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Res."],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>This study aimed to investigate autonomic alterations associated with periodic limb movements during sleep (PLMS) by comparing linear and non-linear heart rate variability (HRV) parameters across whole-night recordings and stage N2 non-rapid eye movement (NREM) sleep (N2).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>From 8082 polysomnographic (PSG) recordings, we identified 21 patients with PLMS and 28 age- and sex-matched controls. Linear and non-linear HRV indices were analyzed for whole-night recordings and the longest N2 segment. Periodic limb movement (PLM) indices and arousal-related parameters were also evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Compared with controls, patients with PLMS showed significantly higher standard deviation of normal-to-normal intervals (SDNN) and root mean square of successive differences (RMSSD), increased low-frequency (LF) power, and reduced approximate entropy (ApEn) and sample entropy (SampEn) across the whole night, together with a lower Stress Index (SI). No significant group differences were observed in high-frequency (HF) power or in the composite sympathetic\/parasympathetic nervous system (SNS\/PNS) indices. During stage N2, the PLM group exhibited significantly greater SDNN, Poincar\u00e9 plot long-axis standard deviation (SD2), detrended fluctuation analysis alpha-1 exponent (DFA \u03b11), and very-low-frequency (VLF) power, along with lower ApEn values. A significant increase in the SD2\/SD1 ratio was also observed specifically during N2, whereas the LF\/HF ratio showed only a non-significant upward trend. PLMS counts, indices, and arousal-related parameters were markedly elevated during stage N2.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>PLMS are characterized by increased autonomic variability (SDNN, SD2, DFA \u03b11) but reduced complexity (ApEn, SampEn), particularly during stage N2. Stage-specific HRV assessment may provide novel insights into the cardiovascular implications of PLMS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10286-025-01184-y","type":"journal-article","created":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T09:17:52Z","timestamp":1768295872000},"page":"213-221","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Autonomic characteristics of periodic limb movements: comparison of whole-night and stage N2 linear and non-linear heart rate variability"],"prefix":"10.1007","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1950-9141","authenticated-orcid":false,"given":"Elif Simin","family":"Iss\u0131","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Selahattin","family":"Ayas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elif G\u00f6ksu","family":"Yi\u011fit Tekkanat","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,1,13]]},"reference":[{"issue":"5","key":"1184_CR1","doi-asserted-by":"publisher","first-page":"589","DOI":"10.1093\/sleep\/32.5.589","volume":"32","author":"AS Walters","year":"2009","unstructured":"Walters AS, Rye DB (2009) Review of the relationship of restless legs syndrome and periodic limb movements in sleep to hypertension, heart disease, and stroke. 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