Sleep disorders in older adults

Sleep pattern changes are considered normal as individuals age. However, changes in sleep patterns can ultimately affect the quality of life of many older adults. In addition, many sleep conditions are associated with an increase in morbidity and mortality. It is essential for clinicians to recognize sleep changes to lead to appropriate treatment. This article will focus on the assessment and interventions of sleep disorders in older adults.

Heredity of restless legs syndrome in a pregnant population

OBJECTIVE

To synthesize published research on genetic and heredity findings related to restless legs syndrome (RLS) in a pregnant population.

DATA SOURCES

PubMed, CINAHL, and PsycINFO databases and reference lists from published articles.

STUDY SELECTION

Literature searches were conducted for primary research studies published in English on the genetic and heredity findings of RLS in pregnant populations.

DATA EXTRACTION

Study characteristics and findings related to genetic and heredity aspects of RLS in a pregnant population.

DATA SYNTHESIS

Five data-based articles met the criteria for study inclusion. Study findings comprised Level-2 and Level-3 evidence. Four of the five studies were larger population studies and contained a subset of pregnant participants. Parity and family history were important predictors of RLS proband status. Probands reported symptoms were often initiated during or after pregnancy.

CONCLUSIONS

Symptoms of RLS for female probands are often initiated during pregnancy or after childbirth. A history of RLS in a previous pregnancy and family history of RLS were strong predictors of RLS in the current pregnancy. Future research on genetic associations of RLS in pregnancy is warranted.

Frequent periodic leg movement during sleep is an unrecognized risk factor for progression of atrial fibrillation

Sleep apnea has been recognized as a factor predisposing to atrial fibrillation recurrence and progression. The effect of other sleep-disturbing conditions on atrial fibrillation progression is not known. We sought to determine whether frequent periodic leg movement during sleep is a risk factor for progression of atrial fibrillation. In this retrospective study, patients with atrial fibrillation and a clinical suspicion of restless legs syndrome who were referred for polysomnography were divided into two groups based on severity of periodic leg movement during sleep: frequent (periodic movement index >35/h) and infrequent (≤35/h). Progression of atrial fibrillation to persistent or permanent forms between the two groups was compared using Wilcoxon rank-sum test, chi-square tests and logistic regression analysis. Of 373 patients with atrial fibrillation (77% paroxysmal, 23% persistent), 108 (29%) progressed to persistent or permanent atrial fibrillation during follow-up (median, 33 months; interquartile range, 16-50). Compared to patients with infrequent periodic leg movement during sleep (n=168), patients with frequent periodic leg movement during sleep (n=205) had a higher rate of atrial fibrillation progression (23% vs. 34%; p=0.01). Patients with frequent periodic leg movement during sleep were older and predominantly male; however, there were no significant differences at baseline in clinical factors that promote atrial fibrillation progression between both groups. On multivariate analysis, independent predictors of atrial fibrillation progression were persistent atrial fibrillation at baseline, female gender, hypertension and frequent periodic leg movement during sleep. In patients with frequent periodic leg movement during sleep, dopaminergic therapy for control of leg movements in patients with restless legs syndrome reduced risk of atrial fibrillation progression. Frequent leg movement during sleep in patients with restless legs syndrome is associated with progression of atrial fibrillation to persistent and permanent forms.

Presenting symptoms in pediatric restless legs syndrome patients

OBJECTIVE

The diagnosis restless legs syndrome (RLS) in children depends on the history told by the child and his parents. The description of symptoms given by the child himor herself is most important. Additional criteria are, among others, the results of polysomnography (PSG). Description of the presenting symptoms is the aim of the study.

METHODS

Survey in two European pediatric sleep centers of presenting symptoms in children who after a detailed work-up proved to have RLS.

RESULTS

Fifty-two percent of the 31 children presented with symptoms similar to those mentioned in the "four questions" relevant for the diagnosis of RLS. In the other patients the description included often very colourful wordings, such as "ants or spiders in the legs, legs want to kick, need to stretch." All children were tired or sleepy during daytime and nearly all reported an urge to move. Insomnia was mentioned by 61% of the patients. The presenting symptoms did not differ significantly from those mentioned in a previous study in the US, but did so when compared to adults with RLS. PSG revealed an abnormal periodic limb movement index in 81% of the children.

CONCLUSIONS

The description of presenting symptoms in children with the final diagnosis of RLS differs from that in adults. The results of this European study corroborate those from the US.

