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Replicability of Psychometric Differences
Between Obstructive Sleep Apnea, Primary
Snoring, And Periodic Limb Movement Disorder
James E. Aikens, Ph.D., Wallace B. Mendelson, M.D., and Erin K. Baehr, M.A.
We previously documented that periodic limb movement disorder (PLMD) patients report
more psychopathological symptoms on the MMPI than obstructive sleep apnea (OSA)
patients, who in turn report more symptoms than primary snorers (PS). The purpose of
this study was to replicate and extend these findings on an independent patient sample
using an alternative measure, the Symptom Checklist 90 - Revised (SCL-90-R). Of 109
consecutive diagnostic polysomnography (PSG) referrals to a Sleep Disorders Clinic, we
studied every patient with PLMD (n=11, 6 males and 5 females; mean age = 55 years).
Two comparison groups were developed by randomly selecting one OSA and one PS
patient from those matching PLMD subjects on gender and age. Subjects completed the
SCL-90-R before undergoing sleep interview, physical examination, 12-channel
diagnostic PSG, and daytime MSLT. Analysis of covariance indicated that, even after
controlling for MSLT latency, the SCL-90-R General Severity Index was significantly
higher (and more likely to be elevated) in the PLMD subjects than in OSA or PS subjects.
PLMDs also scored significantly higher than both of the other groups on the Obsessive-Compulsive,
Interpersonal Sensitivity, and Depression scales. Corresponding differences
emerged in the prevalence of elevated SCL-90-R scores; elevation was 1.7 to 3.6 times
more likely in PLMD than in OSA and PS. We conclude that irrespective of daytime
sleepiness, patients with PLMD are more likely than those with PS or OSA to experience
obsessionality, compulsivity, concentration difficulties, dysphoria, fatigue, low motivation,
and interpersonal oversensitivity. Thus, the relative ranking of psychopathology
symptoms previously observed in patients with PLMD, OSA, and primary snoring was
replicated across different samples and measures. (Sleep and Hypnosis 1999;4:212-216)
| Keywords: sleep apnea, snoring, periodic leg movement disorder, psychological distress. |
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