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A Journal on Diseases of the Respiratory System
Official Journal of the Italian Society of Thoracic Endoscopy
Indexed/Abstracted in: EMBASE, Scopus, Emerging Sources Citation Index
SLEEP DISORDERS 2012
Minerva Pneumologica 2012 September;51(3):107-15
Clinical usefulness of periodic limb movements during sleep in restless legs syndrome and other sleep disorders
Nowak A., Baier P. C.
Center for Sleep Medicine, Psychiatry and Psychotherapy, Christian-Albrechts-University, Kiel, Germany
Periodic limb movements (PLM) in sleep (PLMS) are repetitive and stereotypical movements of the extremities that occur in sleep, frequently observed in polysomnographic (PSG) recordings. This article reviews how PLMS are defined and recorded, delineates the disorders in which PLMS might play a role. PLMS as identified and counted according to current criteria are very frequent, but might consist of a variety of different phenomena ranging from normal variant to pathological condition. If only their mere occurrence is observed and quantified in PSG, they seem to have little or no clinical relevance, for many sleep disorders, with the exception of RLS, where high PLM indices correlate with subjective severity. Much less is known about the clinical usefulness of PLMS with regard to other sleep disturbances: The classical PLMS index does not seem to be sufficiently specific to allow diagnostic or differential diagnostic considerations. In the future, additional analyses, including but not limited to measures for periodicity, might contain additional information, beyond the mere count of sleep-related limb movements. Many questions, however, remain open, and warrant further research. To date it is recommended to include PLMS recordings in every polysomnography, but not to overestimate any finding of high PLMS indices generated by analyses with common standards.