Prevalence and Determinants of Periodic Limb Movements in the General Population.

Haba-Rubio J1, Marti-Soler H2, Marques-Vidal P3, Tobback N1, Andries D1, Preisig M4, Waeber G3, Vollenweider P3, Kutalik Z2,5, Tafti M1,6, Heinzer R1,7.

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Abstract

OBJECTIVE:

Periodic limb movements during sleep (PLMS) are sleep phenomena characterized by periodic episodes of repetitive stereotyped limb movements. The aim of this study was to describe the prevalence and determinants of PLMS in a middle-to-older age general population.

METHODS:

Data from 2162 subjects (51.2% women, mean age 58.4±11.1 years) participating in a population-based study (HypnoLaus, Lausanne, Switzerland) were collected. Assessments included laboratory, socio-demographic, personal and treatment history, and full polysomnography at home. PLMS index (PLMSI) was determined and a PLMSI>15/h was considered as significant.

RESULTS:

Prevalence of PLMSI>15/h was 28.6% (31.3% in men, 26% in women). Compared to subjects with a PLMSI≤15/h, subjects with a PLMSI>15/h were older (p<0.001), predominantly males (p=0.007), with a higher proportion of restless legs syndrome (RLS, p<0.001), a higher BMI (p=0.001), and a lower mean glomerular filtration rate (p<0.001). Subjects with a PLMSI>15/h also had a higher prevalence of diabetes, hypertension, and betablocker or hypnotic treatments. The prevalence of antidepressant use was higher, but not statistically significant (p=0.07). Single nucleotide polymorphisms (SNP) within BTBD9 (rs3923809), TOX3 (rs3104788) and MEIS1 (rs2300478) genes were significantly associated with PLSMI>15/h. Conversely, mean hemoglobin and ferritin levels were similar in both groups. In the multivariate analysis, age, male gender, antidepressant intake, RLS and rs3923809, rs3104788 and rs2300478 SNPs were independently associated with a PLMSI>15/h.

INTERPRETATION:

PLMS are highly prevalent in our middle-age European population. Age, male gender, RLS, antidepressant treatment and specific BTBD9, TOX3 and MEIS1 SNPs distribution are independent predictors of a PLMSI >15/h. This article is protected by copyright. All rights reserved.