Restless legs syndrome in an appalachian primary care population: prevalence, demographic and lifestyle correlates, and burden

BACKGROUND

Restless legs syndrome (RLS) is a common and distressing sensorimotor disorder of unknown etiology. While the epidemiology of RLS has been examined in several North American and European studies, research on RLS and RLS burden in poor, rural populations, including those residing in Appalachia, remains sparse. In this study, we investigated RLS prevalence in an Appalachian primary care population and examined the association of RLS to demographic factors, lifestyle characteristics, sleep quality, and mood disorders.

METHODS

Participants of this anonymous survey study were community-dwelling adults aged ≥ 18 years visiting one of 4 West Virginia primary care clinics. Data gathered included detailed information on sleep patterns, demographic characteristics, lifestyle factors, and health/medical history; the survey also included questions specific to RLS diagnosis and severity. Response rates were excellent, with 68% of eligible adults contacted returning completed surveys (N = 1,424/2,087). Pregnant women (N = 65) and those with missing data on key variables (N = 142) were excluded from the analyses.

RESULTS

Of the 1,217 participants included in the final analytic sample, 19.6% (18.2% with symptoms at least once/month) met the 4 IRLSSG diagnostic criteria in the absence of positional discomfort or leg cramps; 14.5% reported RLS symptoms at least once/week and 10.1% indicated symptoms ≥ 3×/week. Excluding respondents with diabetes, kidney disease, or anemia reduced these rates only slightly. Those with RLS were more likely to be older, female, lower income, unemployed, disabled, non-Hispanic white, and less likely to be college educated than those without RLS. Mood and sleep impairment were significantly elevated in those with RLS; after adjustment for demographic and lifestyle characteristics, health history, and other factors, those with RLS remained significantly more likely to indicate a history of depression (adjusted odds ratio [OR] = 1.9; 95% confidence interval [CI] = 1.4, 2.6) and anxiety (OR = 1.6, CI 1.1, 2.2), to report sleep impairment both 4 (OR = 2.4, CI 1.6, 3.7) and 7 days/week (OR = 1.8, CI 1.3, 2.4), and a mean sleep duration < 5 h/night (OR = 1.7, CI 1.2, 2.3). These associations increased in both strength and magnitude with increasing symptom frequency (p's for trend ≤ 0.01).

CONCLUSIONS

Findings of this preliminary anonymous survey study suggest that RLS prevalence is high in this Appalachian primary care population and that RLS is associated with significant burden in terms of both mood and sleep impairment.

[Diagnosis and novel treatment approaches in restless legs syndrome: I. Pathophysiology and diagnosis]

Restless legs syndrome (RLS) is a clinically important, common disease and should be diagnosed and treated early and adequately. At present, there have been no clinical biomarkers or methodologies that can contribute to the correct diagnosis of RLS, RLS should be diagnosed on the basis of 4 essential criteria: urge to move the legs, improvement after movement, and worsening or occurrence of symptoms in the evening and at rest. When applying the criteria, RLS mimics should be ruled out and comorbid diseases should be taken into account. The origin and pathogenesis of RLS are still under investigation; however, iron deficiency in the brain has been observed on imaging and cerebrospinal fluid analyses of patients with RLS. In contrast, the results of neuroimaging studies evaluating brain dopaminergic functions in patients with RLS have yielded inconclusive results, although involvement of the hypothalamus (A11) is thought to cause impaired dopaminergic modulation in the dorsal horn and intermediolateral nucleus, resulting in the restlessness of legs.

[A cross-sectional study of restless legs syndrome in maintenance hemodialysis patients]

OBJECTIVE

To explore the incidence and possible risk factors of restless legs syndrome (RLS) in the maintenance hemodialysis patients.

METHODS

A total of 375 maintenance hemodialysis patients were enrolled in this study from September 1 to 30 in 2012. The diagnosis and assessment of severity were based on the International Restless Leg Syndrome Study Group (IRLSSG) standard. The relevant laboratory parameters and dialysis indicators were collected, such as hemoglobin, serum ferritin, parathyroid hormone, blood flow and dialysis mode. The clinical data were analyzed by multivariate logistic regression method.

RESULTS

The incidence of RLS was 13.3% with the severity score of 18.69 ± 0.95. The logistic regression analysis showed that anuria (OR 0.292, 95%CI 0.114-0.750) and β2 microglobulin (OR 1.023, 95%CI 1.003-1.044) were the risk factors for RLS in the maintenance hemodialysis patients, while hemoglobin, serum iron and parathyroid hormone were not correlated with RLS.

