睡眠周期性肢体运动是重复性肢体运动(多数为腿部运动),主要发生于非快速动眼期睡眠期间;表现为脚趾和足踝背屈及偶尔的髋膝屈曲。
睡眠周期性肢体运动指数(Periodic Limb Movement of Sleep Index, PLMS-I;睡眠中每小时周期性肢体运动次数)>15,可诊断周期性肢体运动障碍,其可导致临床睡眠障碍。通过多导睡眠图确定诊断,并排除其他造成睡眠-觉醒障碍的原因。
睡眠周期性肢体运动可发生于正常人,对于他们睡眠障碍和白天过度嗜睡的临床意义仍存在争议。
可为原发性(特发性)或继发性。 继发性周期性肢体运动障碍 (PLMD) 可出现于不安腿综合征、阻塞性睡眠呼吸暂停综合征、快速动眼期 (REM) 睡眠行为障碍 (RBD)、发作性睡病、充血性心力衰竭、原发性高血压、终末期肾病、脊髓损伤、脊髓空洞症、酒精依赖性、帕金森病和 Tourette 综合征。
可能与服用含有锂的药物、三环抗抑郁剂和选择性 5-羟色胺再摄取抑制剂有关。
尚未有原发性周期性肢体运动障碍的治疗方法的证据。 传统治疗采用多巴胺激动剂、苯二氮卓和阿片制剂。
睡眠周期性肢体运动表现为反复性肢体运动(多数为腿部运动),主要发生于非快速动眼期睡眠期间。[1]American Academy of Sleep Medicine. International classification of sleep disorders. 3rd ed. Westchester, IL: American Academy of Sleep Medicine; 2014.[2]Garcia-Borreguero D, Ferini-Strambi L, Kohnen R, et al. European guidelines on management of restless legs syndrome: report of a joint task force by the European Federation of Neurological Societies, the European Neurological Society and the European Sleep Research Society. Eur J Neurol. 2012;19:1385-1396.
http://www.ncbi.nlm.nih.gov/pubmed/22937989?tool=bestpractice.com
[3]Zucconi M, Ferri R, Allen R, et al. The official World Association of Sleep Medicine (WASM) standards for recording and scoring periodic leg movements in sleep (PLMS) and wakefulness (PLMW) developed in collaboration with a task force from the International Restless Legs Syndrome Study Group (IRLSSG). Sleep Med. 2006;7:175-183.
http://www.sleep-journal.com/article/PIIS1389945706000049/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/16459136?tool=bestpractice.com
[4]Hornyak M, Feige B, Reimann D, et al. Periodic leg movements in sleep and periodic limb movement disorder: prevalence, clinical significance and treatment. Sleep Med Rev. 2006;10:169-177.
http://www.ncbi.nlm.nih.gov/pubmed/16762807?tool=bestpractice.com
[5]Aurora RN, Kristo DA, Bista SR, et al. The treatment of restless legs syndrome and periodic limb movement disorder in adults-an update for 2012: practice parameters with an evidence-based systematic review and meta-analyses: an American Academy of Sleep Medicine Clinical Practice Guideline. Sleep. 2012;35:1039-1062.
http://www.aasmnet.org/Resources/PracticeParameters/TreatmentRLS.pdf
http://www.ncbi.nlm.nih.gov/pubmed/22851801?tool=bestpractice.com
成人睡眠周期性肢体运动频率 >15 次/小时,可诊断周期性肢体运动障碍(Periodic Limb Movement Disorder, PLMD)。[1]American Academy of Sleep Medicine. International classification of sleep disorders. 3rd ed. Westchester, IL: American Academy of Sleep Medicine; 2014. 周期性肢体运动一定伴有睡眠障碍和日间嗜睡。其与睡眠障碍和日间嗜睡的关联具有争议,然而病因不明。本主题重点介绍成人 PLMD 的诊断和处理。