Fragmentary myoclonus in sleep revisited: A polysomnographic study in 62 patients

Study objectives: To investigate the frequency of fragmentary myoclonus (FM) in a sleep-disorder population, to analyze its distribution across sleep stages and to examine potential associations with clinical correlates and night-to-night variability. Design: Retrospective review of 102 polysomnographic records. Setting: Sleep laboratory at a University Hospital Neurology Department. Patients: Sixty-two sleep-disorder patients. Interventions: None. Measurements and results: Fragmentary myoclonus (FM) was counted according to published criteria. Sleep stage specific FM indices (FMI) were calculated for each patient. Median FMI was 39.5/h sleep. FMI was the highest in REM sleep, followed by similar indices in wakefulness, Si and S2 sleep, and was the lowest in S3/S4 sleep (n.s.). FMI increased with age (rho = 0.350, P = 0.005). Men had a higher FMI than women (median 55.8/h vs. 24.1/h, P = 0.042). In addition, FMI was positively correlated with the presence of sleep-related breathing disorders (rho = 0.270, P = 0.036), respiratory indices (apnea-hypopnea index: rho = 0.403, P = 0.002; oxygen desaturation index: rho = 0.378, P = 0.004) and body mass index (rho = 0.28, P = 0.028). In a linear regression model, age, male sex and oxygen desaturation index were significant (P < 0.05). FMI night-to-night variability was 1.6 (range: 1.0-3.9). Conclusion: Fragmentary myoclonus was present in every patient of this sleep-disorder population. Its clinical significance is unknown, but the association with oxygen desaturation index points to an association with sleep-related breathing disorders. Since FMI was similar during wakefulness and light sleep, these data challenge the concept of a primarily sleep-related phenomenon. (C) 2011 Elsevier B.V. All rights reserved.