CONCLUSIONS

The incidence of RLS is high in the maintenance hemodialysis patients. The risk factors of RLS are anuria and β2 microglobulin. Therefore, the preservation of residual renal function and the improvement of dialysis adequacy, especially the removal of the middle molecular weight toxins, may reduce the occurrence of RLS and improve the quality of life in the hemodialysis patients.

The relationship between physical activity, restless legs syndrome, and health-related quality of life in type 2 diabetes

To evaluate the relationship between physical activity with co morbidities and health-related quality of life in type 2 diabetic patients with and without restless legs syndrome (RLS). This is an observational study, set at tertiary care diabetic outpatient clinic, where 200 consecutive type 2 diabetic patients and 47 controls participated. Physical activity level was established by the International Physical Activity Questionnaire (IPAQ) and RLS diagnosis and RLS severity were established using the criteria defined by the International Restless Legs Syndrome Study Group; excessive daytime sleepiness was evaluated by the Epworth Sleepiness Scale, quality of sleep by the Pittsburgh Sleep Quality Index and Health-Related Quality of Life by the Short-Form Health Survey (SF-36). Depressive symptoms were investigated by Beck Depression Inventory (BDI- II). Among all diabetic patients (58 % women, mean age 52.7 ± 5.7), disease duration varied from 1 to 30 years (11.7 ± 7.5). Diabetic patients had more hypertension (76 %), peripheral neuropathy (65 %), and depressive symptoms (31 %) than controls; no gender differences were found between cases with and without depressive symptoms. RLS patients (72 % female) had worse quality of sleep. With regards to the quality of life domains, more active RLS diabetic patients had better perception of functional capacity, physical limitation, pain, and general health state (p < 0.05). RLS symptom severity did not vary according to physical activity (IPAQ level). This study shows that the physical activity is associated with a better perception of functional capacity, physical limitation, and pain in diabetic patients with RLS; thus a more active lifestyle should be encouraged.

Restless legs syndrome, pica, and iron status in blood donors

BACKGROUND

The association of blood donation-related iron deficiency with pica or restless legs syndrome (RLS) remains poorly elucidated. This study evaluated the prevalence of RLS and pica in blood donors completing the REDS-II Iron Status Evaluation (RISE) study.

STUDY DESIGN AND METHODS

RISE enrolled 2425 blood donors in a prospective cohort study; 1334 donors provided blood samples to characterize iron status and answered a questionnaire inquiring into symptoms of RLS and pica at a final visit after 15 to 24 months of follow-up. Associations between both conditions and iron status were evaluated.

RESULTS

There were 9 and 20% of donors reporting symptoms of probable or probable/possible RLS, respectively. Iron depletion and donation intensity were not predictive of RLS. Pica was reported by 65 donors (5.5%), half of whom reported daily cravings. Prevalence of pica increased with degree of iron depletion in women (2% in iron-replete females, 13% in those with ferritin < 12 ng/mL), but not in men. Probable RLS and pica coexpressed in eight individuals, but no more frequently than expected by chance.

CONCLUSION

RLS and pica have been associated with iron deficiency in nondonor populations. This study indicates a potentially high prevalence of RLS in frequent blood donors but shows no association with iron status or donation intensity. Low iron stores were associated with higher prevalence of pica, but only in females. Furthermore, the results are incompatible with RLS and pica sharing a common pathophysiology.

Prospective study of restless legs syndrome and risk of erectile dysfunction

In our previous cross-sectional study, we found that restless legs syndrome (RLS) was associated with erectile dysfunction (ED). Thus, we conducted a prospective study to examine whether RLS was associated with a higher risk of developing ED based on 6 years of follow-up among 10,394 men (mean age = 63.4 years) in the Health Professionals Follow-up Study. RLS was assessed in 2002 using a set of standardized questions recommended by the International RLS Study Group. Erectile function was assessed by means of questionnaires in 2000, 2004, and 2008. We identified 1,633 incident ED cases. Men with RLS were more likely to develop ED (relative risk = 1.38, 95% confidence interval: 1.14, 1.68; P = 0.001) than were those without the syndrome, after adjustment for potential confounders, such as age, body mass index, smoking, physical activity, other sleep disorders, and snoring status. A higher frequency of RLS symptoms was also associated with an increased risk of ED (P(trend) = 0.001). In conclusion, men with RLS had a higher risk of ED, and the magnitude of the risk increased with a higher frequency of RLS symptoms. Combinations of other sleep disorders with RLS further increased the risk of ED.

