51
|
Olgun Yazar H, Yazar T, Özdemir S, Kasko Arici Y. Serum C-reactive protein/albumin ratio and restless legs syndrome. Sleep Med 2019; 58:61-65. [PMID: 31129525 DOI: 10.1016/j.sleep.2019.02.022] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 02/03/2019] [Accepted: 02/11/2019] [Indexed: 01/11/2023]
Abstract
OBJECTIVES Our study aimed to assess the variation in serum C-reactive protein/albumin ratio (CAR), a biomarker of peripheral inflammation and oxidative stress, in patients with restless legs syndrome (RLS). METHODS The study included a total of 380 individuals including 197 with RLS diagnosis. RLS diagnosis was determined according to the "International Restless Legs Syndrome Study Group" questionnaire. Disease severity was assessed according to the "International Restless Legs Syndrome Study Group Severity Scale''. RESULTS The mean age of patients with restless legs syndrome was 52.5 ± 12.7 years, while the mean age in the control group was 50.8 ± 11.2, with no statistically significant difference found (p = 0.156). The hemoglobin, iron and ferritin levels in the patient group were lower than in the control group (p < 0.001; p < 0.01; p < 0.001), with total iron binding capacity levels higher than the control group (p < 0.001). The mean ferritin in the RLS group (49.8 ± 51.2) was lower than the control group (76.9 ± 44.7). In patients, the c-reactive protein, albumin and c-reactive protein/albumin ratio were found to be 0.21 ± 0.18, 4.43 ± 0.31 and 0.07 ± 0.05, respectively. When compared with the control group, the patient group had high c-reactive protein (CRP), CAR and low albumin levels (p < 0.001). Among patients with "very severe" disease severity, ferritin levels were found to be lower than those with "moderate" disease severity. Additionally, patients with "very severe" disease had albumin levels which were significantly low compared to those with "mild" disease severity (p < 0.05). CONCLUSION Our study supports the hypothesis that serum albumin level, ferritin, CRP, and CAR may be associated with restless legs syndrome.
Collapse
Affiliation(s)
- Hülya Olgun Yazar
- Ordu University Training and Research Hospital, Neurology, Ordu, Turkey.
| | - Tamer Yazar
- Ordu State Hospital, Neurology, Ordu, Turkey
| | - Sonay Özdemir
- İstanbul Gaziosmanpaşa Taksim Training and Research Hospital, Family Medicine, İstanbul, Turkey
| | - Yeliz Kasko Arici
- Ordu University, Faculty of Medicine, Department of Biostatistics and Medical Informatics, Ordu, Turkey
| |
Collapse
|
52
|
Esposito G, Odelli V, Romiti L, Chiaffarino F, Di Martino M, Ricci E, Mauri PA, Bulfoni A, Parazzini F. Prevalence and risk factors for restless legs syndrome during pregnancy in a Northern Italian population. J OBSTET GYNAECOL 2019; 39:480-484. [DOI: 10.1080/01443615.2018.1525341] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Giovanna Esposito
- Department of Obstetrics Gynecology and Neonatology, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Vanessa Odelli
- Dipartimento di Scienze Cliniche e di Comunità, Università di Milano, Milan, Italy
| | - Lucrezia Romiti
- Dipartimento di Scienze Cliniche e di Comunità, Università di Milano, Milan, Italy
| | - Francesca Chiaffarino
- Department of Obstetrics Gynecology and Neonatology, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Mirella Di Martino
- Dipartimento di Scienze Cliniche e di Comunità, Università di Milano, Milan, Italy
| | - Elena Ricci
- Department of Obstetrics Gynecology and Neonatology, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Paola Agnese Mauri
- Department of Obstetrics Gynecology and Neonatology, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- Dipartimento di Scienze Cliniche e di Comunità, Università di Milano, Milan, Italy
| | - Alessandro Bulfoni
- Department of Obstetrics and Gynecology, Humanitas, San Pio X Hospital, Milan, Italy
| | - Fabio Parazzini
- Department of Obstetrics Gynecology and Neonatology, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- Dipartimento di Scienze Cliniche e di Comunità, Università di Milano, Milan, Italy
| |
Collapse
|
53
|
You S, Jeon SM, Do SY, Cho YW. Restless Legs Syndrome in Parkinson's Disease Patients: Clinical Features Including Motor and Nonmotor Symptoms. J Clin Neurol 2019; 15:321-327. [PMID: 31286703 PMCID: PMC6620447 DOI: 10.3988/jcn.2019.15.3.321] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 01/10/2019] [Accepted: 01/14/2019] [Indexed: 01/05/2023] Open
Abstract
Background and Purpose We investigated the frequency and clinical features of restless legs syndrome (RLS) in patients with Parkinson's disease (PD). Methods This study included 74 PD patients. RLS was diagnosed in face-to-face assessments of all of the subjects based on diagnostic criteria of the International Restless Legs Syndrome Study Group revised in 2003. We analyzed the clinical features of PD patients with and without RLS and compared the data to idiopathic RLS. Results The frequency of RLS in the cohort was 21.6% (n=16). Two (12.5%) of the patients with RLS were not treated with dopaminergic drugs, while 14 (24.1%) of the 58 patients without RLS received treatment with dopaminergic drugs. Anxiety, depression, and quality of life (QoL) were significantly worst in patients with RLS. PD patients with RLS had significantly worse sleep quality (p=0.003) and worse scores on the cardiovascular subscale of the Scales for Outcomes in Parkinson's Disease for Autonomic Symptoms (p=0.031) compared to those without RLS. In the group of PD patients with RLS, RLS preceding PD onset was related to a lower Hoehn and Yahr stage. Conclusions We found that the frequency of RLS in the present patients with PD was higher than that in our previous study of a general population of RLS subjects. Compared to the PD patients without RLS, the present PD patients with RLS suffered from worse sleep quality and QoL, depression, anxiety, and autonomic disturbances, especially those with cardiovascular problems.
