Comorbidity features and related factors of restless legs syndrome in patients with obstructive sleep apnea
10.3760/cma.j.cn113661-20250307-00108
- VernacularTitle:阻塞性睡眠呼吸暂停共病不宁腿综合征患者的临床特征及相关因素分析
- Author:
Qin GUO
1
;
Panpan LU
1
;
Hongqiang SUN
1
;
Sifan HU
1
Author Information
1. 北京大学第六医院 北京大学精神卫生研究所 国家卫生健康委员会精神卫生学重点实验室（北京大学）国家精神心理疾病临床医学研究中心（北京大学第六医院），北京100191
- Publication Type:Journal Article
- Keywords:
Sleep apnea, obstructive;
Restless legs syndrome;
Serum phosphorus;
Periodic limb movement during sleep index
- From:
Chinese Journal of Psychiatry
2025;58(8):603-611
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical characteristics and associated factors of comorbid obstructive sleep apnea (OSA) coexisting with restless legs syndrome (RLS).Methods:A retrospective case-control study was conducted, enrolling hospitalized patients diagnosed with OSA or RLS at Peking University Sixth Hospital from June 2015 to May 2023. Participants were divided into three groups: OSA with RLS (comorbid group, n=26), OSA alone ( n=60, RLS-excluding), and RLS alone ( n=45, OSA-excluding). Demographic characteristics, clinical data, laboratory indicators (i.e., hemoglobin, ferritin, serum iron, folate, vitamin B 12, calcium, phosphorus, magnesium, fasting glucose), and polysomnography (PSG) parameters were collected. Group differences were analyzed using ANOVA, chi-square tests, and non-parametric tests. Multivariate logistic regression was performed to identify factors associated with OSA comorbid RLS. Results:Laboratory analyses revealed that patients in the comorbid group had significantly lower hemoglobin ( P=0.046) and ferritin levels ( P=0.024) than the OSA-alone group. Conversely, serum phosphorus was markedly elevated in the comorbid group compared to both control groups ( F=2.23, P<0.01). Polysomnography test found significantly higher periodic limb movement during sleep index (PLMSI) in the comorbid group vs. OSA-alone group (Dunn-Bonferroni correction P=0.001), reduced minimum oxygen saturation in the comorbid group vs. RLS-alone group (Dunn-Bonferroni correction P<0.001), and increased respiratory-related microarousals in the comorbid group vs. RLS-alone group (Dunn-Bonferroni correction P<0.001). Multivariate analysis adjusted for covariates confirmed that periodic limb movement during sleep index (PLMSI) ( OR=1.04, 95% CI=1.02-1.07, P=0.001) and serum phosphorus ( OR=6.51, 95% CI=1.86-27.40, P=0.003) independently contributed to OSA-RLS comorbidity. Conclusion:The coexistence of OSA and RLS manifests as dual dysregulation in iron-phosphorus metabolism and synchronized respiratory-motor dysfunction. Mechanistically, hypoxia-induced systemic inflammation may serve as a nexus linking metabolic perturbations and sleep fragmentation in this clinical subpopulation, highlighting potential biomarkers for targeted management.
