Comorbidities in children with elevated periodic limb movement index during sleep

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Published on: December 6, 2016

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Lourdes M Delrosso1, Carey Lockhart1, Joanna E Wrede1

  • 1Seattle Children's Hospital, Seattle, WA Italy.

Sleep
|September 27, 2019
PubMed

Insights

Children with elevated periodic limb movement index (PLMI) during polysomnography (PSG) show higher rates of comorbidities like RLS, mood disorders, and epilepsy. This study highlights associated health conditions in pediatric sleep patients with increased PLMI.

Area of Science:

  • Pediatric Sleep Medicine
  • Neurology
  • Clinical Research

Background:

  • Elevated periodic limb movement index (PLMI) during polysomnography (PSG) in children is not well understood regarding associated comorbidities.
  • Identifying these comorbidities is crucial for comprehensive pediatric sleep disorder management.

Purpose of the Study:

  • To identify and compare comorbidities in children with elevated PLMI (PLMI > 5) versus those with normal PLMI (PLMI < 5) presenting to a pediatric sleep center.
  • To determine the prevalence of periodic limb movement disorder (PLMD) in a referred pediatric population.

Main Methods:

  • Retrospective review of clinically indicated PSGs from 3/2017-3/2019 at Seattle Children's Sleep Disorders Center.
  • Data included demographics, clinical presentation, medications, medical history, family history of restless legs syndrome (RLS), ferritin levels, and PSG metrics.
  • Comparison of characteristics between children with elevated PLMI (cases) and normal PLMI (controls).

Main Results:

  • A 5% prevalence of elevated PLMI (PLMI > 5) was found in 148 subjects; 188 controls had PLMI < 5. No significant differences in sex or age between groups.
  • Children with elevated PLMI showed higher rates of RLS, snoring, insomnia, mood disorders, behavioral problems, morning headaches, chronic kidney disease, epilepsy, and chronic heart disease.
  • Increased use of antidepressants, antipsychotics, and antiseizure medications was noted in children with elevated PLMI. The prevalence of PLMD was 0.3%.

Conclusions:

  • This study identified key comorbidities and associated medications in children with elevated PLMI referred for polysomnography.
  • The findings underscore the importance of evaluating for comorbidities in pediatric patients with increased PLMI during PSG.
  • Prevalence of PLMD was low (0.3%) in this referred population, but elevated PLMI was associated with significant comorbidities.
Abstract

Keywords:
pediatricsperiodic limb movement disorderperiodic limb movement indexperiodic limb movements of sleep

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