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Nocturnal blood pressure changes in patients with restless legs syndrome

From the Sleep Disorders Center (M.H.P., J.M., G.L., P.A.L.) and Cardiology Division (P.A.L.), Sacré-Cur Hospital, and Departments of Psychology (M.H.P.), Psychiatry (J.M.), and Medicine (P.A.L.), and Faculty of Dentistry (G.L.), University of Montreal, Canada; and Department of Bioengineering (R.C.), Salvatore Maugeri Foundation, Veruno, Italy.

Address correspondence and reprint requests to Dr. Paola A. Lanfranchi, Centre de Recherche 3K, Hôpital du Sacré-Cur de Montréal, 5400 Boul. Gouin Ouest, Montréal, Québec, H4J 1C5 Canada; e-mail: Paola.Lanfranchi{at}umontreal.ca

Objectives: To assess heart rate (HR) and blood pressure (BP) changes associated with periodic leg movements during sleep (PLMS) with or without EEG signs of arousal in subjects with primary restless legs syndrome (RLS).

Methods: Ten patients with RLS (4 women, aged 47.3 ± 13.5 years) underwent one night of polysomnography along with noninvasive beat-to-beat BP monitoring. Ten PLMS with microarousals (PLMS-MA) and 10 PLMS without microarousals (PLMS-noMA) were analyzed in each subject. Systolic and diastolic BP (SBP, DBP) were measured within a 25-beat temporal window comprising 10 beats before and 15 beats after onset of each movement. PLMS-related BP changes were assessed by repeated measures one-way analysis of variance. BP changes associated with PLMS-MA and PLMS-noMA were compared by paired t-tests. Pearson correlation coefficients were used to assess the relationship between cardiovascular changes and clinical and polysomnographic variables.

Results: BP increased significantly in association with all PLMS (on average, SBP 22 mm Hg, DBP 11 mm Hg). BP changes associated with PLMS-MA were greater vs those associated with PLMS-noMA (p < 0.05). SBP and DBP changes increased with age and the duration of illness.

Conclusions: Periodic leg movements–related repetitive nocturnal blood pressure fluctuations could contribute to the risk of cardiovascular diseases in patients with restless legs syndrome, especially in the elderly.

Supported by the Fonds de la Recherche en Santé du Québec (Studentship to M.H. Pennestri and Scholarship to P.A. Lanfranchi), the Canadian Institutes of Health Research (grants to P.A Lanfranchi and J. Montplaisir), and the Heart and Stroke Foundation of Québec (operating grant to P.A. Lanfranchi).

Disclosure: The authors report no conflicts of interest.

Received September 6, 2006. Accepted in final form December 10, 2006.

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