Research Article
BibTex RIS Cite

Obstrüktif Uyku Apne Sendromunda Pozitif Havayolu Basıncı Tedavisinin Huzursuz Bacak Sendromu Şiddeti Üzerindeki Uzun Dönem Etkileri

Year 2023, Volume: 45 Issue: 3, 348 - 354, 23.05.2023
https://doi.org/10.20515/otd.1233819

Abstract

Obstrüktif uyku apne sendromunda (OUAS) pozitif hava yolu basıncı (PAP) tedavisinin huzursuz bacak sendromu şiddeti üzerindeki uzun vadeli etkilerini araştırmak. Çalışmaya polisomnografi (PSG) ile orta ve ağır OUAS tanısı konulan ve PAP tedavisi alan 320 kişi dahil edildi. Bu hastalardan huzursuz bacak sendromu (HBS) tanı kriterlerini karşılayan 72 hastanın demografik verileri analiz edildi. OUAS tedavisinde PAP öncesi ve sonrası 12. ayda hastalar Uluslararası HBS Çalışma Grubu Derecelendirme Ölçeği (IRLS) ile değerlendirildi. OUAS ve HBS olan 72 hastanın ortalama vücut kitle indeksi 31,2 (±5,8), ortalama apne-hipopne indeksi 44,9±27,7 idi. Orta ve şiddetli OUAS'ta HBS prevalansı %24 idi. IRLS skoru ile tüm gece ortalama oksijen satürasyonu (r: -0.075), tüm gece minimum oksijen satürasyonu (r: -0.125), <%90 satürasyonun altında geçirilen süre (r: -0.172) ve uyku arasında negatif korelasyon vardı. etkinliği (r: 0,087) ve PAP tedavisi sonrası 12. ayda IRLS skoru ile haftalık PAP kullanım saati arasında negatif korelasyon (r: -0,316; p<0,001) saptandı. Bu çalışmadan elde edilen veriler OUAS ve HBS birlikteliğinin yaygın olduğunu ve yandaş hastalıkların tanısında göz ardı edilmemesi gerektiğini düşündürmektedir. Uzun süreli PAP tedavisi HBS semptomlarını azaltmada etkilidir. Bu konuda ileri çalışmalara ihtiyaç vardır.

Supporting Institution

YOKTUR.

Project Number

YOKTUR.

Thanks

YOKTUR.