Collapse
Affiliation(s)
- Sooyeoun You
- Department of Neurology, Keimyung University School of Medicine, Daegu, Korea.,Ewha Womans University, School of Medicine, Seoul, Korea
| | - Soo Myeong Jeon
- Department of Neurology, Keimyung University School of Medicine, Daegu, Korea
| | - So Young Do
- Department of Neurology, Keimyung University School of Medicine, Daegu, Korea
| | - Yong Won Cho
- Department of Neurology, Keimyung University School of Medicine, Daegu, Korea.
| |
Collapse
|
54
|
Yang X, Liu B, Yang B, Li S, Wang F, Li K, Hu F, Ren H, Xu Z. Prevalence of restless legs syndrome in individuals with migraine: a systematic review and meta-analysis of observational studies. Neurol Sci 2018; 39:1927-1934. [PMID: 30116981 DOI: 10.1007/s10072-018-3527-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Accepted: 08/05/2018] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Recent studies have shown an association between migraine and restless legs syndrome (RLS), but RLS prevalence among individuals with migraine differs substantially across studies. The present work aimed to comprehensively assess available evidence to estimate RLS prevalence among individuals with migraine and non-migraine controls. METHOD Web of Science, PubMed, Embase, Chinese National Knowledge Infrastructure, Wanfang, and SinoMed databases were searched for observational and case-control studies of RLS prevalence among individuals with migraine. Eligible studies were meta-analyzed using Stata 12.0 software. RESULTS Pooled RLS prevalence in migraine was 19%, and the prevalence was lower in Asia (16%) than outside Asia (21%). Pooled RLS prevalence was 18.8% among individuals with migraine with aura, and 18.5% among individuals with migraine without aura; the RLS prevalence in migraine with aura (MA) was higher than that of migraine without aura (MO) (OR 1.17, 95%CI 1.01-1.34; p = 0.037). Pooled RLS prevalence in a case-control study was significantly higher among individuals with migraine (17.9%) than among non-migraine controls (7.1%) (OR 2.65, 95%CI 2.26-3.10; p < 0.001). CONCLUSION Our meta-analysis provides the first reliable pooled estimate of RLS prevalence among individuals with migraine, and it provides strong evidence that RLS risk is higher among individuals with migraine than among controls.
Collapse
Affiliation(s)
- Xinglong Yang
- Department of Geriatric Neurology, First Affiliated Hospital of Kunming Medical University, Kunming, 650032, Yunnan, People's Republic of China
| | - Bin Liu
- Department of Geriatric Neurology, First Affiliated Hospital of Kunming Medical University, Kunming, 650032, Yunnan, People's Republic of China
| | - Baiyuan Yang
- Department of Neurology, The Seventh People's Hospital of Chengdu, Chengdu, 650041, Sichuan, People's Republic of China
| | - Shimei Li
- Department of Anesthesia, Kunming Xishan District People's Hospital, Kunming, 650100, Yunnan, People's Republic of China
| | - Fang Wang
- Department of Geriatric Neurology, First Affiliated Hospital of Kunming Medical University, Kunming, 650032, Yunnan, People's Republic of China
| | - Kelu Li
- Department of Geriatric Neurology, First Affiliated Hospital of Kunming Medical University, Kunming, 650032, Yunnan, People's Republic of China
| | - Fayun Hu
- Department of Neurology, West China Hospital, SCU, Chengdu, 650041, Sichuan, People's Republic of China
| | - Hui Ren
- Department of Geriatric Neurology, First Affiliated Hospital of Kunming Medical University, Kunming, 650032, Yunnan, People's Republic of China.
