Periodic limb movements in sleep: Prevalence and associated sleepiness in the Wisconsin Sleep Cohort

Objectives: Periodic limb movements in sleep (PLMS) are thought to be prevalent in elderly populations, but their impact on quality of life remains unclear. We examined the prevalence of PLMS, impact of age on prevalence, and association between PLMS and sleepiness. Methods: We identified limb movements in 2335 Wisconsin Sleep Cohort polysomnograms collected over 12 years. Prevalence of periodic limb movement index (PLMI) >= 15 was calculated at baseline (n = 1084). McNemar's test assessed changes in prevalence over time. Association of sleepiness and PLMS evaluated using linear mixed modeling and generalized estimating equations. Models adjusted for confounders. Results: Prevalence of PLMI >= 15 at baseline was 25.3%. Longitudinal prevalence increased significantly with age (p = 2.97 x 10(-14)). Sleepiness did not differ significantly between PLMI groups unless stratified by restless legs syndrome (RLS) symptoms. The RLS+/PLM+ group was sleepier than the RLS+/PLM-group. Multiple Sleep Latency Test trended towards increased alertness in the RLS-/PLM+ group compared to RLS-/PLM-. Conclusions: A significant number of adults have PLMS and prevalence increased with age. No noteworthy association between PLMI category and sleepiness unless stratified by RLS symptoms. Significance: Our results indicate that RLS and PLMS may have distinct clinical consequences and interactions that can help guide treatment approach. (C) 2018 Published by Elsevier B.V. on behalf of International Federation of Clinical Neurophysiology.