Autonomic correlates of large muscle group movements during non-REM sleep in restless legs syndrome: a comparative analysis with periodic and non-periodic leg movements
Notice bibliographique
Résumé
STUDY OBJECTIVES: Large muscle group movements during sleep (LMMS) have recently been recognized as a prevalent feature in patients with restless legs syndrome (RLS), yet their autonomic profile remains insufficiently characterized. This study aimed to compare heart rate (HR) changes associated with LMMS to those accompanying short-interval (SILMS), periodic (PLMS), and isolated leg movements (ISOLMS) during non-REM sleep in RLS. METHODS: Thirty drug-free RLS patients (20 women, mean age 57.6 ± 12.73 years) underwent full-night polysomnography. For each subject, five arousal-associated events per movement type were selected, provided they were isolated by at least 30 seconds of motor/arousal-free sleep. HR changes were analyzed by computing R-R intervals and expressing them as a percentage of baseline, synchronized to movement onset. The area under the curve (AUC,-10 to +20 s), HR change peak, and movement durations were statistically compared using non-parametric tests. RESULTS: LMMS were significantly longer than other movement types (mean duration: 9.3 s vs. <3.0 s for others) and induced the highest HR response (peak: 129.6%, AUC: 369.3%), followed by SILMS (peak: 125.4%, 266.3%), ISOLMS (peak: 118.2%, 173.4%), and PLMS (peak: 118.5%, 166.9%). SILMS and LMMS were associated with rapid and sustained HR increases, without post-peak bradycardia, while PLMS and ISOLMS showed a modest transient bradycardia following the peak. CONCLUSIONS: LMMS are associated with strong autonomic activation indicating parasympathetic withdrawal and/or sympathetic activation, distinguishing them from other sleep-related leg movements in RLS. The absence of post-peak bradycardia suggests reduced parasympathetic buffering, potentially reflecting more sustained arousal mechanisms. Statement of Significance This study provides the first detailed characterization of the heart rate dynamics associated with large muscle group movements during sleep (LMMS) in patients with restless legs syndrome (RLS). By comparing LMMS with established motor patterns such as periodic, isolated, and short-interval leg movements during sleep, we show that LMMS induce the strongest and most sustained autonomic responses. These responses are likely driven by sympathetic activation and/or parasympathetic withdrawal due to sustained arousal-related central autonomic commands. These findings support the hypothesis that LMMS represent a physiologically distinct class of sleep-related motor events with unique implications for cardiovascular and sleep disruption risk in RLS.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,002 | 0,002 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».