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Viola-Saltzman M, Watson NF, Bogart A, Goldberg J, Buchwald D. High prevalence of restless legs syndrome among patients with fibromyalgia: a controlled cross-sectional study. J Clin Sleep Med 2010; 6:423-427. [PMID: 20957840 PMCID: PMC2952743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
STUDY OBJECTIVES To investigate the prevalence of restless legs syndrome (RLS) in fibromyalgia (FM) and determine the presence and amount of sleep disruption in FM patients with RLS. RLS and FM have been associated in uncontrolled studies using a variety of RLS definitions. We explored this relationship using a cross-sectional study design. METHODS FM cases that met the American College of Rheumatology diagnostic criteria were recruited through an academic referral clinic and advertising. Pain- and fatigue-free controls were recruited from the Seattle metropolitan area. We enrolled 172 FM patients (mean age 50 years, 93% female) and 63 pain- and fatigue-free controls (mean age 41 years, 56% female). RLS was ascertained by a self-administered validated diagnostic interview. RESULTS The age- and gender-adjusted prevalence of RLS was higher in the FM group than the control group (33.0%; 95% CI: 25.9, 40.1 vs. 3.1%; 95% CI: 0.0, 7.4; p = 0.001). Likewise, the FM group was more likely to report RLS (OR = 11.7; 95% CI: 2.6, 53.0), even after adjusting for age and gender. The mean Pittsburgh Sleep Quality Index score was higher among FM patients with RLS than those without (11.8 vs. 9.9; p = 0.01) but subjective limb pain measures did not differ between these 2 groups. CONCLUSIONS There is a higher prevalence and odds of RLS in those with FM compared to controls. Clinicians should routinely query FM patients regarding RLS symptoms because treatment of RLS can potentially improve sleep and quality of life in these patients.
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Yang C, Winkelman JW. Clinical and polysomnographic characteristics of high frequency leg movements. J Clin Sleep Med 2010; 6:431-438. [PMID: 20957842 PMCID: PMC2952745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
STUDY OBJECTIVES The aim of this study was to describe the clinical and polysomnographic characteristics of patients with high frequency leg movements (HFLM) on polysomnographic recording. METHODS Among 486 patients (male 232, female 254) referred for overnight diagnostic PSG over a 9-month period, 37 patients demonstrated HFLM: 19 males (8.2% of PSGs) and 18 females (7.1% of PSGs). An equal number of age- and sex-matched consecutive patients who did not show HFLM were selected. HFLM was defined as > or = 4 discrete leg movements occurring at a frequency of 0.3-4.0 Hz. RESULTS Two-thirds (64.3%) of all HFLMs occurred during waking; 35.7% occurred during sleep. Of those HFLM episodes occurring during sleep, 44.8% occurred during stage 1, 45.1% during stage 2, 0.6% during stages 3 and 4, and 9.5% during REM. The movements usually appeared unilaterally, but sometimes they showed a bilateral pattern. The mean frequency was 1.6 +/- 0.6 Hz (range 0.4-3.7), the mean number of episodes of HFLM per subject per night was 26.5 +/- 30.5 (range 2-111), and the mean duration per episode was 17.6 +/- 35.4 sec (range 1.5 sec-6.1 minutes). The mean HFLM index, (total number of HFLM divided by the time in bed, in hours), was 107.7 +/- 254.5 (range 2.0-1078.3). Patients with HFLM complained of RLS symptoms significantly more often than the group without HFLM (p < 0.05). CONCLUSION Further studies are needed to establish criteria for scoring HFLM. Examination of other patient cohorts with HFLM will be needed to determine whether HFLM are in fact associated with RLS.
