Association Between Periodic Limb Movement and Sarcopenia: Insights From Polysomnography and Bioelectrical Impedance Analysis

Objectives: Sarcopenia, characterized by loss of skeletal muscle mass and function, is a growing health issue, especially in the elderly. Sleep disorders have recently been implicated as potential contributors to its development. This study investigated the association between Periodic Limb Movements during Sleep (PLMS) and sarcopenia using polysomnography (PSG) and bioelectrical impedance analysis (BIA). Methods: We analyzed the data of 663 patients (404 males and 259 females) who underwent type I PSG and BIA at Samsung Medical Center from January 2019 to May 2024. PLMS was defined as a periodic limb movement index (PLMI) of ≥15/h. Sarcopenia was defined based on skeletal muscle index (SMI) cutoffs of <7 kg/m2 for males and <5.7 kg/m2 for females. Statistical analyses included chi-squared tests, Fisher’s exact tests, t-tests, and Wilcoxon rank-sum tests using R version 4.3.1. Results: PLMI of ≥15/h was observed in 204 males and 126 females. Among males, those with PLMS had significantly lower SMI (8.02±0.66 kg/m2 vs. 8.19±0.68 kg/m2) and fat-free mass index (18.90±1.48 kg/m2 vs. 19.31±1.51 kg/m2). In contrast, females with PLMS showed higher muscle mass percentage (37.97%±1.10% vs. 36.89%±3.66%). Sarcopenia prevalence was higher in males with PLMS (6.86%) compared to those without (2.00%), with no significant difference in females. After adjusting for age, exercise, and alcohol consumption, PLMI ≥15/h remained an independent risk factor for sarcopenia in males (adjusted prevalence ratio: 5.808; 95% confidence interval, 1.338–25.215). Conclusions: PLMS is independently associated with sarcopenia in males, suggesting the need to assess sleep disorders in sarcopenia management.