Abstract Introduction Obstructive Sleep Apnea (OSA) is a common sleep disorder that can be complicated by conditions like Restless Legs Syndrome (RLS) and Periodic Limb Movements in Sleep (PLMS), both of which may hinder adherence to Positive Airway Pressure (PAP) therapy. Poor PAP adherence is associated with increased health risks in OSA patients. This study aims to evaluate the impact of PLMS and RLS on PAP compliance and assess the role of medications in improving PLMS symptoms. Methods This prospective cohort study followed 40 patients with OSA undergoing PAP therapy over a 3-month period. The cohort consisted of 55% males and 45% females, with an average age of 52.4 years. Patients were divided into two groups: 20 patients whose PLMS improved with PAP therapy and 20 patients whose PLMS did not improve. The study objectives included (1) assessing the effect of PLMS on PAP compliance, (2) comparing PAP adherence in patients with improved vs. persistent PLMS, and (3) evaluating the effect of medications on PLMS improvement and PAP adherence. Key variables included the Apnea-Hypopnea Index (AHI), PLMS index, RLS history, medication use, and PAP compliance, defined as using PAP ≥ 4 hours per night on 70% of nights. Statistical analyses, including t-tests and multivariate regression, were conducted to assess associations between PLMS, RLS, AHI, medication, and PAP adherence. Results The overall PAP compliance rate was 75%, with significant differences between groups. Patients whose PLMS improved with PAP therapy demonstrated a compliance rate of 85%, compared to 65% in those whose PLMS did not improve (p 0.05). The mean AHI was 20 events/hour in patients with improved PLMS and 18 events/hour in those with persistent PLMS, showing no significant difference (p = 0.4). Among patients using medications to manage PLMS, those with improved PLMS had a higher compliance rate (90%) compared to those with persistent PLMS despite medication (60%, p 0.05). The RLS history did not significantly impact PAP compliance (p = 0.1). Conclusion Improvement in PLMS signs is associated with significantly higher adherence to PAP therapy in OSA patients, regardless of RLS symptoms. Medications aimed at reducing PLMS may enhance PAP compliance, emphasizing the need for targeted interventions in managing PLMS in OSA patients. This abstract is funded by: None
Jilani et al. (Fri,) studied this question.