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Walters AS, Rye DB. Evidence continues to mount on the relationship of restless legs syndrome/ periodic limb movements in sleep to hypertension, cardiovascular disease, and stroke. Sleep 2010; 33:287. [PMID: 20337185 DOI: 10.1093/sleep/33.3.287] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Sieb JP. [Restless legs: recent advances in basic research and therapy]. MEDIZINISCHE MONATSSCHRIFT FUR PHARMAZEUTEN 2010; 33:133-139. [PMID: 20429403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
In Germany approximately one percent of the population suffers from clinically relevant restless legs syndrome (RLS). Three non-ergoline dopamine agonists and levodopa/benserazide are now specifically licensed for RLS in Germany. Augmentation is the main complication of long-term dopaminergic treatment of RLS. Augmentation is defined as a paradoxical worsening of the symptoms during long-term dopaminergic treatment with increasing dose. According to a recent study this occurs in up to 60% of RLS patients during the first 6 months of treatment. Augmentation emerges less frequently during dopamine agonist treatment. The dopamine agonist doses required for the treatment of RLS patients is far below the dose range in Parkinson therapy. However, severe complications of dopamine agonist treatment can occur even in this dose range, like compulsive behaviours. A considerable number of RLS patients needs non-dopaminergic treatment for RLS. Most of them receive opioids as one of the second-line options in RLS therapy.
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Jáuregui-Barrutia A, Tijero-Merino B, Gómez-Esteban JC, Zarranz JJ. [Sleep disorders in Parkinson's disease: REM sleep behaviour disorder and restless legs syndrome]. Rev Neurol 2010; 50 Suppl 2:S15-S19. [PMID: 20205137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
INTRODUCTION It is well known that patients with Parkinson's disease (PD) and other neurodegenerative diseases very commonly present sleep disorders, and that they possibly share common pathophysiological mechanisms with motor signs. DEVELOPMENT In the case of REM sleep behaviour disorder, a number of studies have shown that it may appear more than ten years before the motor signs. Although there is no evidence to prove that patients with restless legs syndrome have an increased risk of suffering from PD, the high prevalence of this symptom in PD and the good response to dopamine agonists suggest the existence of a relation between the two conditions. CONCLUSIONS The impact that these conditions have on patients' quality of life makes it very important to know how to diagnose and treat them.
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Roepke SK, Ancoli-Israel S. Sleep disorders in the elderly. Indian J Med Res 2010; 131:302-310. [PMID: 20308755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023] Open
Abstract
Nearly half of older adults report difficulty initiating and maintaining sleep. With age, several changes occur that can place one at risk for sleep disturbance including increased prevalence of medical conditions, increased medication use, age-related changes in various circadian rhythms, and environmental and lifestyle changes. Although sleep complaints are common among all age groups, older adults have increased prevalence of many primary sleep disorders including sleep-disordered breathing, periodic limb movements in sleep, restless legs syndrome, rapid eye movement (REM) sleep behaviour disorder, insomnia, and circadian rhythm disturbances. The present review discusses age-related changes in sleep architecture, aetiology, presentation, and treatment of sleep disorders prevalent among the elderly and other factors relevant to ageing that are likely to affect sleep quality and quantity.
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Cornelius JR, Tippmann-Peikert M, Slocumb NL, Frerichs CF, Silber MH. Impulse control disorders with the use of dopaminergic agents in restless legs syndrome: a case-control study. Sleep 2010; 33:81-87. [PMID: 20120624 PMCID: PMC2802252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
STUDY OBJECTIVES To determine the frequency of impulse control disorders (ICDs) with the use of dopaminergic agents in restless legs syndrome (RLS). DESIGN Prospective case-control study using a screening questionnaire for ICDs, followed by phone interview to confirm diagnoses for those meeting preset scoring thresholds on the questionnaire. SETTING Academic, comprehensive sleep medicine center. PATIENTS OR PARTICIPANTS (1) One hundred patients with RLS treated with dopaminergic agents, (2) 275 patients with obstructive sleep apnea (OSA) without RLS or exposure to dopaminergic agents; and (3) 52 patients with RLS who were never treated with dopaminergic agents. Subjects with parkinsonism were excluded. INTERVENTIONS Not applicable. MEASUREMENTS AND RESULTS Based on the questionnaire, frequencies of ICDs for the RLS treatment group were 10% compulsive shopping, 7% pathologic gambling, 23% compulsive eating, 8% hypersexuality, and 10% punding. These values were statistically significant when compared with control subjects with OSA for compulsive shopping and pathologic gambling. With additional information from the phone interview, adjusted frequencies for the RLS treatment group were 9% compulsive shopping, 5% pathologic gambling, 11% compulsive eating, 3% hypersexuality, 7% punding, and 17% any ICD. These values were statistically significant when compared with those of control subjects with OSA for compulsive shopping, pathologic gambling, punding, and any ICD, as well as for compulsive shopping when compared with control subjects with RLS who were not treated with dopaminergic agents. In the RLS treatment group, a statistically significant dose effect was found for pramipexole in those subjects confirmed to have ICDs by both the questionnaire and phone interview. Mean duration of treatment at ICD onset was 9.5 months. CONCLUSIONS ICDs are common with the use of dopaminergic agents for treatment of RLS. Given the potentially devastating psychosocial consequences of these behaviors, it is critical to actively screen for ICDs in this population.