The prevalence and impact of restless legs syndrome on patients with iron deficiency anemia

Restless Legs Syndrome (RLS) a common, under-recognized disorder disrupts sleep and diminishes quality of life. Despite a clear relation between low peripheral iron and increased prevalence and severity of RLS, the prevalence and clinical significance of RLS in iron-deficient anemic (IDA) populations is unknown. In this study all new patients referred for anemia to a community-based hematology practice over a 1-year period (March 2011-2012) were included if they had IDA and no RLS treatment. Patients completed a validated questionnaire identifying RLS, blood tests, and a sleep-vitality questionnaire (SVQ). Patients with RLS were compared to patients with no RLS for differences on SVQ, blood tests, baseline characteristics, and sleep quality. Three hundred forty-three patients were evaluated and 251 (89.2% female, average age of 45.6 years) included in the study. The prevalence of clinically significant RLS (RLS sufferers) was 23.9%, nine times higher than the general population. IDA-RLS sufferers reported poorer quality of sleep, decreased sleep time, increased tiredness, and decreased energy during the day compared to patients with IDA without RLS. Blood tests did not relate to RLS diagnosis but RLS was less likely for African-American than Caucasian patients. Clinically significant RLS occurs commonly with IDA producing much greater disruption of sleep and shorter sleep times than does IDA alone. This indicates the need for identification of RLS with IDA and consideration of appropriate therapeutic interventions for this sizeable subgroup: either aggressive iron treatment to reduce the RLS symptoms or medications for RLS or both.

[Sleep disturbances in children and adolescents with psychiatric disorders - affective and anxiety disorders]

Sleep disorders are common in children and adolescents, their incidence is estimated to be within 25-40%. Among children with psychiatric disorders, sleep problems often arise. Sleep disorders are a symptom of many mental illnesses, they have a major impact on the severity of other symptoms of the disease and the treatment is often difficult. Epidemiological and clinical studies have shown that children in this group often suffer from chronic insomnia, but also relatively frequently are seen in them primary sleep disorders such as restless legs syndrome or obstructive sleep apnea. On the other hand, there is evidence that primary insomnia may be a risk factor for many psychiatric diseases especially depression and anxiety disturbances, and may even produce symptoms of mental illness. Researches regarding pharmacotherapy in pediatric sleep disorders are limited. As a first-line treatment nonpharmacologic strategies are usually recommended.

Restless legs syndrome in a group of patients with Alzheimer's disease

BACKGROUND

Restless legs syndrome (RLS) is a neurological disorder characterized by the urge to move the legs associated with peculiar unpleasant sensations during periods of rest and inactivity that are relieved by movement. A few studies analyzed RLS in neurodegenerative diseases such as Alzheimer's Disease (AD). The aim of our study was to assess the prevalence and the clinical characteristics of RLS in a cohort of AD patients.

METHODS

Three hundred and thirty-nine subjects with a diagnosis of AD were recruited. Cognitive, functional, and neuropsychiatric measures were collected at baseline and six-monthly for a 2-years follow-up

RESULTS

Fourteen subjects met the RLS criteria. RLS subjects were more frequently male (p:0,006) and younger than AD subject without RLS (p:0,029). MMSE, ADL and IADL were not significantly different. NPI total scores did not differ significantly, however, AD patients with RLS were found to be more apathetic (p:0,001) than AD subjects without RLS.

CONCLUSION

RLS prevalence in our AD cohort was estimated to be about 4%. RLS appeared to be associated with neuropsychiatric symptoms such as apathy. RLS and apathy might share a common pathophysiological basis represented by a dysfunction of the central dopaminergic system.

[A woman with restless genital syndrome: a difficult-to-treat condition]

BACKGROUND

Restless Genital Syndrome (RGS) refers to the uncommon experience of excessive and persistent sensations of genital and clitoral arousal, with either restless legs or symptoms of an overactive bladder, in the absence of conscious feelings of sexual desire. RGS is caused by a small fiber sensory neuropathy of the dorsal nerve of the clitoris. To date, there is no consensus on the treatment for RGS.

CASE DESCRIPTION

A 58-year-old woman presented with persistent and unwanted genital arousal in her clitoris and labia minora. The arousal symptoms were accompanied by restless legs. Despite the pre-orgasmic feelings, orgasm was not achieved. Sexual activity did not resolve the symptoms. Two months prior to the onset of RGS symptoms a presacral abscess had been drained.