| | - Zhong Xu
- Department of Geriatric Neurology, First Affiliated Hospital of Kunming Medical University, Kunming, 650032, Yunnan, People's Republic of China.
| |
Collapse
|
55
|
Odabaş FÖ, Uca AU. Is there any association between antidepressants and restless legs syndrome in a large Turkish population receiving mono or combined treatment? A cross-sectional comparative study. PSYCHIAT CLIN PSYCH 2018. [DOI: 10.1080/24750573.2018.1480855] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
Affiliation(s)
- Faruk Ömer Odabaş
- Department of Neurology, Konya Health Application and Research Center, University of Health Sciences, Konya, Turkey
| | - Ali Ulvi Uca
- Department of Neurology, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| |
Collapse
|
56
|
Complementary and alternative therapies for restless legs syndrome: An evidence-based systematic review. Sleep Med Rev 2018; 38:158-167. [DOI: 10.1016/j.smrv.2017.06.003] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2017] [Revised: 05/23/2017] [Accepted: 06/09/2017] [Indexed: 12/19/2022]
|
57
|
Theorell-Haglöw J, Miller CB, Bartlett DJ, Yee BJ, Openshaw HD, Grunstein RR. Gender differences in obstructive sleep apnoea, insomnia and restless legs syndrome in adults – What do we know? A clinical update. Sleep Med Rev 2018; 38:28-38. [DOI: 10.1016/j.smrv.2017.03.003] [Citation(s) in RCA: 78] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Revised: 03/20/2017] [Accepted: 03/20/2017] [Indexed: 01/16/2023]
|
58
|
Yang X, Liu B, Shen H, Li S, Zhao Q, An R, Hu F, Ren H, Xu Y, Xu Z. Prevalence of restless legs syndrome in Parkinson's disease: a systematic review and meta-analysis of observational studies. Sleep Med 2018; 43:40-46. [DOI: 10.1016/j.sleep.2017.11.1146] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2017] [Revised: 10/07/2017] [Accepted: 11/13/2017] [Indexed: 10/18/2022]
|
59
|
Per H, Günay N, İsmailoğulları S, Öztop DB, Günay O. Determination of restless legs syndrome prevalence in children aged 13-16 years in the provincial center of Kayseri. Brain Dev 2018; 40:256-257. [PMID: 29102468 DOI: 10.1016/j.braindev.2017.08.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Revised: 08/03/2017] [Accepted: 08/06/2017] [Indexed: 11/19/2022]
Affiliation(s)
- Hüseyin Per
- Erciyes University Medical Faculty, Department of Pediatrics, Division of Pediatric Neurology, Talas Kayseri, Turkey.
| | - Neslihan Günay
- Erciyes University Medical Faculty, Department of Pediatrics, Kayseri, Turkey.
| | - Sevda İsmailoğulları
- Erciyes University Medical Faculty, Department of Neurology, Division of Sleep Medicine, Kayseri, Turkey.
| | - Didem Behice Öztop
- Erciyes University Medical Faculty, Department of Child Psychiatry, Kayseri, Turkey.
| | - Osman Günay
- Erciyes University Medical Faculty, Department of Public Health, Kayseri, Turkey.
| |
Collapse
|
60
|
TOX3 Variants Are Involved in Restless Legs Syndrome and Parkinson’s Disease with Opposite Effects. J Mol Neurosci 2018; 64:341-345. [DOI: 10.1007/s12031-018-1031-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Accepted: 01/12/2018] [Indexed: 10/18/2022]
|
61
|
Roy M, de Zwaan M, Tuin I, Philipsen A, Brähler E, Müller A. Association Between Restless Legs Syndrome and Adult ADHD in a German Community-Based Sample. J Atten Disord 2018; 22:300-308. [PMID: 25555628 DOI: 10.1177/1087054714561291] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Previous research in clinical samples indicated a significant association between ADHD and restless legs syndrome (RLS). The present study examined the association between adult ADHD and RLS in the German population. METHOD Self-rating instruments to assess RLS, childhood ADHD, and adult ADHD were administered to a community-based sample ( N = 1,632). In addition, current depression and anxiety, sleep disturbances, weight, and height were assessed by self-report. RESULTS Adult ADHD was associated with statistically significant increases in the odds of meeting diagnostic criteria for RLS even when adjusting for potential confounding variables such as weight (odds ratio [OR] = 3.18, 95% confidence interval [CI] = [1.29, 7.63], p< .001). However, the association did not hold true after adjusting for the presence of sleep disturbances (OR = 2.02, 95% CI = [0.82, 4.96], p = .13). CONCLUSION The findings suggest a strong link between RLS and adult ADHD symptoms. Clinicians should be aware of RLS among adult ADHD patients, especially as there might be a negative interactive effect.