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MESH Headings
- Adult
- Aged
- Benzothiazoles/adverse effects
- Benzothiazoles/therapeutic use
- Case-Control Studies
- Cross-Sectional Studies
- Disruptive, Impulse Control, and Conduct Disorders/chemically induced
- Disruptive, Impulse Control, and Conduct Disorders/diagnosis
- Disruptive, Impulse Control, and Conduct Disorders/epidemiology
- Disruptive, Impulse Control, and Conduct Disorders/psychology
- Dopamine Agents/adverse effects
- Dopamine Agents/therapeutic use
- Female
- Humans
- Indoles/adverse effects
- Indoles/therapeutic use
- Male
- Middle Aged
- Pramipexole
- Prospective Studies
- Restless Legs Syndrome/drug therapy
- Restless Legs Syndrome/epidemiology
- Restless Legs Syndrome/psychology
- Sleep Apnea, Obstructive/epidemiology
- Sleep Apnea, Obstructive/psychology
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Cavallini L, Impedovo A, Abaterusso C, Loschiavo C, Lupo A. [Restless legs syndrome in kidney patients]. GIORNALE ITALIANO DI NEFROLOGIA : ORGANO UFFICIALE DELLA SOCIETA ITALIANA DI NEFROLOGIA 2010; 27:37-46. [PMID: 20191459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Restless legs syndrome (RLS) is a sensorimotor disorder characterized by a strong urge to move the legs associated with paresthesias, motor restlessness, worsening of symptoms at night, and at least partial relief by activity. RLS has a negative impact on sleep, may cause depressive and anxious states, result in poor quality of life, and be a risk factor for cardiovascular disease. RLS is frequent in patients with end-stage renal disease; in this patient population it is consistently associated with severe comorbidities. It remains an underdiagnosed clinical condition. Appropriate diagnosis and management of RLS and sleep disorders is necessary to improve the quality of life and survival of kidney patients.
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Tikkinen KAO, Auvinen A, Johnson TM, Weiss JP, Keränen T, Tiitinen A, Polo O, Partinen M, Tammela TLJ. A systematic evaluation of factors associated with nocturia--the population-based FINNO study. Am J Epidemiol 2009; 170:361-8. [PMID: 19515794 PMCID: PMC2714949 DOI: 10.1093/aje/kwp133] [Citation(s) in RCA: 122] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
In a case-control study with prevalence sampling, the authors explored the correlates for nocturia and their population-level impact. In 2003–2004, questionnaires were mailed to 6,000 subjects (aged 18–79 years) randomly identified from the Finnish Population Register (62.4% participated; 53.7% were female). Questionnaires contained items on medical conditions, medications, lifestyle, sociodemographic and reproductive factors, urinary symptoms, and snoring. Nocturia was defined as ≥2 voids/night. In age-adjusted analyses, factors associated with nocturia were entered into a multivariate model. Backward elimination was used to select variables for the final model, with adjustment for confounding. Although numerous correlates were identified, none affected ≥50% of nocturia cases of both sexes. The factors with the greatest impact at the population level were (urinary) urgency (attributable number/1,000 subjects (AN) = 24), benign prostatic hyperplasia (AN = 19), and snoring (AN = 16) for men and overweight and obesity (AN = 40), urgency (AN = 24), and snoring (AN = 17) for women. Moreover, correlates included prostate cancer and antidepressant use for men, coronary artery disease and diabetes for women, and restless legs syndrome and obesity for both sexes. Although several correlates were identified, none accounted for a substantial proportion of the population burden, highlighting the multifactorial etiology of nocturia.
