The New WASM rules for Respiratory-Related Leg Movements lack clinical or polysomnographic validation

The new World Association of Sleep Medicine (WASM) rules allow movements that start up to 10.25 seconds after a sleep disordered breathing event to be counted as respiratory-related leg movements (1). There are two problems with this approach: (A) First, it is not clear that these movements are leg movements rather than generalized body movements, during which the legs have become activated as part of generalized body movement. A video validation that these are truly leg movements ought to be considered; (B) Second it makes no sense that there would be respiratory-related leg movements that occur up to 10.25 seconds after a respiratory event without some intervening hyperventilation or EEG arousal.

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