Collapse
Affiliation(s)
| | | | | | | | - Elmar Brähler
- 2 University of Mainz, Germany.,4 University of Leipzig, Germany
| | | |
Collapse
|
62
|
Wajszilber D, Santiseban JA, Gruber R. Sleep disorders in patients with ADHD: impact and management challenges. Nat Sci Sleep 2018; 10:453-480. [PMID: 30588139 PMCID: PMC6299464 DOI: 10.2147/nss.s163074] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Attention deficit/hyperactivity disorder (ADHD) is one of the most commonly diagnosed disorders in childhood, enduring through adolescence and adulthood and presenting with symptoms of inattention, hyperactivity, and/or impulsivity and significantly impairing functioning. Primary sleep disorders such as sleep-disordered breathing, restless leg syndrome, circadian rhythm sleep disorder, insomnia, and narcolepsy are commonly comorbid in these individuals but not often assessed and are therefore often left untreated. Sleep disturbances in individuals with ADHD can result in significant functional impairments that affect mood, attention, behavior, and ultimately school/work performance and quality of life. Previous reviews have described findings related to sleep but have neglected to examine potential impacts of these sleep disorders and ADHD on daytime functioning. This review investigates empirical findings pertaining to sleep abnormalities and related cognitive, behavioral, emotional, and physical impairments in individuals with ADHD and comorbid primary sleep disorders across the life span. It discusses implications to management and highlights existing limitations and recommended future directions.
Collapse
Affiliation(s)
- Dafna Wajszilber
- Department of Psychiatry, Faculty of Medicine, McGill University, Montréal, Quebec, Canada,
| | - José Arturo Santiseban
- Department of Psychiatry, Faculty of Medicine, McGill University, Montréal, Quebec, Canada, .,Attention Behavior and Sleep Lab, Douglas Research Center, Montréal, Quebec, Canada,
| | - Reut Gruber
- Department of Psychiatry, Faculty of Medicine, McGill University, Montréal, Quebec, Canada, .,Attention Behavior and Sleep Lab, Douglas Research Center, Montréal, Quebec, Canada,
| |
Collapse
|
63
|
Li Y, Li Y, Winkelman JW, Walters AS, Han J, Hu FB, Gao X. Prospective study of restless legs syndrome and total and cardiovascular mortality among women. Neurology 2017; 90:e135-e141. [PMID: 29247069 DOI: 10.1212/wnl.0000000000004814] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Accepted: 09/27/2017] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVE We prospectively examined whether women with physician-diagnosed restless legs syndrome (RLS) had a higher risk of total and cardiovascular disease (CVD) mortality relative to those without RLS. METHODS The current study included 57,417 women (mean age 67 years) from the Nurses' Health Study without cancer, renal failure, and CVD at baseline (2002). Main outcomes were total and CVD mortality. We used the Cox proportional hazards model to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause and CVD-specific mortality based on RLS status, adjusting for age, presence of major chronic diseases, and other potential confounders. RESULTS We documented 6,448 deaths during 10 years of follow-up. We did not observe a significant association between presence of physician-diagnosed RLS and high risk of total mortality (adjusted HR 1.15, 95% CI 0.98-1.34). When cause-specific mortality was studied, participants with RLS had a significantly higher risk of CVD mortality (adjusted HR 1.43, 95% CI 1.02-2.00) relative to those without RLS after adjustment for potential confounders. Longer duration of RLS diagnosis was significantly associated with a higher risk of CVD mortality (p for trend = 0.04). Excluding participants with common RLS comorbidities strengthened the association between RLS and total (adjusted HR 1.43, 95% CI 1.03-1.97) and CVD mortality (adjusted HR 2.27, 95% CI 1.21-4.28). However, we did not find a significant association between RLS and mortality due to cancer and other causes. CONCLUSIONS Women with RLS had a higher CVD mortality rate, which may not be fully explained by common co-occurring disorders of RLS.
