The prevalence and significance of periodic leg movements during sleep in patients with congestive heart failure

Sleep Breath. 2009 Mar;13(1):43-7. doi: 10.1007/s11325-008-0207-5. Epub 2008 Jul 1.

Abstract

Purpose: The aim of this study was to evaluate (1) the prevalence of periodic leg movements during sleep (PLMs) in a consecutive sample of congestive heart failure (CHF) outpatients; (2) the presence of correlation between PLMs, subjective daytime sleepiness, and sleep architecture; and (3) the heart rate response to PLMs in CHF.

Materials and methods: Seventy-nine [50 men, age 59 +/- 11 years, body mass index (BMI) 26 +/- 5 kg/m(2)] consecutive adult stable outpatients with CHF [left ventricular ejection fraction (LVEF) 36 +/- 6%] were prospectively evaluated. The patients underwent assessment of echocardiography, sleepiness (Epworth Scale), and overnight in-lab polysomnography.

Results: Fifteen patients (19%) had PLM index >5. These subjects were similar in sex distribution, BMI, subjective somnolence, LVEF, and apnea-hypopnea index (AHI), but were significantly older than subjects without PLMs. Sleep architecture was similar in subjects with and without PLMs. There was a small but significant elevation of heart rate after PLMs (80.1 +/- 9.4 vs. 81.5 +/- 9.2; p < 0.001). The cardiac acceleration was also present in absence of electroencephalogram activation.

Conclusion: The prevalence of PLMs in consecutive sample of adult CHF outpatients was 19%. There were no differences in subjective daytime sleepiness, sleep architecture, AHI, and severity of CHF in subjects with and without PLMs. PLMs caused a small but statistically significant cardiac acceleration.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Body Mass Index
  • Disorders of Excessive Somnolence / diagnosis
  • Disorders of Excessive Somnolence / epidemiology
  • Echocardiography
  • Female
  • Heart Failure / epidemiology*
  • Heart Rate / physiology
  • Humans
  • Male
  • Middle Aged
  • Nocturnal Myoclonus Syndrome / diagnosis
  • Nocturnal Myoclonus Syndrome / epidemiology*
  • Polysomnography
  • Prevalence
  • Prospective Studies
  • Severity of Illness Index
  • Sleep Apnea, Obstructive / diagnosis
  • Sleep Apnea, Obstructive / epidemiology
  • Sleep Stages / physiology
  • Ventricular Dysfunction, Left / diagnosis
  • Ventricular Dysfunction, Left / epidemiology