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Cho SJ, Hong JP, Hahm BJ, Jeon HJ, Chang SM, Cho MJ, Lee HB. Restless legs syndrome in a community sample of Korean adults: prevalence, impact on quality of life, and association with DSM-IV psychiatric disorders. Sleep 2009; 32:1069-1076. [PMID: 19725258 PMCID: PMC2717197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
STUDY OBJECTIVES Conflicting reports on prevalence of RLS exist in Asian countries due to differences in sampling strategies and assessment instruments. We assessed the prevalence, correlates, quality of life, and psychiatric comorbidity of RLS in South Korea. DESIGN/SETTING Cross-sectional nationwide survey. PARTICIPANTS Nationally representative sample of 6,509 Korean adults aged 18-64. MEASUREMENT & RESULTS Face-to-face interviews based on the Korean translation of the four features of RLS defined by the International RLS Study Group (IRLSSG), the Korean version of Composite International Diagnostic Interview (K-CIDI), and EuroQol (EQ-5D) were conducted for all participants. The weighted prevalence of RLS in South Korea was 0.9% (men, 0.6%; women, 1.3%). Subjects with RLS had a lower quality of life according to EQ-5D than those without RLS. Adjusted odds ratio for lifetime diagnosis of DSM-IV major depressive disorder (2.57, 95% confidence interval [1.33, 4.96]), panic disorder (18.9 [4.72, 75.9]) and posttraumatic stress disorder (3.76 [1.32, 10.7]) suggest strong association between RLS and DSM-IV depression and anxiety disorders. CONCLUSIONS Prevalence of RLS estimated based on the IRLSSG diagnostic criteria is substantially lower in South Korea than in Western countries. Differences in culture and risk factors that affect the expression of RLS may vary across the countries.
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Ram S, Seirawan H, Kumar SKS, Clark GT. Prevalence and impact of sleep disorders and sleep habits in the United States. Sleep Breath 2009; 14:63-70. [PMID: 19629554 DOI: 10.1007/s11325-009-0281-3] [Citation(s) in RCA: 174] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2009] [Revised: 06/19/2009] [Accepted: 06/24/2009] [Indexed: 12/23/2022]
Abstract
PURPOSE Epidemiologic studies on sleep disorders in the USA have mostly focused on specific disorders in specific groups of individuals. Most studies on sleep habits and sleep-related difficulties have focused on children and adolescents. The authors describe the prevalence of the three common physician-diagnosed sleep disorders (insomnia, sleep apnea, and restless legs syndrome (RLS)) by age, gender, and race in the US population. In addition, the authors describe the sleep habits and sleep-related difficulties in carrying routine daily activities. The authors also investigate the impact of the sleep disorders on performing routine daily activities. METHODS Data from the 2005-2006 National Health and Nutrition Examination Survey for 6,139 individuals over the age of 16 was analyzed for sleep-related parameters. RESULTS The prevalence was highest for sleep apnea (4.2%), followed by insomnia (1.2%) and RLS (0.4%). Hispanics and Whites reported longer sleep duration than Blacks by 24 to 30 min. The predominant sleep habits were snoring while sleeping (48%), feeling unrested during the day (26.5%), and not getting enough sleep (26%). Difficulty concentrating (25%) or remembering (18%) were the main sleep-related difficulties in our sample. Insomnia, sleep apnea, and RLS had the highest impact on concentration and memory. CONCLUSIONS Our findings suggest that the prevalence of sleep disorders in the USA is much lower than previously reported in the literature suggesting under diagnosis of sleep disorders by primary care physicians.