References

  • 1. Peppard PE, Young T, Barnet JH, Palta M, Hagen EW, Hla KM. Increased prevalence of sleep-disordered breathing in adults. Am J Epidemiol. 2013;177:1006-14.
  • 2. Rundo JV. Obstructive sleep apnea basics. Cleve Clin J Med. 2019;86:2-9.
  • 3. Klingelhoefer L, Bhattacharya K, Reichmann H. Restless legs syndrome. Clin Med (Lond). 2016 ;16:379-82.
  • 4. Ohayon MM, O'Hara R, Vitiello MV. Epidemiology of restless legs syndrome: a synthesis of the literature. Sleep Med Rev. 2012;16:283-95.
  • 5. Acar S, Gencer AM. Genetics in restless legs syndrome. Turkish Journal of Physical Medicine and Rehabilitation 51, no.4 2005: 156 - 160.
  • 6. Guo S, Huang J, Jiang H, Han C, Li J, Xu X, et al. Restless Legs Syndrome: From Pathophysiology to Clinical Diagnosis and Management. Front Aging Neurosci. 2017; 9: 171.
  • 7. Khaldy H, León J, Escames G, Bikjdaouene L, García JJ, Acuña-Castroviejo D. Circadian rhythms of dopamine and dihydroxyphenyl acetic acid in the mouse striatum: effects of pinealectomy and of melatonin treatment. Neuroendocrinology. 2002 ;75:201-8.
  • 8. Allen RP, Picchietti DL, Garcia-Borreguero D, Ondo WG, Walters AS, Winkelman JW, et al; International Restless Legs Syndrome Study Group. Restless legs syndrome/Willis-Ekbom disease diagnostic criteria: updated Internati,onal Restless Legs Syndrome Study Group (IRLSSG) consensus criteria--history, rationale, description, and significance. Sleep Med 2014;15:860-73.
  • 9. Kushida CA. Clinical presentation, diagnosis and quality of life issues in restless legs syndrome. Am J Med 2007;120:4-12.
  • 10. Gossard TR, Trotti LM, Videnovic A, St Louis EK. Restless Legs Syndrome: Contemporary Diagnosis and Treatment. Neurotherapeutics. 2021;18:140-155.
  • 11. Lee JJ, Sundar KM. Evaluation and Management of Adults with Obstructive Sleep Apnea Syndrome. Lung. 2021;199:87-101.
  • 12. Berry RB, Brooks R, Gamaldo C, Harding SM, Lloyd RM, Quan SF, et al. AASM scoring manual updates for 2017 (Version 2.4). J Clin Sleep Med. 2017;13:665–666.
  • 13. Walters AS, LeBrocq C, Dhar A, Hening W, Rosen R, Allen RP, et al. International Restless Legs Syndrome Study Group. Validation of the International Restless Legs Syndrome Study Group rating scale for restless legs syndrome. Sleep Med. 2003 Mar;4:121-32.
  • 14. Filiz Bilgilisoy M, Çakır T, Restless Legs Syndrome with Current Diagnostic Criteria. Turkish Journal of Osteoporosis, 2015;21, 87 - 95.
  • 15. Lindberg E, Benediktsdottir B, Franklin KA, Holm M, Johannessen A, Jögi R, et al. Women with symptoms of sleep-disordered breathing are less likely to be diagnosed and treated for sleep apnea than men. Sleep Med. 2017;35:17-22.
  • 16. Bostan OC, Akcan B, Saydam CD, Tekin M, Dascı O, Balcan B. Impact of Gender on Symptoms and Comorbidities in Obstructive Sleep Apnea. Eurasian J Med. 2021;53:34-39.
  • 17. Erikson KM, Jones BC, Beard JL. Iron deficiency alters dopamine transporter functioning in rat striatum. J Nutr. 2000;130:2831-7.
  • 18. Erikson KM, Jones BC, Hess EJ, Zhang Q, Beard JL. Iron deficiency decreases dopamine D1 and D2 receptors in rat brain. Pharmacol Biochem Behav. 2001;69:409-18.
  • 19. Patton SM, Ponnuru P, Snyder AM, Podskalny GD, Connor JR. Hypoxia-inducible factor pathway activation in restless legs syndrome patients. Eur J Neurol. 2011 ;18:1329-35.
  • 20. Yang Q, Wang Y, Feng J, Cao J, Chen B. Intermittent hypoxia from obstructive sleep apnea may cause neuronal impairment and dysfunction in central nervous system: the potential roles played by microglia. Neuropsychiatr Dis Treat. 2013 9:1077–86.
  • 21. Wu X, Gong L, Xie L, Gu W, Wang X, Liu Z, et al. NLRP3 Deficiency Protects Against Intermittent Hypoxia-Induced Neuroinflammation and Mitochondrial ROS by Promoting the PINK1-Parkin Pathway of Mitophagy in a Murine Model of Sleep Apnea. Front Immunol. 2021 ;12:628168.
  • 22. Connor JR, Ponnuru P, Lee BY, Podskalny GD, Alam S, Allen RP, et al. Postmortem and imaging based analyses reveal CNS decreased myelination in restless legs syndrome. Sleep Med. 2011;12:614-9.
  • 23. Sevim S, Dogu O, Camdeviren H, Bugdayci R, Sasmaz T, Kaleagasi H, et al. Unexpectedly low prevalence and unusual characteristics of RLS in Mersin, Turkey. Neurology 2003;61:1562-9.
  • 24. Kaplan Y, Inonu H, Yilmaz A, Ocal S. Restless legs syndrome in patients with chronic obstructive pulmonary disease. Can J Neurol Sci. 2008;35:352-7.
  • 25. Patil SP, Ayappa IA, Caples SM, Kimoff RJ, Patel SR, Harrod CG. Treatment of Adult Obstructive Sleep Apnea with Positive Airway Pressure: An American Academy of Sleep Medicine Clinical Practice Guideline. J Clin Sleep Med. 2019;15:335-343.
  • 26. Marillier M, Gruet M, Baillieul S, LE Roux Mallouf T, Wuyam B, Tamisier R, Levy P, Pepin JL, Verges S. Neuromuscular Dysfunction and Cortical Impairment in Sleep Apnea Syndrome. Med Sci Sports Exerc. 2018;50:1529-1539.
  • 27. Salminen AV, Rimpilä V, Polo O. Peripheral hypoxia in restless legs syndrome (Willis-Ekbom disease). Neurology. 2014 ;82:1856-61.
  • 28. Delgado Rodrigues RN, Alvim de Abreu E Silva Rodrigues AA, Pratesi R, Krieger J. Outcome of restless legs severity after continuous positive air pressure (CPAP) treatment in patients affected by the association of RLS and obstructive sleep apneas. Sleep Med. 2006 ;7:235-9.
  • 29. Silva C, Peralta AR, Bentes C. The urge to move and breathe - the impact of obstructive sleep apnea syndrome treatment in patients with previously diagnosed, clinically significant restless legs syndrome. Sleep Med. 2017;38:17-20.
  • 30. Lakshmanan S, Thompson NR, Pascoe M, Mehra R, Foldvary-Schaefer N, Katzan IL, et al. Impact of Positive Airway Pressure on International Restless Legs Syndrome Score in Sleep Disordered Breathing. J Clin Med. 2019 14;8:2212.

