The prevalence and significance of periodic leg movements during sleep in patients with congestive heart failure

The aim of this study was to evaluate (1) the prevalence of periodic leg movements during sleep (PLMs) in a consecutive sample of congestive heart failure (CHF) outpatients; (2) the presence of correlation between PLMs, subjective daytime sleepiness, and sleep architecture; and (3) the heart rate response to PLMs in CHF.Seventy-nine [50 men, age 59 +/- 11 years, body mass index (BMI) 26 +/- 5 kg/m(2)] consecutive adult stable outpatients with CHF [left ventricular ejection fraction (LVEF) 36 +/- 6%] were prospectively evaluated. the patients underwent assessment of echocardiography, sleepiness (Epworth Scale), and overnight in-lab polysomnography.Fifteen patients (19%) had PLM index > 5. These subjects were similar in sex distribution, BMI, subjective somnolence, LVEF, and apnea-hypopnea index (AHI), but were significantly older than subjects without PLMs. Sleep architecture was similar in subjects with and without PLMs. There was a small but significant elevation of heart rate after PLMs (80.1 +/- 9.4 vs. 81.5 +/- 9.2; p < 0.001). the cardiac acceleration was also present in absence of electroencephalogram activation.The prevalence of PLMs in consecutive sample of adult CHF outpatients was 19%. There were no differences in subjective daytime sleepiness, sleep architecture, AHI, and severity of CHF in subjects with and without PLMs. PLMs caused a small but statistically significant cardiac acceleration.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Univ Saskatchewan, Saskatoon, SK, CanadaUniversidade Federal de São Paulo, Dept Psychobiol, Discipline Med & Biol Sleep, BR-04004040 São Paulo, BrazilUniv São Paulo, Dept Neurol, São Paulo, BrazilUniv São Paulo, Heart Inst InCor, Div Pulm, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Psychobiol, Discipline Med & Biol Sleep, BR-04004040 São Paulo, BrazilWeb of Scienc