Association between Self-Perceived Periodic Limb Movement during Sleep and Excessive Daytime Sleepiness Depend on Restless Leg Symptoms in Korean Adolescents.

Although periodic limb movement during sleep (PLMS) and restless legs syndrome (RLS) are common in children and adolescents, they are relatively overlooked as a target of treatment. PLMS has been evaluated as having a lower clinical significance than RLS. This study examined the relationship of socio-behavioral factors of PLMS in Korean adolescents and checked whether PLMS is associated with excessive daytime sleepiness (EDS), depending on whether restless legs symptoms accompany it. In a cross-sectional study, 25,789 adolescents between 12 and 18 years of age (15.76 ± 1.73 years; female 51.49%) were evaluated using an online survey. Various self-report questionnaires were used to assess PLMS and RLS symptoms, EDS, sleep habits, and various socio-behavioral factors. The prevalence of self-perceived PLMS and restless legs symptoms were 903 (3.50%) and 1311 (5.08%), respectively. Of the 1311 participants, 399 had self-perceived PLMS. The odds ratios (ORs) for self-perceived PLMS in participants with restless legs symptoms were: males (OR = 1.528; 95% CI: 1.145-2.040), usually/always experienced apnea apnea (OR, 3.006; 95% CI, 1.954-4.624), increased proneness to Internet addiction (OR = 1.013; 95% CI: 1.001-1.025), sometimes/often consuming coffee (OR = 1.312; 95% CI: 1.015-1.695), EDS (OR = 0.826; 95% CI: 0.488-1.398), and perceived insufficient sleep (OR = 1.143; 95% CI: 0.835-1.565). The male gender, witness apnea, consuming coffee, and being prone to Internet addiction were identified as factors significantly associated with self-perceived PLMS in participants with restless legs symptoms. However, EDS and insufficient sleep were associated with self-perceived PLMS in the absence of restless legs symptoms.

[Restless legs syndrome and periodic limb movements during sleep in a patient with obstructive sleep apnea]. / Zespól niespokojnych nóg i okresowe ruchy konczyn w czasie snu u chorego na obturacyjny bezdech senny.

A case of moderate obstructive sleep apnea in which effective treatment with continuous positive airway pressure did not reduce excessive daytime sleepiness was described. Polysomnography with tibial muscles activity recording revealed frequent periodic limb movements in sleep (PLMS) with sleep fragmentation. PLMS index was 13.6/h of sleep. Clonazepam combined with iron and magnesium supplementation reduced limb movements, excessive daytime sleepiness and improved the patient's mood. Causes of PLMS and treatment options are discussed. PLMS and restless legs syndrome (RLS) should be considered in the differential diagnosis of excessive daytime sleepiness.