PLMI升高的成人中呼吸负荷与周期性肢体运动频率：一项回顾性多导睡眠图研究
Respiratory burden and periodic limb movement frequency in adults with elevated PLMI: A retrospective polysomnographic study.
文献信息
| PMID | 42933131 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Duygu Arslan Mehdiyev |
| 作者单位 | Department of Neurology, Ankara Etlik City Hospital, Ankara, Türkiye. Electronic address: dr.duyguarslan@googlemail.com. |
| 期刊 | Sleep medicine |
| SCI 分区 | Q1 |
| IF | 4.5 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 耳科 |
中文摘要
目的： 睡眠期周期性肢体运动（PLMS）常与阻塞性睡眠呼吸暂停（OSA）共存，而在OSA未治疗时是否应判读PLMS仍不明确。在周期性肢体运动指数（PLMI）升高的成人中，我们主要检验呼吸暂停低通气指数（AHI）是否与PLMI相关；次要分析评估其与PLM-觉醒指数（PLMAI）及PLM-觉醒耦联的关系。
方法： 我们回顾性分析了507例连续成人PLMI≥15次/小时的多导睡眠图。采用Spearman相关、对数转换PLMI的校正回归以及按OSA严重程度的分层分析，评估呼吸和氧合指标与PLMI的关联。PLMAI采用均值中心化的PLMI和AHI、二者交互项、年龄、性别和体重指数建模，并使用异方差稳健（HC3）推断和敏感性分析。
结果： AHI与PLMI无关联（ρ=0.003；95% CI -0.08至0.09）。校正年龄、性别和体重指数后，AHI每增加10次/小时，PLMI变化-0.2%（95% CI -2.2%至1.8%）。PLMI在不同OSA严重程度类别间无差异（p=0.63），AHI不能预测PLMI>30次/小时（每10次/小时OR 1.05；95% CI 0.98-1.12）。AHI与PLMAI无独立主效应关联（p=0.08），但PLMI×AHI交互项为正，且在敏感性分析中保持显著（HC3 p<0.001）。
结论： 在PLMI升高的成人中，呼吸负荷与PLM频率无关，支持在OSA患者中继续判读和报告PLMS。较高的AHI适度增强了PLMI与PLM相关觉醒之间的关联；因此，当呼吸负荷较重时，PLMAI应谨慎解读。
英文摘要
OBJECTIVE: Periodic limb movements during sleep (PLMS) frequently coexist with obstructive sleep apnea (OSA), and whether PLMS should be scored when OSA is untreated remains unclear. In adults with an elevated periodic limb movement index (PLMI), we primarily examined whether the apnea-hypopnea index (AHI) was associated with PLMI; secondary analyses assessed its associations with the PLM-arousal index (PLMAI) and PLM-arousal coupling.
METHODS: We retrospectively analyzed polysomnograms of 507 consecutive adults with PLMI ≥15 events/h. Associations of respiratory and oxygenation measures with PLMI were assessed using Spearman correlation, adjusted regression of log-transformed PLMI, and categorical analyses across OSA severity. PLMAI was modeled using mean-centered PLMI and AHI, their interaction, age, sex, and body mass index, with heteroscedasticity-robust (HC3) inference and sensitivity analyses.
RESULTS: AHI was not associated with PLMI (ρ = 0.003; 95% CI -0.08 to 0.09). After adjustment for age, sex, and body mass index, PLMI changed by -0.2% per 10 events/h of AHI (95% CI -2.2% to 1.8%). PLMI did not differ across OSA severity categories (p = 0.63), and AHI did not predict PLMI >30 events/h (OR per 10 events/h 1.05; 95% CI 0.98-1.12). AHI showed no independent main association with PLMAI (p = 0.08), but the PLMI×AHI interaction was positive and remained significant across sensitivity analyses (HC3 p < 0.001).
CONCLUSION: In adults with elevated PLMI, respiratory burden was not associated with PLM frequency, supporting continued scoring and reporting of PLMS in patients with OSA. Higher AHI modestly strengthened the association between PLMI and PLM-related arousals; therefore, PLMAI should be interpreted cautiously when the respiratory burden is substantial.