Exploring sex differences in periodic leg movements during sleep across the lifespan of patients with restless legs syndrome

• Published in: Sleep medicine 2024-10, Vol.122, p.253-257
• Main Authors: Mogavero, Maria P., Lanza, Giuseppe, DelRosso, Lourdes M., Lanuzza, Bartolo, Bruni, Oliviero, Ferini Strambi, Luigi, Ferri, Raffaele
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Age Factors; Aged; Aged, 80 and over; Child; Child, Preschool; Female; Hormones; Humans; Lifespan; Male; Middle Aged; Nocturnal Myoclonus Syndrome - epidemiology; Nocturnal Myoclonus Syndrome - physiopathology; Periodic leg movements during sleep; Polysomnography; Restless legs syndrome; Restless Legs Syndrome - epidemiology; Restless Legs Syndrome - physiopathology; Retrospective Studies; Sex differences; Sex Factors; Sleep - physiology; Young Adult
• ISSN: 1389-9457; 1878-5506; 1878-5506
• DOI: 10.1016/j.sleep.2024.08.023

Restless legs syndrome (RLS) and periodic leg movements during sleep (PLMS) are prevalent sleep disorders with significant implications for health and well-being. While previous research has highlighted sex-related disparities in RLS and PLMS prevalence, comprehensive understanding of these differences across the lifespan remains limited. This study aims to explore sex differences in RLS and PLMS across diverse age groups, spanning ages 2 to over 80 years, and to investigate the underlying mechanisms influenced by sex hormones. A retrospective analysis was conducted on drug-free patients diagnosed with RLS, including 95 females (age range: 2–83.2 years) and 89 males (age range: 2–79.5 years). Polysomnographic recordings were analyzed to assess leg movement activity, including PLMS index and Periodicity index. A more rapid increase in PLMS index was observed in women starting before age 10, plateauing lower than men until around age 55. An increase in women occurred after 55, lasting over a decade, while in men, PLMS index continued to rise after 75. Conversely, Periodicity index displayed a simpler pattern, increasing progressively from prepuberty to around 35 in males and 45–50 in females. Females maintained a slightly higher Periodicity index than males for over a decade after this age. These findings underscore the complex interplay between sex hormones, age, and sleep disorders, highlighting the need for tailored approaches to diagnosis and management across diverse demographic cohorts. Further research is warranted to elucidate the underlying mechanisms and develop targeted interventions to optimize sleep health outcomes. •PLMS increases with age in both sexes but plateaus earlier in women.•Women over 50 show increased PLMS periodicity, unlike men.•Sex hormones, particularly estrogen, influence sleep motor activity.•Study highlights need for personalized RLS and PLMS management by sex and age.