Collapse
Affiliation(s)
- Yinge Li
- From the Department of Nutritional Science (Yinge Li, X.G.), Pennsylvania State University, University Park; Department of Nutrition (Yanping Li, F.B.H.), Harvard School of Public Health; Department of Neurology (J.W.W.), Massachusetts General Hospital and Harvard Medical School, Boston; Department of Neurology (A.S.W.), Sleep Division, Vanderbilt University Medical Center, Nashville, TN; Department of Epidemiology (J.H.), Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis; and Channing Division of Network Medicine (J.H., F.B.H.), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Yanping Li
- From the Department of Nutritional Science (Yinge Li, X.G.), Pennsylvania State University, University Park; Department of Nutrition (Yanping Li, F.B.H.), Harvard School of Public Health; Department of Neurology (J.W.W.), Massachusetts General Hospital and Harvard Medical School, Boston; Department of Neurology (A.S.W.), Sleep Division, Vanderbilt University Medical Center, Nashville, TN; Department of Epidemiology (J.H.), Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis; and Channing Division of Network Medicine (J.H., F.B.H.), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - John W Winkelman
- From the Department of Nutritional Science (Yinge Li, X.G.), Pennsylvania State University, University Park; Department of Nutrition (Yanping Li, F.B.H.), Harvard School of Public Health; Department of Neurology (J.W.W.), Massachusetts General Hospital and Harvard Medical School, Boston; Department of Neurology (A.S.W.), Sleep Division, Vanderbilt University Medical Center, Nashville, TN; Department of Epidemiology (J.H.), Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis; and Channing Division of Network Medicine (J.H., F.B.H.), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Arthur S Walters
- From the Department of Nutritional Science (Yinge Li, X.G.), Pennsylvania State University, University Park; Department of Nutrition (Yanping Li, F.B.H.), Harvard School of Public Health; Department of Neurology (J.W.W.), Massachusetts General Hospital and Harvard Medical School, Boston; Department of Neurology (A.S.W.), Sleep Division, Vanderbilt University Medical Center, Nashville, TN; Department of Epidemiology (J.H.), Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis; and Channing Division of Network Medicine (J.H., F.B.H.), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Jiali Han
- From the Department of Nutritional Science (Yinge Li, X.G.), Pennsylvania State University, University Park; Department of Nutrition (Yanping Li, F.B.H.), Harvard School of Public Health; Department of Neurology (J.W.W.), Massachusetts General Hospital and Harvard Medical School, Boston; Department of Neurology (A.S.W.), Sleep Division, Vanderbilt University Medical Center, Nashville, TN; Department of Epidemiology (J.H.), Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis; and Channing Division of Network Medicine (J.H., F.B.H.), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Frank B Hu
- From the Department of Nutritional Science (Yinge Li, X.G.), Pennsylvania State University, University Park; Department of Nutrition (Yanping Li, F.B.H.), Harvard School of Public Health; Department of Neurology (J.W.W.), Massachusetts General Hospital and Harvard Medical School, Boston; Department of Neurology (A.S.W.), Sleep Division, Vanderbilt University Medical Center, Nashville, TN; Department of Epidemiology (J.H.), Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis; and Channing Division of Network Medicine (J.H., F.B.H.), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Xiang Gao
- From the Department of Nutritional Science (Yinge Li, X.G.), Pennsylvania State University, University Park; Department of Nutrition (Yanping Li, F.B.H.), Harvard School of Public Health; Department of Neurology (J.W.W.), Massachusetts General Hospital and Harvard Medical School, Boston; Department of Neurology (A.S.W.), Sleep Division, Vanderbilt University Medical Center, Nashville, TN; Department of Epidemiology (J.H.), Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis; and Channing Division of Network Medicine (J.H., F.B.H.), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
| |
Collapse
|
64
|
Ozer İ, Guzel I, Orhan G, Erkılınç S, Öztekin N, Ak F, Taşçı Y. A prospective case control questionnaire study for restless leg syndrome on 600 pregnant women. J Matern Fetal Neonatal Med 2017; 30:2895-2899. [DOI: 10.3109/14767058.2016.1170801] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- İrfan Ozer
- Department of Obstetrics and Gynecology, Zekai Tahir Burak Women’s Health Education and Research Hospital, Ankara, Turkey
| | - Işıl Guzel
- Department of Neurology, Ankara Numune Education and Research Hospital, Ankara, Turkey
| | - Gürdal Orhan
- Department of Neurology, Ankara Numune Education and Research Hospital, Ankara, Turkey
| | - Selçuk Erkılınç
- Department of Obstetrics and Gynecology, Zekai Tahir Burak Women’s Health Education and Research Hospital, Ankara, Turkey
| | - Neşe Öztekin
- Department of Neurology, Ankara Numune Education and Research Hospital, Ankara, Turkey
| | - Fikri Ak
- Department of Neurology, Ankara Numune Education and Research Hospital, Ankara, Turkey
| | - Yasemin Taşçı
- Department of Obstetrics and Gynecology, Zekai Tahir Burak Women’s Health Education and Research Hospital, Ankara, Turkey
| |
Collapse
|
65
|
Carlos K, Prado GF, Teixeira CDM, Conti C, de Oliveira MM, Prado LBF, Carvalho LBC. Benzodiazepines for restless legs syndrome. Cochrane Database Syst Rev 2017; 3:CD006939. [PMID: 28319266 PMCID: PMC6464545 DOI: 10.1002/14651858.cd006939.pub2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND Restless legs syndrome (RLS) is a common disease affecting about 5% to 15% of the population. Symptoms of RLS can be severe in a minority of and can have a major impact on sleep, mostly sleep initiation, and quality of life. Benzodiazepines are drugs that can induce and maintain sleep and, hence, intuitively are thought to be beneficial to people with RLS. Altough benzodiazepines, particularly clonazepam, are used to treat RLS symptoms, a systematic review done by the American Academy of Sleep Medicine stated that benzodiazepines should not be used as a first-line treatment, although could be used as a coadjuvant therapy. OBJECTIVES To evaluate the efficacy and safety of benzodiazepine compared to placebo or other treatment for idiopathic RLS, including unconfounded trials comparing benzodiazepines versus open control. SEARCH METHODS In March 2016 we searched CENTRAL, MEDLINE, Embase and LILACS We checked the references of each study and contacted study authors to identify any additional studies. We considered studies published in any language. SELECTION CRITERIA Randomised clinical trials of benzodiazepine treatment in idiopathic RLS. DATA COLLECTION AND ANALYSIS We did not perform data collection and analysis, since we did not include any studies, MAIN RESULTS: We did not identify any studies that met the inclusion criteria of the review. Two cross-over studies are awaiting classification because the cross-over trials did not give data at the end of the first cross-over period. AUTHORS' CONCLUSIONS The effectiveness of benzodiazepines for RLS treatment is currently unknown.