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Bhowmik D, Bhatia M, Tiwari S, Mahajan S, Gupta S, Agarwal SK, Dash SC. Low Prevalence of Restless Legs Syndrome in Patients with Advanced Chronic Renal Failure in the Indian Population: A Case Controlled Study. Ren Fail 2009; 26:69-72. [PMID: 15083925 DOI: 10.1081/jdi-120028557] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Restless legs syndrome (RLS) is reported to occur in 20-70% of uremic patients. There is no study from India regarding the prevalence of RLS in chronic renal failure (CRF) patients. Studies from other Asian countries have shown a much lower prevalence compared to the West. This study investigated the prevalence of RLS in patients with advanced CRF in the Indian population. PATIENTS AND METHODS Sixty-five CRF patients and 99 controls were evaluated using a predesigned standard questionnaire. The control group consisted of prospective renal donors. RESULTS The mean age of our patients was 42.4 +/- 14.9 years as compared to 43.7 +/- 11.2 years (p = NS). The distribution of cause of CRF was as follows: diabetes 38.5%, hypertension 13.9%, chronic interstitial nephritis 29.2% and chronic glomerulonephritis 18.4%. RLS was present in 1 patient (1.5%) and none of the controls. CONCLUSION The prevalence of RLS in CRF patients in India is very low as compared to the Western population.
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Allen RP, Stillman P, Myers AJ. Physician-diagnosed restless legs syndrome in a large sample of primary medical care patients in western Europe: Prevalence and characteristics. Sleep Med 2009; 11:31-7. [PMID: 19464949 DOI: 10.1016/j.sleep.2009.03.007] [Citation(s) in RCA: 142] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2008] [Revised: 03/22/2009] [Accepted: 03/25/2009] [Indexed: 11/19/2022]
Abstract
BACKGROUND Restless legs syndrome (RLS) is a medical condition with established neuropathology and genetic associations. Significant questions have, however, recently been raised about its true prevalence, medical significance and the degree to which it is under or over-diagnosed. This study therefore aimed to determine its prevalence, morbidity and adequacy of diagnosis based on physician evaluations of their own patients in primary care practice. METHODS Screening questionnaires were completed by adult patients attending 62 primary care practices across six western European countries within a one-week period. Patients screening positive for significant RLS symptoms were clinically evaluated for RLS by their physician. Physicians also classified the degree RLS affected the patient's health and well-being. Patients independently completed the SF-36 Quality of Life and Medical Outcomes Study (MOS) sleep questionnaires. RESULTS Ten thousand five hundred and sixty-four patients completed the screening questionnaire; 804 responded positively to RLS symptoms and 630 of these were subsequently evaluated by their physician. The physicians diagnosed RLS in 365 patients. Ninety-one percent of these had not been previously diagnosed with RLS. In this cohort of adult primary care patients (without or with prorating for missed interviews) the estimated prevalence for diagnosed RLS was 3.5% or 4.4% and for medically-significant RLS 2.1% or 2.7%. A moderate to high degree of RLS negative impact on health related strongly to a lower vitality subscale on the SF-36 and short sleep times (5.2-5.4h) with more sleep disturbance on the MOS sleep scale. CONCLUSION RLS in these western European countries is a common, clinically-significant medical condition that, despite all the publicity, remains largely undiagnosed. RLS evaluation is particularly recommended for patients complaining of insomnia.
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215
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Yee B, Killick R, Wong K. Restless legs syndrome. AUSTRALIAN FAMILY PHYSICIAN 2009; 38:296-300. [PMID: 19458798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
BACKGROUND Restless legs syndrome (RLS) is a common, but frequently undiagnosed, chronic, sensorimotor disorder. In western countries, it is seen in approximately 10% of the general population, with a higher prevalence in women and the elderly (10-20%). OBJECTIVE This article outlines the epidemiology, aetiology, diagnosis and management of RLS. Information that is most relevant to general practice is presented, with an emphasis on practical management. DISCUSSION Restless legs syndrome is divided into primary and secondary forms. There is a strong genetic influence in primary RLS. Secondary forms are associated with iron deficiency, pregnancy, and renal failure. Diagnosis is essentially by clinical history using simple diagnostic criteria. Management depends on severity, and ranges from nonpharmacologic to pharmacologic measures. Recent research has provided insights into the pathophysiology of RLS and provided an evidence base for some of the newer treatments.