Long-Term Effects of Positive Airway Pressure Treatment on Restless Legs Syndrome Severity in Obstructive Sleep Apnea Syndrome

Year 2023, Volume: 45 Issue: 3, 348 - 354, 23.05.2023
https://doi.org/10.20515/otd.1233819

Abstract

To research how long-term positive airway pressure (PAP) therapy affects the severity of restless legs syndrome in patients with obstructive sleep apnea syndrome (OSASThe study included 320 individuals that were diagnosed with moderate and severe OSAS using polysomnography (PSG) and under PAP treatment. Among these patients, the demographic data of 72 patients who met the diagnostic criteria of restless legs syndrome (RLS) were analyzed. The patients were evaluated with the International RLS Study Group rating scale (IRLS) before and at the 12th month after PAP in the treatment of OSAS. The mean body mass index of the 72 patients with OSAS and RLS was 31.2 (±5.8), and their mean apnea-hypopnea index was 44.9±27.7. The prevalence of RLS in moderate and severe OSAS was 24%. There was a negative correlation between the IRLS score and mean oxygen saturation all night (r: -0.075), minimum oxygen saturation all night (r: -0.125), time spent below <90% saturation (r: -0.172), and sleep efficiency (r: 0.087) on PSG performed before PAP treatment, as well as a negative correlation between the IRLS score and weekly PAP use hours at the 12th month after PAP treatment (r: -0.316; p<0.001). The data obtained from this study suggest that the coexistence of OSAS and RLS is common and should not be overlooked in the diagnosis of comorbid diseases. Long-term PAP treatment is effective in reducing RLS symptoms. Further studies are needed on this subject.

Project Number

YOKTUR.