Collapse
Affiliation(s)
- Karla Carlos
- Escola Paulista de Medicina, Universidade Federal de São PauloDepartment of NeurologySão PauloBrazil
| | - Gilmar F Prado
- Escola Paulista de Medicina, Universidade Federal de São PauloDepartment of NeurologySão PauloBrazil
| | - Camila DM Teixeira
- Escola Paulista de Medicina, Universidade Federal de São PauloDepartment of NeurologySão PauloBrazil
| | - Cristiane Conti
- Universidade Federal do MaranhãoDepartment of MorphologyAv. dos Portugueses, 1966BacangaSão LuisMaranhãoBrazil65080‐805
| | - Marcio M de Oliveira
- Universidade Federal do MaranhãoDepartment of MorphologyAv. dos Portugueses, 1966BacangaSão LuisMaranhãoBrazil65080‐805
| | - Lucila BF Prado
- Escola Paulista de Medicina, Universidade Federal de São PauloDepartment of NeurologySão PauloBrazil
| | - Luciane BC Carvalho
- Escola Paulista de Medicina, Universidade Federal de São PauloDepartment of NeurologySão PauloBrazil
| | | |
Collapse
|
66
|
Abstract
Biological needs for sleep are met by engaging in behaviors that are largely influenced by the environment, social norms and demands, and societal influences and pressures. Insufficient sleep duration and sleep disorders such as insomnia and sleep apnea are highly prevalent in the US population. This article outlines some of these downstream factors, including cardiovascular and metabolic disease risk, neurocognitive dysfunction, and mortality, as well as societal factors such as age, sex, race/ethnicity, and socioeconomics. This review also discusses societal factors related to sleep, such as globalization, health disparities, public policy, public safety, and changing patterns of use of technology.
Collapse
Affiliation(s)
- Michael A Grandner
- Department of Psychiatry, College of Medicine, University of Arizona, 1501 North Campbell Avenue, PO Box 245002, BUMC Suite 7326, Tucson, AZ 85724-5002, USA.
| |
Collapse
|
67
|
Sherbin N, Ahmed A, Fatani A, Al-Otaibi K, Al-Jahdali F, Ali YZ, Al-Harbi A, Khan M, Baharoon S, Al-Jahdali H. The prevalence and associated risk factors of restless legs syndrome among Saudi adults. Sleep Biol Rhythms 2017. [DOI: 10.1007/s41105-017-0089-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
68
|
Özsimsek A, Koyuncuoglu HR. Electrophysiological findings of Turkish patients with restless legs syndrome. Neuropsychiatr Dis Treat 2017; 13:2005-2010. [PMID: 28794635 PMCID: PMC5538691 DOI: 10.2147/ndt.s132903] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
We aimed to investigate changes in electrophysiological findings in Turkish patients with restless legs syndrome (RLS), including F-wave latency (FWL), peripheral silent period (PSP), and Hoffmann reflex. The study took place in a university hospital in Turkey and involved 30 newly diagnosed RLS patients and 30 healthy controls who were matched for age and gender. Participant's demographics (age, gender, weight, and height), laboratory findings, and electrophysiological test outcomes were gathered and analyzed. There was no significant difference in the FWL of the median and ulnar nerves, whereas the H-wave maximum amplitude and H/M ratio were significantly higher in the RLS patients than in the controls at rest. All of the PSP parameters were similar between patients and controls for the abductor pollicis brevis and gastrocnemius muscles. However, for the tibialis anterior muscle, all the PSP duration parameters were shorter in the RLS patients, whereas the PSP latency parameters were similar. The data suggest that there may be a reduction in spinal segmental inhibition at the L4-L5-S1 level, but the mechanisms of inhibition at the L4-L5 and S1 levels may be different; furthermore, there may be no pathology in the peripheral nerves. Further prospective studies with larger cohorts are now needed to evaluate the pathophysiology of RLS with different neurophysiological assessment tools.