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216
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Inoue Y. [Diagnosis and symptom rating scale of restless legs syndrome]. BRAIN AND NERVE = SHINKEI KENKYU NO SHINPO 2009; 61:533-538. [PMID: 19514513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Restless legs syndrome (RLS) is a sensorimotor disorder, characterized by an irresistible urge to move the legs and usually accompanied or caused by uncomfortable and unpleasant sensations. It begins or worsens during periods of rest or inactivity, is partially or totally relieved by movement and is exacerbated or occurs mainly in the evening or night. People suffering from RLS are estimated to represent 2-3% of the general Japanese population, which is relatively lower than the estimated prevalence in western countries. Supportive diagnostic critevia include family history, the presence of periodic-leg movements (PLM) when awake or asleep, and a positive response to dopaminergic treatment. RLS phenotypes include an early onset form that is usually idiopathic with frequent familial history and a late onset form that is usually secondary to other somatic conditions that are causative factors in RLS occurrence. In all patients presenting with complaints of insomnia or discomfort in the lower limbs, diagnosis of RLS should be considered. RLS should be differentiated from akathisia, which is an urge to move the whole body in the absence of uncomfortable sensations. Polysomnographic studies and the suggested immobilization test (SIT) can detect PLM in patients that are asleep or awake. RLS may cause severe sleep disturbances, poor quality of life, depressive and anxious symptoms, and may be a risk factor for cardiovascular disease. Secondary RLS may occur due to iron deficiency, end-stage renal disease, pregnancy, peripheral neuropathy and drug use including antipsychotics and antidepressants. Small fiber neuropathy can trigger RLS or mimic its symptoms. RLS is associated with many neurological disorders, including Parkinson disease and multiple system atrophy; althoughit does not predispose to these diseases. A symptom rating scale for RLS authorized by the International RLS Study Group (IRLS) would facilitate accurate diagnosis of this condition.
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Al-Jahdali HH, Al-Qadhi WA, Khogeer HA, Al-Hejaili FF, Al-Ghamdi SM, Al Sayyari AA. Restless legs syndrome in patients on dialysis. SAUDI JOURNAL OF KIDNEY DISEASES AND TRANSPLANTATION 2009; 20:378-385. [PMID: 19414938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
Abstract
Restless legs syndrome (RLS) is an extremely distressing problem experienced by patients on dialysis; the prevalence appears to be greater than in the general population, with a wide variation from 6.6% to 80%. The diagnosis of RLS is a clinical one, and its definition has been clarified and standardized by internationally recognized diagnostic criteria, published in 1995 by the International Restless Legs Syndrome Study Group (IRLSSG). This study was designed to find out the prevalence of RLS in Saudi patients with end-stage renal disease (ESRD) on maintenance dialysis. This is a cross sectional study carried out between May and Sept 2007 at two centers, King Abdulaziz Medical City-King Fahad National Guard Hospital (KAMC-KFNGH), Riyadh and King Faisal Specialist Hospital and Research Centre (KFHRC), Jeddah, Saudi Arabia. Data were gathered on 227 Saudi patients on chronic maintenance hemodialysis or chronic peritoneal dialysis. The prevalence of RLS was measured using IRLSSG's RLS Questionnaire (RLSQ). Potential risk factors for RLS including other sleep disorders, underlying cause of chronic renal failure, duration on dialysis, dialysis shift, biochemical tests and demographic data were also evaluated. The overall prevalence of RLS was 50.22% including 53.7% males and 46.3% females. Their mean age was 55.7 +/- 17.2 years and mean duration on dialysis 40.4 +/- 37.8 months. Significant predictors of RLS were history of diabetes mellitus (DM), coffee intake, afternoon dialysis, gender and type of dialysis (P= 0.03, 0.01, < 0.001, 0.05 and 0.009 respectively). Patients with RLS were found to be at increased risk of having insomnia and excessive daytime sleepiness (EDS) (P= < 0.001 and 0.001, respectively). Our study suggests that RLS is a very common problem in dialysis population and was significantly associated with other sleep disorders, particularly insomnia, and EDS. Optimal care of dialysis patient should include particular attention to the diagnosis and management of sleep disorders.
