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The cyclic alternating pattern plays a gate-control on periodic limb movements during non-rapid eye movement sleep.
- Source :
-
Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society [J Clin Neurophysiol] 1996 Jul; Vol. 13 (4), pp. 314-23. - Publication Year :
- 1996
-
Abstract
- Periodic limb movements in sleep (PLMS) is a disorder characterized by a cyclic pattern of motor phenomena and EEG changes (mostly arousals), both recurring at approximately 20- to 40-s intervals. The periodicity of the PLMS phenomena recalls the physiological EEG arousal rhythm of non-rapid eye movement (NREM) sleep known as the cyclic alternating pattern (CAP). During CAP, arousals and arousal-equivalent features do not appear as isolated events but periodically intrude (phase A) between intervals of background EEG activity (phase B). Though the A phases can be expressed by a variety of EEG patterns, each with a different arousal impact on polygraphic parameters, overall CAP is a sequence of biphasic cycles reflecting a condition of unstable sleep. Twelve middle-aged PLMS subjects complaining of poor sleep were polygraphically compared with 12 age-matched and gender-matched healthy volunteers (controls). With respect to controls, the PLMS recordings showed an enhancement of the more powerful arousals and presented significantly increased amounts of CAP time (+45 min) and CAP rate (+15%). Of all the jerks detected in NREM sleep, 92% occurred in CAP, with the great majority of limb movements (96%) associated with phase A. Ninety-four percent of the nocturnal jerks coupled with phase A started jointly with the onset of the phase or when the latter had already begun. In particular, most of the myoclonic events (67%) occurred in the first 2.5 s of the A phase. The CAP cycles coupled with periodic movements were significantly longer than those without motor events (+6.4 s). Compared to the American Sleep Disorders Association's rules for scoring EEG arousals, the CAP framework offers a more extensive insight into PLMS. In effect, the present study indicates an entrainment of nocturnal myoclonus by means of CAP and sheds light on the complex interactions between arousal mechanisms and motor phenomena during sleep.
- Subjects :
- Adult
Cerebral Cortex physiopathology
Female
Humans
Male
Middle Aged
Motor Neurons physiology
Muscle, Skeletal innervation
Periodicity
Reference Values
Restless Legs Syndrome diagnosis
Sleep Initiation and Maintenance Disorders diagnosis
Sleep Initiation and Maintenance Disorders physiopathology
Arousal physiology
Polysomnography instrumentation
Restless Legs Syndrome physiopathology
Signal Processing, Computer-Assisted instrumentation
Subjects
Details
- Language :
- English
- ISSN :
- 0736-0258
- Volume :
- 13
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society
- Publication Type :
- Academic Journal
- Accession number :
- 8858493
- Full Text :
- https://doi.org/10.1097/00004691-199607000-00005