References

  • 1. Peppard PE, Young T, Barnet JH, Palta M, Hagen EW, Hla KM. Increased prevalence of sleep-disordered breathing in adults. Am J Epidemiol. 2013;177:1006-14.
  • 2. Rundo JV. Obstructive sleep apnea basics. Cleve Clin J Med. 2019;86:2-9.
  • 3. Klingelhoefer L, Bhattacharya K, Reichmann H. Restless legs syndrome. Clin Med (Lond). 2016 ;16:379-82.
  • 4. Ohayon MM, O'Hara R, Vitiello MV. Epidemiology of restless legs syndrome: a synthesis of the literature. Sleep Med Rev. 2012;16:283-95.
  • 5. Acar S, Gencer AM. Genetics in restless legs syndrome. Turkish Journal of Physical Medicine and Rehabilitation 51, no.4 2005: 156 - 160.
  • 6. Guo S, Huang J, Jiang H, Han C, Li J, Xu X, et al. Restless Legs Syndrome: From Pathophysiology to Clinical Diagnosis and Management. Front Aging Neurosci. 2017; 9: 171.
  • 7. Khaldy H, León J, Escames G, Bikjdaouene L, García JJ, Acuña-Castroviejo D. Circadian rhythms of dopamine and dihydroxyphenyl acetic acid in the mouse striatum: effects of pinealectomy and of melatonin treatment. Neuroendocrinology. 2002 ;75:201-8.
  • 8. Allen RP, Picchietti DL, Garcia-Borreguero D, Ondo WG, Walters AS, Winkelman JW, et al; International Restless Legs Syndrome Study Group. Restless legs syndrome/Willis-Ekbom disease diagnostic criteria: updated Internati,onal Restless Legs Syndrome Study Group (IRLSSG) consensus criteria--history, rationale, description, and significance. Sleep Med 2014;15:860-73.
  • 9. Kushida CA. Clinical presentation, diagnosis and quality of life issues in restless legs syndrome. Am J Med 2007;120:4-12.
  • 10. Gossard TR, Trotti LM, Videnovic A, St Louis EK. Restless Legs Syndrome: Contemporary Diagnosis and Treatment. Neurotherapeutics. 2021;18:140-155.
  • 11. Lee JJ, Sundar KM. Evaluation and Management of Adults with Obstructive Sleep Apnea Syndrome. Lung. 2021;199:87-101.
  • 12. Berry RB, Brooks R, Gamaldo C, Harding SM, Lloyd RM, Quan SF, et al. AASM scoring manual updates for 2017 (Version 2.4). J Clin Sleep Med. 2017;13:665–666.
  • 13. Walters AS, LeBrocq C, Dhar A, Hening W, Rosen R, Allen RP, et al. International Restless Legs Syndrome Study Group. Validation of the International Restless Legs Syndrome Study Group rating scale for restless legs syndrome. Sleep Med. 2003 Mar;4:121-32.
  • 14. Filiz Bilgilisoy M, Çakır T, Restless Legs Syndrome with Current Diagnostic Criteria. Turkish Journal of Osteoporosis, 2015;21, 87 - 95.
  • 15. Lindberg E, Benediktsdottir B, Franklin KA, Holm M, Johannessen A, Jögi R, et al. Women with symptoms of sleep-disordered breathing are less likely to be diagnosed and treated for sleep apnea than men. Sleep Med. 2017;35:17-22.
  • 16. Bostan OC, Akcan B, Saydam CD, Tekin M, Dascı O, Balcan B. Impact of Gender on Symptoms and Comorbidities in Obstructive Sleep Apnea. Eurasian J Med. 2021;53:34-39.
  • 17. Erikson KM, Jones BC, Beard JL. Iron deficiency alters dopamine transporter functioning in rat striatum. J Nutr. 2000;130:2831-7.
  • 18. Erikson KM, Jones BC, Hess EJ, Zhang Q, Beard JL. Iron deficiency decreases dopamine D1 and D2 receptors in rat brain. Pharmacol Biochem Behav. 2001;69:409-18.
