Leg movement activity during sleep in multiple sclerosis with and without restless legs syndrome

Raffaele Ferri; Davide Sparasci; Anna Castelnovo; Silvia Miano; Kosuke Tanioka; Naoko Tachibana; Chiara Carelli; Gianna Carla Riccitelli; Giulio Disanto; Chiara Zecca; Claudio Gobbi; Mauro Manconi

doi:10.5664/jcsm.9466

Leg movement activity during sleep in multiple sclerosis with and without restless legs syndrome

J Clin Sleep Med. 2022 Jan 1;18(1):11-20. doi: 10.5664/jcsm.9466.

Authors

Raffaele Ferri¹, Davide Sparasci², Anna Castelnovo^{2

3}, Silvia Miano², Kosuke Tanioka⁴, Naoko Tachibana⁵, Chiara Carelli², Gianna Carla Riccitelli^{6

7}, Giulio Disanto⁶, Chiara Zecca^{3

6}, Claudio Gobbi^{3

6}, Mauro Manconi^{2

3}

Affiliations

¹ Sleep Research Centre; Department of Neurology I.C., Oasi Institute for Research on Mental Retardation and Brain Aging (IRCCS), Troina, Italy.
² Sleep Medicine Unit, Neurocenter of Southern Switzerland, Ospedale Civico, Lugano, Switzerland.
³ Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland.
⁴ Department of Somnology, Tokyo Medical University, Tokyo, Japan.
⁵ Division of Sleep Medicine, Kansai Electric Power Medical Research Institute, Osaka, Japan.
⁶ Multiple Sclerosis Center, Neurocenter of Southern Switzerland, Ospedale Civico, Lugano, Switzerland.
⁷ Neuropsychology and Behavioural Neurology Research Unit, Neurocenter of Southern Switzerland, Ospedale Civico, Lugano, Switzerland.

Abstract

Study objectives: To carry out an analysis of leg movement activity during sleep in a polysomnography dataset of patients with multiple sclerosis (MS) in comparison to idiopathic restless legs syndrome (iRLS) and healthy controls.

Methods: In this cross-sectional, observational, instrumental study, 57 patients (males/females: 11/46; mean age 46.2 ± 10.2 years) with a diagnosis of MS underwent a telephone interview assessing the 5 standard diagnostic criteria for RLS and polysomnography. Sleep architecture and leg movement activity during sleep were subsequently compared: 1) 40 patients with MS without RLS (MS-RLS) vs 28 healthy controls; 2) 17 patients with MS with RLS (MS+RLS) vs 35 patients with iRLS; 3) MS+RLS vs MS-RLS.

Results: MS-RLS and MS+RLS presented increased sleep latency, percentage of sleep stage N1, and reduced total sleep time compared to healthy controls and iRLS, respectively. The periodic limb movements during sleep (PLMS) index was higher in MS-RLS than in healthy controls (P = .035) and lower in MS+RLS compared to iRLS (P = .024). PLMS in MS+RLS were less periodic, less often bilateral, and with shorter single movements compared to the typical PLMS in iRLS.

Conclusions: MS is a risk factor for RLS, PLMS, and for a lower sleep quality in comparison to healthy patients. PLMS in MS+RLS are fewer and shorter if compared to iRLS. Our results suggest a dissociation between motor (PLMS) and sensory symptoms (RLS sensory component) in RLS secondary to MS, with possible treatment implications.

Citation: Ferri R, Sparasci D, Castelnovo A, et al. Leg movement activity during sleep in multiple sclerosis with and without restless legs syndrome. J Clin Sleep Med. 2022;18(1):11-20.

Keywords: multiple sclerosis; periodic limb movements; polysomnography; restless legs syndrome.

Publication types

Observational Study
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Cross-Sectional Studies
Female
Humans
Leg
Male
Middle Aged
Movement
Multiple Sclerosis* / complications
Nocturnal Myoclonus Syndrome* / complications
Nocturnal Myoclonus Syndrome* / epidemiology
Restless Legs Syndrome* / complications
Sleep