P = 0.343).

Conclusion: In conclusion, this study confirms the high prevalence of PLM in tetraplegia and the presence of leg movements in NREM and REM sleep along with wakefulness after controlling for OSA. No associations between the presence of PLMS and patient characteristics or injury specific aspects were found.

Item Type: Article
Additional Information: This is an Accepted Manuscript of an article published by Taylor & Francis Group in Journal of Spinal Cord Medicine on 2 May 2017, available online: https://doi.org/10.1080/10790268.2017.1320874
Uncontrolled Keywords: Science & Technology; Life Sciences & Biomedicine; Clinical Neurology; Neurosciences & Neurology; Sleep; Periodic limb movements of sleep; Cervical spinal cord injury; Obstructive sleep apnea; Tetraplegia; RESTLESS LEGS SYNDROME; SPINAL-CORD-INJURY; SLEEP DISTURBANCES; 1ST YEAR; POPULATION; SYMPTOMS; DISORDER; PEOPLE; APNEA
Subjects: Q Science > QP Physiology
R Medicine > RC Internal medicine > RC1200 Sports Medicine
Divisions: Sport & Exercise Sciences
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Date Deposited: 25 Jul 2019 08:10
Last Modified: 04 Sep 2021 09:06
DOI or ID number: 10.1080/10790268.2017.1320874
URI: https://researchonline.ljmu.ac.uk/id/eprint/11112
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