CONCLUSION

Lidocaine, oxazepam, clonazepam, tramadol and transcutaneous electrical nerve stimulation, combined with psychotherapeutic counseling, have been described as the most appropriate treatment modalities for RGS based on the experiences to date.

Prevalence and impact of restless legs syndrome in pregnancy

BACKGROUND

Restless legs syndrome (RLS) is a frequent neurological disorder which predominantly affects women. Pregnancy is one of the most common conditions leading to secondary RLS. Severe symptoms of RLS may lead to complications of pregnancy and/or labor. The aim of this study was to determine the prevalence and characteristics of RLS in pregnant women.

METHODS

Women in the third trimester of gravidity filled out a simple questionnaire based on the official diagnostic criteria for RLS. Positive responders were interviewed in order to further characterize their symptoms. Afterwards information on changes in frequency and/or intensity of the symptoms after delivery was obtained by a telephone follow-up. All data were statistically analysed.

RESULTS

A total of 300 questionnaires were completed. All 94 RLS-positives met the four diagnostic criteria (31.33%). There was no difference in age, body mass index, or the number of previous pregnancies between RLS-positives and RLS-negatives, but weight gain during pregnancy was significantly higher in RLS-positives. More than 30% of positives had clinically significant symptoms, and 50% reported sleep disturbances. Almost 75% of the cases of RLS were secondary, i.e., symptoms occurred only during pregnancy (with a peak in the third trimester). More complications of pregnancy or labor occurred in women with RLS, but this was only marginally significant.

CONCLUSIONS

Our study confirmed the relatively high prevalence of RLS in pregnant women compared with the general population. Although almost three-fourths of the symptoms were only transient throughout pregnancy, the impact of the severe symptoms and sleep deprivation on the course of pregnancy and delivery was not negligible. Early detection and adequate treatment of severe RLS are necessary to prevent maternal discomfort and possible health risks. The questionnaire method is a simple, reliable diagnostic tool.

Symptoms of restless legs syndrome in a palliative care population: frequency and impact

OBJECTIVES

We hypothesized that restless legs syndrome (RLS) would be common and associated with impaired quality of life (QOL) among palliative care outpatients.

METHODS

76 palliative care clinic patients completed the National Institutes of Health restless legs syndrome (NIH-RLS) screening questionnaire. Questionnaire data was also gathered on RLS severity and RLS-related QOL, and the Short Form Health Survey (SF-12) was used to measure QOL. Analysis was performed for associations between RLS categorization and QOL measures.

RESULTS

31 patients (40.8 percent) met criteria for RLS. RLS-positive patients had moderate-to-severe RLS symptoms and impaired RLS-specific QOL. RLS-positive patients scored lower on the mental component of the SF-12 (39 +/- 11 versus 45 +/- 12, p=0.03), though not on the physical component. In a multivariate regression analysis, higher levels of RLS severity had 2-point lower SF-12 mental component scores compared to lower levels of RLS severity (p=0.04), with no difference in physical component scores (p=0.47).

CONCLUSION

RLS appears common in palliative care outpatients and is associated with impairments in QOL.

Restless legs syndrome in people affected by leprosy

OBJECTIVES

Restless legs syndrome (RLS) is one of the most commonly encountered sleep disorders. The prevalence of RLS and its association'with leprosy have not previously been elucidated. The aims of this study were to investigate the prevalence of RLS in people affected by leprosy and to determine the presence and amount of sleep disruption in leprosy affected people with RLS.

DESIGN

Each leprosy-affected person was matched to two healthy controls for age and sex. A total of 236 leprosy-affected people who lived in Sorokdo and 472 healthy control subjects who lived in Namwon were included in this study. A diagnosis of RLS and a severity assessment were made using the criteria described by the International Restless Legs Syndrome Study Group.

RESULTS

The prevalence of RLS was significantly higher in people affected by leprosy (60/236; 25.4%) than in controls (42/472; 8.8%). Pittsburgh Sleep Quality Index (PSQI) global score was higher in leprosy-affected people than in controls. No significant difference was found between leprosy-affected people and controls with regard to the severity of RLS. Leprosy-affected people with RLS had a poorer sleep quality (higher PSQI global score) than those without RLS, but the Geriatric Depression Scale was not different between leprosy-affected people with RLS and those without RLS.

