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Retrospective analysis of risk factors for periodic limb movements in a large cohort of insomnia and chronic fatigue patients

(2020) PHARMACOPSYCHIATRY. 53(2). p.71-77
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Abstract
Introduction Although the pathophysiology of periodic limb movements in sleep (PLMS) is not well understood, there is increasing belief that management of PLMS can modulate humans' general health. The aim of this study is to investigate the associations between risk factors including the use of antidepressants, hypnotics, and antihistamines as well as of caffeine, alcohol, and nicotine and the occurrence of PLMS and periodic limb movement disorder (PLMD). Methods Patients with either chronic fatigue or insomnia who underwent polysomnography as standardized clinical assessment were included in a retrospective study. Associations were calculated between substance use and sleep variables. Results Tricyclic antidepressants and serotonin and norepinephrine reuptake inhibitor (SNRI) are significantly associated with higher rates of PLMS. Additionally, SNRI is significantly positive associated with PLMD, as also seen for selective serotonin reuptake inhibitors (SSRI). The most frequently used SSRI escitalopram was significantly positively associated with PLMS and PLMD. A significantly negative association was found between paroxetine and PLMS. Benzodiazepines are negatively associated with PLMS and PLMD. Sedative antidepressants, antihistamines, and substance use are not associated with PLMS nor PLMD in this study. Discussion This retrospective study adds supportive evidence to the association of drug classes with PLMS and PLMD. These findings may impact on clinical management of patients with a combined anxiety or mood disorder in need for these drug classes on the one hand and a significant sleep architecture disturbance through PLMS, potentially contributing to daytime symptoms, on the other hand.
Keywords
periodic limb movements, antidepressant, benzodiazepine, restless legs, RESTLESS LEGS SYNDROME, SLEEP, ANTIDEPRESSANTS, PREVALENCE, DISORDER

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MLA
Tobback, Els, et al. “Retrospective Analysis of Risk Factors for Periodic Limb Movements in a Large Cohort of Insomnia and Chronic Fatigue Patients.” PHARMACOPSYCHIATRY, vol. 53, no. 2, 2020, pp. 71–77, doi:10.1055/a-0991-0498.
APA
Tobback, E., Desmet, O., Hanoulle, I., Delesie, L., Pevernagie, D., Vogelaers, D., & Mariman, A. (2020). Retrospective analysis of risk factors for periodic limb movements in a large cohort of insomnia and chronic fatigue patients. PHARMACOPSYCHIATRY, 53(2), 71–77. https://doi.org/10.1055/a-0991-0498
Chicago author-date
Tobback, Els, Olivier Desmet, Ignace Hanoulle, Liesbeth Delesie, Dirk Pevernagie, Dirk Vogelaers, and An Mariman. 2020. “Retrospective Analysis of Risk Factors for Periodic Limb Movements in a Large Cohort of Insomnia and Chronic Fatigue Patients.” PHARMACOPSYCHIATRY 53 (2): 71–77. https://doi.org/10.1055/a-0991-0498.
Chicago author-date (all authors)
Tobback, Els, Olivier Desmet, Ignace Hanoulle, Liesbeth Delesie, Dirk Pevernagie, Dirk Vogelaers, and An Mariman. 2020. “Retrospective Analysis of Risk Factors for Periodic Limb Movements in a Large Cohort of Insomnia and Chronic Fatigue Patients.” PHARMACOPSYCHIATRY 53 (2): 71–77. doi:10.1055/a-0991-0498.
Vancouver
1.
Tobback E, Desmet O, Hanoulle I, Delesie L, Pevernagie D, Vogelaers D, et al. Retrospective analysis of risk factors for periodic limb movements in a large cohort of insomnia and chronic fatigue patients. PHARMACOPSYCHIATRY. 2020;53(2):71–7.
IEEE
[1]
E. Tobback et al., “Retrospective analysis of risk factors for periodic limb movements in a large cohort of insomnia and chronic fatigue patients,” PHARMACOPSYCHIATRY, vol. 53, no. 2, pp. 71–77, 2020.
@article{8656243,
  abstract     = {{Introduction Although the pathophysiology of periodic limb movements in sleep (PLMS) is not well understood, there is increasing belief that management of PLMS can modulate humans' general health. The aim of this study is to investigate the associations between risk factors including the use of antidepressants, hypnotics, and antihistamines as well as of caffeine, alcohol, and nicotine and the occurrence of PLMS and periodic limb movement disorder (PLMD).

Methods Patients with either chronic fatigue or insomnia who underwent polysomnography as standardized clinical assessment were included in a retrospective study. Associations were calculated between substance use and sleep variables.

Results Tricyclic antidepressants and serotonin and norepinephrine reuptake inhibitor (SNRI) are significantly associated with higher rates of PLMS. Additionally, SNRI is significantly positive associated with PLMD, as also seen for selective serotonin reuptake inhibitors (SSRI). The most frequently used SSRI escitalopram was significantly positively associated with PLMS and PLMD. A significantly negative association was found between paroxetine and PLMS. Benzodiazepines are negatively associated with PLMS and PLMD. Sedative antidepressants, antihistamines, and substance use are not associated with PLMS nor PLMD in this study.

Discussion This retrospective study adds supportive evidence to the association of drug classes with PLMS and PLMD. These findings may impact on clinical management of patients with a combined anxiety or mood disorder in need for these drug classes on the one hand and a significant sleep architecture disturbance through PLMS, potentially contributing to daytime symptoms, on the other hand.}},
  author       = {{Tobback, Els and Desmet, Olivier and Hanoulle, Ignace and Delesie, Liesbeth and Pevernagie, Dirk and Vogelaers, Dirk and Mariman, An}},
  issn         = {{0176-3679}},
  journal      = {{PHARMACOPSYCHIATRY}},
  keywords     = {{periodic limb movements,antidepressant,benzodiazepine,restless legs,RESTLESS LEGS SYNDROME,SLEEP,ANTIDEPRESSANTS,PREVALENCE,DISORDER}},
  language     = {{eng}},
  number       = {{2}},
  pages        = {{71--77}},
  title        = {{Retrospective analysis of risk factors for periodic limb movements in a large cohort of insomnia and chronic fatigue patients}},
  url          = {{http://doi.org/10.1055/a-0991-0498}},
  volume       = {{53}},
  year         = {{2020}},
}

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