Collapse
|
69
|
Yeh P, Ondo WG, Picchietti DL, Poceta JS, Allen RP, Davies CR, Wang L, Shi Y, Bagai K, Walters AS. Depth and Distribution of Symptoms in Restless Legs Syndrome/ Willis-Ekbom Disease. J Clin Sleep Med 2016; 12:1669-1680. [PMID: 27655450 PMCID: PMC5155205 DOI: 10.5664/jcsm.6356] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Accepted: 08/17/2016] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES To determine the depth and distribution of sensory discomfort in idiopathic restless legs syndrome/Willis-Ekbom disease (RLS) and RLS concurrent with other leg conditions, specifically peripheral neuropathy, sciatica, leg cramps, and arthritis. METHODS RLS subjects (n = 122) were divided into 71 idiopathic RLS and 51 RLS-C, or Comorbid, groups. All subjects were examined by an RLS expert, answered standardized RLS questionnaires, and received a body diagram to draw the location and depth of their symptoms. RESULTS Age was 63.04 ± 12.84 years, with 77 females and 45 males. All patients had lower limb involvement and 43/122 (35.25%) also had upper limb involvement. Of the 122 subjects, 42.62% felt that the RLS discomfort was only deep, 9.84% felt that the discomfort was only superficial, and 47.54% felt both superficial and deep discomfort. There were no defining characteristics in depth or distribution of RLS sensations that differentiated those patients with idiopathic RLS from those patients with RLS associated with other comorbid leg conditions. The sensation of arthritis was felt almost exclusively in the joints and not in the four quadrants of the leg, whereas the exact opposite was true of RLS sensations. CONCLUSIONS Depth and distribution cannot be used as a discriminative mechanism to separate out idiopathic RLS from RLS comorbid with other leg conditions. Although seen in clinical practice, the total absence of patients with non-painful RLS only in the joints in the current study attests to the rarity of this presentation and raises the possibility of misdiagnosis under these circumstances. We recommend that such patients not be admitted to genetic or epidemiological studies.
Collapse
Affiliation(s)
- Paul Yeh
- Department of Psychiatry, University of Texas Health Science Center at San Antonio, TX
| | - William G. Ondo
- Department of Neurology, Methodist Neurological Institute, Houston, TX
| | - Daniel L. Picchietti
- Carle Neuroscience Institute, University of Illinois College of Medicine at Urbana-Champaign, Urbana, IL
| | | | - Richard P. Allen
- RLS Center, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Charles R. Davies
- Carle Neuroscience Institute, University of Illinois College of Medicine at Urbana-Champaign, Urbana, IL
| | - Lily Wang
- Department of Biostatistics, Vanderbilt School of Medicine, Nashville, TN
| | - Yaping Shi
- Department of Biostatistics, Vanderbilt School of Medicine, Nashville, TN
| | - Kanika Bagai
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN
| | - Arthur S. Walters
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN
| |
Collapse
|
70
|
Acay A, Bal A, Oruc S, Ozkececi T, Sariaydin M, Demirbas H, Acarturk G. Does frequency of restless legs syndrome and poor sleep quality increase with age in irritable bowel syndrome? Wien Klin Wochenschr 2016; 128:604-609. [DOI: 10.1007/s00508-016-1065-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Accepted: 07/29/2016] [Indexed: 01/29/2023]
|
71
|
Koskderelioglu A, Kusbeci T, Kusbeci OY, Gedizlioglu M. Optic nerve head, retinal nerve fiber layer and macular thickness analysis in restless legs syndrome. Parkinsonism Relat Disord 2016; 31:110-115. [PMID: 27524286 DOI: 10.1016/j.parkreldis.2016.08.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Revised: 07/14/2016] [Accepted: 08/01/2016] [Indexed: 11/29/2022]
Abstract
PURPOSE The human retina contains dopaminergic neurons within the inner retinal layer. Several studies demonstrated dopaminergic neuronal loss in Parkinson's disease (PD) using optical coherence tomography (OCT). Hypothetically, restless legs syndrome (RLS) may have an underlying dopaminergic mechanism and a probable relation to PD is assumed. Therefore, we aimed to analyze retinal morphology in RLS patients. METHODS In this cross-sectional study we used spectral domain OCT to measure the features of various retinal layers such as thicknesses of peripapillary retinal nerve fiber layer (RNFL), macular and foveal layers, ganglion cell complex (GCC), and optic nerve head parameters of 36 patients with idiopathic RLS, together with 36 age and sex-matched controls. Differences in the thicknesses of RNFL, macula, GCC and optic disc parameters are statistically compared between patients and controls. RESULTS The average peripapillary RNFL thickness, mean macular volume and total retinal thickness were reduced in RLS compared with healthy controls (p = 0.032, p = 0.029, and p = 0.026, respectively). After Bonferroni correction, only the reduction in the inferior inner and outer quadrants of the macula remained significant (p = 0.0040, for both). Optic nerve head parameters (cup volume, cup/disc area ratio, rim area and disc area) and GCC thickness showed no significant difference between patients and healthy controls. CONCLUSION Our study revealed significant retinal thinning in the macula region in RLS. Our results may support the dopaminergic dysfunction in the pathogenesis of RLS. Prospective longitudinal studies with a larger sample are needed to corroborate our results.