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218
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Nomura T, Nakashima K. [Prevalence of restless legs syndrome]. BRAIN AND NERVE = SHINKEI KENKYU NO SHINPO 2009; 61:515-521. [PMID: 19514511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Restless legs syndrome (RLS) is a common movement disorder wherein sensory motor symptoms are observed in the limbs mainly during sleep and quiet wakefulness. The diagnostic criteria for RLS were established in 1995 by the International RLS Study Group (IRLSSG) and revised in 2003. The prevalence of RLS in Europe and North America was reported to be between 5% and 12%. On the other hand, the prevalence of RLS in Asia was lesser than that in Europe and North America: it was estimated to be less than 4%. This difference might be associated with vacial, cultural, and language differences. Genetic factors are known to contribute to the etiology of RLS in up to two-thirds of these patients. Furthermore, RLS might complicate an already existing medical condition. The development of secondary RLS is associated with renal failure, iron deficiency, frequent blood donation, Parkinson disease, neuropathy, as well as pregnancy. Generally, these medical condition are more frequently complicated in patient with RLS than in healthy controls. However, there is no conclusive evidence to prove an association between these medical conditions and RLS. Genetic contribution, environmental factors and other covariates such as gender, age, iron deficiency, as well as medical conditions play an important role in the development of RLS. In conclusion, epidemiological evidence suggests that both the primary and secondary forms of RLS are common neurological disorders. Future epidemiological studies are required to determine the potential risk factors contributing to the development of this disorder.
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219
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Tobiasson M, Alyass B, Söderlund S, Birgegård G. High prevalence of restless legs syndrome among patients with polycytemia vera treated with venesectio. Med Oncol 2009; 27:105-7. [PMID: 19225914 DOI: 10.1007/s12032-009-9180-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2009] [Accepted: 02/03/2009] [Indexed: 11/26/2022]
Abstract
In order to examine whether symptoms of iron deficiency anemia are due to the iron deficiency itself or the associated anemia, 34 patients with polycytemia vera (PV) treated with venesectio, who had iron deficiency but normal hemoglobin (Hb) levels, were given a questionnaire covering symptoms of iron deficiency including the international RLS-scale and the Fact-fatigue quality of life scale (QoL). We found a prevalence of pica of 11.7%, mouth paresthesias of 5.8% and rest-less legs 29.6% (RLS "normal" prevalence 10%). Thus, the prevalence of RLS is significantly higher in our population. We also saw a significant difference in QoL between patients with and without RLS (P = 0.015) and QoL correlated with the severity of RLS (R = 0.85). In conclusion, RLS seems to be a frequent and serious problem for PV patients treated with venesectio according to standard guidelines.
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220
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Allen RP, Burchell BJ, MacDonald B, Hening WA, Earley CJ. Validation of the self-completed Cambridge-Hopkins questionnaire (CH-RLSq) for ascertainment of restless legs syndrome (RLS) in a population survey. Sleep Med 2009; 10:1097-100. [PMID: 19195928 DOI: 10.1016/j.sleep.2008.10.007] [Citation(s) in RCA: 151] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2008] [Revised: 10/23/2008] [Accepted: 10/30/2008] [Indexed: 11/18/2022]
Abstract
BACKGROUND AND PURPOSE Epidemiological studies of restless legs syndrome (RLS) have been limited by lack of a well validated patient-completed diagnostic questionnaire that has a high enough specificity to provide a reasonable positive predictive value. Most of the currently used patient completed diagnostic questionnaires have neither been validated nor included items facilitating the differential diagnosis of RLS from conditions producing similar symptoms. The Cambridge-Hopkins diagnostic questionnaire for RLS (CH-RLSq) was developed with several iterations to include items covering the basic diagnostic features of RLS and to provide some basic differential diagnosis. This validation study sought to determine the sensitivity and specificity of the RLS diagnosis based on this questionnaire. PATIENTS AND METHODS The CH-RLSq was completed by 2005 blood donors who were asked to consent to being contacted for a telephone diagnostic interview. A scoring criterion was established for ascertainment of RLS based on the clinical definition of the disorder and the exclusion of "mimic" conditions. A weighted sample (N=185) of all completed questionnaires was selected for expert clinical diagnosis of RLS using the validated Hopkins Telephone Diagnostic Interview (HDTI). The telephone interviewers were blinded to all questionnaire responses. RESULTS A telephone diagnosis was obtained on 183 of the sample's 185 questionnaires. The questionnaire's normalized sensitivity and specificity were 87.2% and 94.4%, respectively, for RLS compared to not RLS. The positive predictive values in this sample were 85.5%. CONCLUSIONS The Cambridge-Hopkins RLS questionnaire provides a reasonable level of sensitivity and specificity for ascertainment of RLS in population-based studies.
