Obstructive sleep apnoea: periodic limb movements during sleep tied to elevated systolic BP

Takeaway

• In patients with obstructive sleep apnoea (OSA), periodic limb movements during sleep (PLMS), at least with a frequency of ≥25 events per hour, is associated with an increased systolic blood pressure (SBP).

Why this matters

• Findings concerning the outcomes of the association between PLMS and OSA have shown inconsistent results regarding the sleepiness or cardiovascular complications.

Study design

• Cross-sectional study included 1487 patients with OSA recruited in the European Sleep Apnoea Database (ESADA) study.
• All patients were divided into 2 groups:
  • patients with significant PLMS (frequency of ≥25 events per hour; group 1; n=132) and
  • patients without significant PLMS Index (PLMSI frequency of <25 events per hour; group 2; n=1355).
• Funding: European Union COST Action B26 and others.

Key results

• In the univariate analysis, SBP was significantly higher in patients with OSA and significant PLMS vs those without significant PLMSI (135.7, mean standard deviation [SD]17.70] mmHg vs 130.90, SD 14.64] mmHg: P<.001).
• After adjustment for confounders, increase in SBP (+2.64 mmHg; P=.044) remained significant in patients with OSA and significant PLMS vs those without significant PLMSI.
• No significant increment was observed in diastolic BP (0.99 mmHg; P=.310) and pulse pressure (1.64 mmHg; P=.119) between patients with OSA and significant PLMS vs those without significant PLMSI.

Limitations

• Study did not evaluate causal link between PLMS and BP elevation.
• Risk of bias.