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Cardiovascular variability during periodic leg movements in sleep in children

Lisa M Walter1, Alison M Foster, Ruth R Patterson

  • 1Ritchie Centre for Baby Health Research, Monash Institute of Medical Research, Monash University, Melbourne, Australia. lisa.walter@med.monash.edu.au

Sleep
|September 4, 2009
PubMed

Insights

Periodic leg movements in sleep (PLMS) in children are linked to reduced vagal activity and increased sympathetic influence. These leg movements during sleep impact cardiac autonomic control, affecting heart rate variability.

Area of Science:

  • Pediatric Sleep Medicine
  • Autonomic Nervous System Function
  • Cardiovascular Regulation

Background:

  • Periodic leg movements in sleep (PLMS) are known to affect sleep quality and cardiovascular autonomic control in adults.
  • Limited research exists on the impact of PLMS on cardiac autonomic control in children.

Purpose of the Study:

  • To investigate the effect of PLMS episodes during NREM2 sleep on heart rate variability (HRV) in children.
  • To quantify changes in sympathovagal balance associated with PLMS in pediatric subjects.

Main Methods:

  • Retrospective analysis of overnight polysomnography data from 20 children (7-12 years old).
  • Comparison of 10 children with PLMS (PLM+) against 10 age- and sleep disordered breathing (SDB)-matched controls (PLM-).
  • Assessment of heart rate variability (HRV) measures, specifically the LF/HF ratio, during sleep.

Main Results:

  • The LF/HF ratio was significantly higher during PLM+ periods compared to PLM- periods within PLMS subjects and controls.
  • Parasympathetic inhibition was indicated during PLMS episodes.
  • Cardiac acceleration followed by a return to baseline was observed at the onset of individual leg movements.

Conclusions:

  • Episodes of PLMS in children are associated with vagal inhibition.
  • Decreased vagal activity is suggested by rapid cardiac acceleration coinciding with leg movements during sleep.
Abstract

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