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Miranda C M, Fabres O L, Contreras S A, Torres Ch T. [Restless legs syndrome is highly underdiagnosed in a neurologic-psychiatric outpatient clinic]. Rev Med Chil 2009; 137:255-258. [PMID: 19543648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
BACKGROUND Restless legs syndrome (RLS) is a neurological condition that is characterized by the irresistible urge to move the legs and is very common. In the last decade, much attention has been focused on RLS, given its high occurrence, underdiagnosis, and impact on quality of life. AIM To determine the frequency of RLS in a neurologic-psychiatric outpatient clinic. PATIENTS AND METHODS We interviewed patients attending a private neurological outpatient clinic, using a standardized validated questionnaire, and an additional phone interview to confirm diagnosis. RESULTS Of approximately 800 people attending the clinic, the questionnaire was answered by 238 subjects (168 females). Fifteen percent of respondents were affected by RLS and none had been diagnosed before. Most patients had a severe form that probably required treatment. CONCLUSIONS A low awareness of RLS exists in Chile, even among specialized physicians.
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Douay X, Waucquier N, Hautecoeur P, Vermersch P. Prévalence élevée du syndrome des jambes sans repos dans la sclérose en plaques. Rev Neurol (Paris) 2009; 165:194-6. [PMID: 18808767 DOI: 10.1016/j.neurol.2008.06.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2008] [Revised: 05/12/2008] [Accepted: 06/06/2008] [Indexed: 11/19/2022]
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223
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Llaneza-González MA, Abella-Corral J, Aldrey-Vázquez JM, Aneiros-Díaz A, Macías-Arribi M, Santos-García D. [Restless legs syndrome]. Rev Neurol 2009; 48 Suppl 1:S33-S36. [PMID: 19222013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
INTRODUCTION Restless legs syndrome (RLS) is a movement disorder with a neurological origin that manifests in the form of sensory-motor symptoms which are located mainly in the lower limbs. DEVELOPMENT We review the epidemiological, pathophysiological, clinical and therapeutic characteristics of this disease, with special emphasis on the diagnostic criteria. CONCLUSIONS Diagnosis of RLS is mainly clinical and is based on the criteria established by the National Institutes of Health consensus development conference in 2002. There are specific criteria for special groups (the elderly with cognitive impairment and children) in which it is not possible to determine whether RLS exists or not using the usual diagnostic criteria.
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Pienczk-Recławowicz K, Pilarska E, Sławek J. [Restless legs syndrome - an underestimated health problem in children]. MEDYCYNA WIEKU ROZWOJOWEGO 2009; 13:26-33. [PMID: 19648656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Restless legs syndrome (RLS) is one of the most common neurological diseases. Even though there is a large progress in its diagnosis, pathophysiology and treatment, it still remains recognised too rarely. It is elderly people who mostly suffer from restless legs syndrome, but it is established that the disease may begin in childhood. The aim of this study is to present the diagnostic criteria and differential diagnosis in cases of this syndrome, in children. Correct diagnosis of restless legs syndrome is a starting point for epidemiological studies on the incidence of RLS in children.
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Stehlik R, Arvidsson L, Ulfberg J. Restless Legs Syndrome Is Common among Female Patients with Fibromyalgia. Eur Neurol 2008; 61:107-11. [PMID: 19065057 DOI: 10.1159/000180313] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2008] [Accepted: 08/19/2008] [Indexed: 11/19/2022]
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