CONCLUSIONS

The frequency of RLS among leprosy-affected people was significantly higher than that of RLS in the general population. Leprosy-affected people should be examined for RLS and treatment for RLS can potentially improve sleep.

Prospective study of restless legs syndrome and coronary heart disease among women

BACKGROUND

Previous cross-sectional studies suggested a positive association between restless legs syndrome (RLS) and coronary heart disease (CHD). This observation was not confirmed by subsequent prospective studies. However, these prospective studies did not take into account the duration of RLS symptoms. Therefore, we prospectively examined whether RLS was associated with an increased risk of CHD in women who participated in the Nurses' Health Study, taking into account the duration of RLS symptoms.

METHODS AND RESULTS

A total of 70 977 women (mean age, 67 years) who were free of CHD and stroke at baseline (2002) were followed up until 2008. Physician-diagnosed RLS was collected via questionnaire. CHD was defined as nonfatal myocardial infarction or fatal CHD. Women with RLS at baseline had a marginally higher risk of developing CHD (multivariable-adjusted hazard ratio, 1.46; 95% confidence interval, 0.97-2.18) compared with women without RLS. The risk was dependent on duration of symptoms: 0.98 (95% confidence interval, 0.44-2.19) for women with RLS for <3 years and 1.72 (95% confidence interval, 1.09-2.73) for women with RLS for ≥3 years (P trend=0.03). The multivariable-adjusted hazard ratios of women with RLS for ≥3 years were 1.80 (95% confidence interval, 1.07-3.01) for nonfatal myocardial infarction and 1.49 (95% confidence interval, 0.55-4.04) for fatal CHD relative to women without RLS.

CONCLUSIONS

We observed that women with RLS for at least 3 years had an elevated risk of CHD. These results suggest that RLS or RLS-associated conditions may contribute to the origin of cardiovascular disease.

Prospective study of restless legs syndrome and risk of depression in women

Most research on the association between restless legs syndrome (RLS) and depression has involved cross-sectional data. The objective of the present study was to evaluate this issue prospectively among Nurses' Health Study participants. A total of 56,399 women (mean age = 68 years) who were free of depression symptoms at baseline (2002) were followed until 2008. Physician-diagnosed RLS was self-reported. During 300,155 person-years of follow-up, the authors identified 1,268 incident cases of clinical depression (regular use of antidepressant medication and physician-diagnosed depression). Women with RLS at baseline were more likely to develop clinical depression (multivariate-adjusted relative risk (RR) = 1.5, 95% confidence interval (CI): 1.1, 2.1; P = 0.02) than those without RLS. The presence of RLS at baseline was also associated with higher scores on the 10-item Center for Epidemiologic Studies Depression Scale (CESD-10) and the 15-item Geriatric Depression Scale (GDS-15) thereafter. Multivariable-adjusted mean differences were 1.00 (standard error, 0.12) for CESD-10 score and 0.47 (standard error, 0.07) for GDS-15 score between women with RLS and those without RLS (P < 0.0001). In conclusion, women with physician-diagnosed RLS had an increased risk of developing clinical depression and clinically relevant depression symptoms. Further prospective studies using refined approaches to ascertainment of RLS and depression are warranted.

Frequency, severity and risk factors for restless legs syndrome in healthcare personnel

OBJECTIVE

To evaluate the frequency, severity, and risk factors for restless legs syndrome (RLS) in healthcare personnel.

METHODS

This cross-sectional study was performed at the Outpatient Family Medicine Clinic of Meram Medical Faculty in Konya, Turkey and included 354 healthcare personnel who were working at the Meram Medical Faculty Hospital between October 2010 and June 2011. The International RLS (IRLS) rating scale was used to calculate RLS severity. The RLS symptoms positive patients were investigated for neurological examination.

RESULTS

Of all the participants, 277 (78.2%) were female. The overall prevalence of RLS according to the 4 essential criteria in the participating healthcare personnel was 15% (n=53) (16.9% male, 14.4% female). Gender (p=0.726) and age (p=0.197) were not significantly related to RLS. According to the International Restless Legs Syndrome Study Group (IRLSSG) the severity scale for RLS, of the RLS positive patients, 16% were classified as mild (n=8), 40% as moderate (n=21), and 44% as severe (n=24). Approximately, 54.7% of 53 RLS patients had a positive family history of the disorder.

CONCLUSION

Restless leg syndrome is a treatable disorder; however, it is still widely misdiagnosed by physicians. The history of the patient and family is very important in the diagnosis of RLS.