{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T02:43:45Z","timestamp":1784169825739,"version":"3.55.0"},"reference-count":20,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2013,7,1]],"date-time":"2013-07-01T00:00:00Z","timestamp":1372636800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"None reported"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2014,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Positive\u2010airway\u2010pressure (PAP) is a treatment for obstructive\u2010sleep\u2010apnea (OSA). In adults, initiation of PAP\u2010therapy may unmask periodic\u2010limb movements\u2010of\u2010sleep (PLMS). We present a series of children in whom PLMS was aggravated or induced following initiation of PAP therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective analysis was performed on children who had PAP\u2010studies performed over a 3\u2010year period. Children with OSA without significant PLMS on baseline studies and who then showed a periodic\u2010limb\u2010movement\u2010index (PLMI) (&gt;5\/hr) during titration with PAP\u2010therapy were identified. Charts were reviewed for demographics, OSA severity based on apnea hypopnea index (AHI), PLMI, PLM\u2010arousal\u2010index (PLMAI) and pressures titrated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Two hundred fourteen PAP\u2010titration studies (151 on continuous positive airway pressure [CPAP] and 63 on bilevel positive airway pressure [BiPAP]) were done. Eleven (10 on CPAP, 1 on BiPAP) met study criteria. Eight patients were boys. The median age was 12 years (range 6 months\u201318 years). On baseline studies, median AHI was 5\/hr (range 1.5\u201332\/hr), median PLMI was 1\/hr (range 0\u20134\/hr) and median PLMAI 0.3\/Hr (range 0\u20132\/hr). On titration studies, pressures ranged from 4 to 14\u2009cm of water, median AHI was 0.5\/hr (range 0\u20131), median PLMI was 12\/hr (range 5\u201355\/hr) and median PLMAI 9\/hr (range 0\u201325). PLMS were seen predominantly during N1, N2 sleep and on PAP of &gt;7\u2009cm of water. One patient had resolution of PLMS at 1\u2010year follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>PLMS were seen in 5.1% of children after initiation of PAP. OSA may mask PLMS, which appears as breathing improves. Alternatively, PAP may unmask or induce PLMS. PLMS may potentially be a cause of treatment failure in children on recent\u2010onset PAP therapy. <jats:bold>Pediatr Pulmonol. 2014; 49:252\u2013256.<\/jats:bold> \u00a9 2013 Wiley Periodicals, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ppul.22802","type":"journal-article","created":{"date-parts":[[2013,7,1]],"date-time":"2013-07-01T19:03:56Z","timestamp":1372705436000},"page":"252-256","source":"Crossref","is-referenced-by-count":9,"title":["Prevalence of pediatric periodic leg movements of sleep after initiation of PAP therapy"],"prefix":"10.1002","volume":"49","author":[{"given":"Vidya","family":"Pai","sequence":"first","affiliation":[{"name":"Department of Neurology Boston Children's Hospital, Harvard Medical School Boston Massachusetts"},{"name":"Center for Pediatric Sleep Disorders Boston Children's Hospital, Harvard Medical School Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Umakanth","family":"Khatwa","sequence":"additional","affiliation":[{"name":"Center for Pediatric Sleep Disorders Boston Children's Hospital, Harvard Medical School Boston Massachusetts"},{"name":"Division of Respiratory Diseases, Department of Medicine Center for Pediatric Sleep Disorders, Boston Children's Hospital, Harvard Medical School Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sriram","family":"Ramgopal","sequence":"additional","affiliation":[{"name":"Department of Neurology Boston Children's Hospital, Harvard Medical School Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kanwaljit","family":"Singh","sequence":"additional","affiliation":[{"name":"Lurie Center Massachusetts General Hospital for Children Boston 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