{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T17:57:16Z","timestamp":1792691836883,"version":"4.5.0"},"reference-count":67,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2024,2,6]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Obstructive sleep apnea is a well\u2010established risk factor for cardiovascular disease (CVD). Recent studies have also linked periodic limb movements during sleep to CVD. We aimed to determine whether periodic limb movements during sleep and obstructive sleep apnea are independent or synergistic factors for CVD events or death.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">We examined data from 1049 US veterans with an apnea\u2010hypopnea index (AHI) &lt;30 events\/hour. The primary outcome was incident CVD or death. Cox proportional hazards regression assessed the relationships between the AHI, periodic limb movement index (PLMI), and the AHI\u00d7PLMI interaction with the primary outcome. We then examined whether AHI and PLMI were associated with primary outcome after adjustment for age, sex, race and ethnicity, obesity, baseline risk of mortality, and Charlson Comorbidity Index. During a median follow\u2010up of 5.1\u2009years, 237 of 1049 participants developed incident CVD or died. Unadjusted analyses showed an increased risk of the primary outcome with every 10\u2010event\/hour increase in PLMI (hazard ratio [HR], 1.08 [95% CI, 1.05\u20131.13]) and AHI (HR, 1.17 [95% CI, 1.01\u2013 1.37]). Assessment associations of AHI and PLMI and their interaction with the primary outcome revealed no significant interaction between PLMI and AHI. In fully adjusted analyses, PLMI, but not AHI, was associated with an increased risk of primary outcome: HR of 1.05 (95% CI, 1.00\u20131.09) per every 10 events\/hour. Results were similar after adjusting with Framingham risk score.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Our study revealed periodic limb movements during sleep as a risk factor for incident CVD or death among those who had AHI &lt;30 events\/hour, without synergistic association between periodic limb movements during sleep and obstructive sleep apnea.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.123.031630","type":"journal-article","created":{"date-parts":[[2024,1,19]],"date-time":"2024-01-19T11:41:24Z","timestamp":1705664484000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":20,"title":["Association of Periodic Limb Movements and Obstructive Sleep Apnea With Risk of Cardiovascular Disease and Mortality"],"prefix":"10.1161","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0488-9778","authenticated-orcid":false,"given":"Andrey","family":"Zinchuk","sequence":"first","affiliation":[{"name":"Section of Pulmonary, Critical Care and Sleep Medicine Yale University School of Medicine New Haven CT USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6945-329X","authenticated-orcid":false,"given":"Narat","family":"Srivali","sequence":"additional","affiliation":[{"name":"Section of Pulmonary, Critical Care and Sleep Medicine Yale University School of Medicine New Haven CT USA"},{"name":"Center for Outcomes Research and Evaluation Yale University School of Medicine New Haven CT USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7030-5251","authenticated-orcid":false,"given":"Li","family":"Qin","sequence":"additional","affiliation":[{"name":"Division of Acute Care\/Health Systems Yale School of Nursing, Yale University New Haven CT USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2855-2053","authenticated-orcid":false,"given":"Sangchoon","family":"Jeon","sequence":"additional","affiliation":[{"name":"Brigham and Women\u2019s Hospital Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-4769-5944","authenticated-orcid":false,"given":"Ahmad","family":"Ibrahim","sequence":"additional","affiliation":[{"name":"Section of Pulmonary, Critical Care and Sleep Medicine Yale University School of Medicine New Haven CT USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3752-0328","authenticated-orcid":false,"given":"Scott A.","family":"Sands","sequence":"additional","affiliation":[{"name":"Harvard Medical School Boston MA USA"},{"name":"Department of Neurology Yale University New Haven CT USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0166-5074","authenticated-orcid":false,"given":"Brian","family":"Koo","sequence":"additional","affiliation":[{"name":"Clinial Epidemiology Research Center VA CT Health Care System West Haven CT USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9888-2480","authenticated-orcid":false,"given":"Henry K.","family":"Yaggi","sequence":"additional","affiliation":[{"name":"Section of Pulmonary, Critical Care and Sleep Medicine Yale University School of Medicine New Haven CT USA"},{"name":"Clinial Epidemiology Research Center Connecticut Department of Veterans Affairs West Haven CT USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpcardiol.2005.07.002"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.109.901801"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200911-1746OC"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa043104"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200509-1442OC"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.111.038968"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/zsx023"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000259036.89411.52"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinph.2007.05.006"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kws342"},{"key":"e_1_3_1_12_2","first-page":"1221","article-title":"Periodic limb movements during sleep: population prevalence, clinical correlates, and racial differences","volume":"31","author":"Scofield H","year":"2008","unstructured":"Scofield H, Roth T, Drake C. 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