  • 19. Patton SM, Ponnuru P, Snyder AM, Podskalny GD, Connor JR. Hypoxia-inducible factor pathway activation in restless legs syndrome patients. Eur J Neurol. 2011 ;18:1329-35.
  • 20. Yang Q, Wang Y, Feng J, Cao J, Chen B. Intermittent hypoxia from obstructive sleep apnea may cause neuronal impairment and dysfunction in central nervous system: the potential roles played by microglia. Neuropsychiatr Dis Treat. 2013 9:1077–86.
  • 21. Wu X, Gong L, Xie L, Gu W, Wang X, Liu Z, et al. NLRP3 Deficiency Protects Against Intermittent Hypoxia-Induced Neuroinflammation and Mitochondrial ROS by Promoting the PINK1-Parkin Pathway of Mitophagy in a Murine Model of Sleep Apnea. Front Immunol. 2021 ;12:628168.
  • 22. Connor JR, Ponnuru P, Lee BY, Podskalny GD, Alam S, Allen RP, et al. Postmortem and imaging based analyses reveal CNS decreased myelination in restless legs syndrome. Sleep Med. 2011;12:614-9.
  • 23. Sevim S, Dogu O, Camdeviren H, Bugdayci R, Sasmaz T, Kaleagasi H, et al. Unexpectedly low prevalence and unusual characteristics of RLS in Mersin, Turkey. Neurology 2003;61:1562-9.
  • 24. Kaplan Y, Inonu H, Yilmaz A, Ocal S. Restless legs syndrome in patients with chronic obstructive pulmonary disease. Can J Neurol Sci. 2008;35:352-7.
  • 25. Patil SP, Ayappa IA, Caples SM, Kimoff RJ, Patel SR, Harrod CG. Treatment of Adult Obstructive Sleep Apnea with Positive Airway Pressure: An American Academy of Sleep Medicine Clinical Practice Guideline. J Clin Sleep Med. 2019;15:335-343.
  • 26. Marillier M, Gruet M, Baillieul S, LE Roux Mallouf T, Wuyam B, Tamisier R, Levy P, Pepin JL, Verges S. Neuromuscular Dysfunction and Cortical Impairment in Sleep Apnea Syndrome. Med Sci Sports Exerc. 2018;50:1529-1539.
  • 27. Salminen AV, Rimpilä V, Polo O. Peripheral hypoxia in restless legs syndrome (Willis-Ekbom disease). Neurology. 2014 ;82:1856-61.
  • 28. Delgado Rodrigues RN, Alvim de Abreu E Silva Rodrigues AA, Pratesi R, Krieger J. Outcome of restless legs severity after continuous positive air pressure (CPAP) treatment in patients affected by the association of RLS and obstructive sleep apneas. Sleep Med. 2006 ;7:235-9.
  • 29. Silva C, Peralta AR, Bentes C. The urge to move and breathe - the impact of obstructive sleep apnea syndrome treatment in patients with previously diagnosed, clinically significant restless legs syndrome. Sleep Med. 2017;38:17-20.
  • 30. Lakshmanan S, Thompson NR, Pascoe M, Mehra R, Foldvary-Schaefer N, Katzan IL, et al. Impact of Positive Airway Pressure on International Restless Legs Syndrome Score in Sleep Disordered Breathing. J Clin Med. 2019 14;8:2212.
There are 30 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section ORİJİNAL MAKALE
Authors

Gülşah Yaşa Öztürk 0000-0002-9033-5095

Sinem Berik Safçi 0000-0002-0977-0015

Project Number YOKTUR.
Publication Date May 23, 2023
Published in Issue Year 2023 Volume: 45 Issue: 3

Cite

Vancouver Yaşa Öztürk G, Berik Safçi S. Long-Term Effects of Positive Airway Pressure Treatment on Restless Legs Syndrome Severity in Obstructive Sleep Apnea Syndrome. Osmangazi Tıp Dergisi. 2023;45(3):348-54.


13299        13308       13306       13305    13307  1330126978