Collapse
Affiliation(s)
- Asli Koskderelioglu
- Izmir Bozyaka Education and Research Hospital, Neurology Department, Izmir, Turkey.
| | - Tuncay Kusbeci
- Izmir Bozyaka Education and Research Hospital, Ophthalmology Department, Izmir, Turkey.
| | - Ozge Yilmaz Kusbeci
- Izmir Bozyaka Education and Research Hospital, Neurology Department, Izmir, Turkey.
| | - Muhtesem Gedizlioglu
- Izmir Bozyaka Education and Research Hospital, Neurology Department, Izmir, Turkey.
| |
Collapse
|
72
|
Shin JW, Koo YS, Lee BU, Shin WC, Lee SK, Cho YW, Jung KY. Prevalence and Characteristics of Periodic Limb Movements during Sleep in Korean Adult Patients with Restless Legs Syndrome. J Clin Sleep Med 2016; 12:1089-97. [PMID: 27306390 DOI: 10.5664/jcsm.6042] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Accepted: 05/11/2016] [Indexed: 12/25/2022]
Abstract
STUDY OBJECTIVES The aim of this study was to investigate the prevalence and characteristics of periodic limb movements during sleep (PLMS) in Korean patients with restless legs syndrome (RLS). METHODS Unmedicated adult patients with idiopathic RLS (n = 354) who underwent polysomnography at three major sleep centers in tertiary hospitals were included. Characteristics of PLMS in RLS were analyzed using the time structure of polysomnographically recorded leg movements and periodicity indices (PIs). RLS severity and subjective sleep quality were assessed. RESULTS Out of 354 patients with idiopathic RLS (mean age: 52.9 ± 12.0 years), 150 patients (42.3%) had RLS with a PLMS index greater than 15 events/h, and 204 (57.9%) had a PLMS index greater than 5 events/h. The distribution of inter-LM intervals was bimodal, and high PIs (0.86 ± 0.10) were observed in patients with RLS and PLMS (PLMS index > 15 events/h). The PLMS index was positively correlated with age (r = 0.228; p < 0.001), the periodic limb movements in wakefulness index (r = 0.455, p < 0.001) and arousal index (r = 0.174, p = 0.014), but not with RLS severity and parameters of sleep quality. In multivariate analysis, age and male gender were independently associated with PLMS > 15 events/h. CONCLUSIONS The prevalence of PLMS in Korean patients with RLS was lower than that observed in Western countries, but the characteristics of PLMS were not different. Ethnic differences and/or different genetic backgrounds may contribute to the varying prevalence of PLMS in RLS.
Collapse
Affiliation(s)
- Jung-Won Shin
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.,Department of Neurology, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea
| | - Yong Seo Koo
- Department of Neurology, Korea University Medical Center Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Byeong Uk Lee
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Won Chul Shin
- Department of Neurology, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul, Republic of Korea
| | - Sang Kun Lee
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Yong Won Cho
- Department of Neurology, Dongsan Medical Center, Keimyung University College of Medicine, Daegu, Republic of Korea
| | - Ki-Young Jung
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| |
Collapse
|
73
|
Holland MT, Rettenmaier LA, Flouty OE, Thomsen TR, Jerath NU, Reddy CG. Epidural Spinal Cord Stimulation: A Novel Therapy in the Treatment of Restless Legs Syndrome. World Neurosurg 2016; 92:582.e15-582.e18. [PMID: 27268311 DOI: 10.1016/j.wneu.2016.05.077] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Revised: 05/24/2016] [Accepted: 05/25/2016] [Indexed: 11/15/2022]
Affiliation(s)
- Marshall T Holland
- Department of Neurosurgery, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
| | - Leigh A Rettenmaier
- Department of Neurosurgery, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
| | - Oliver E Flouty
- Department of Neurosurgery, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
| | - Teri R Thomsen
- Department of Neurology, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
| | - Nivedita U Jerath
- Department of Neurology, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
| | - Chandan G Reddy
- Department of Neurosurgery, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA.
| |
Collapse
|
74
|
de Oliveira CO, Carvalho LBC, Carlos K, Conti C, de Oliveira MM, Prado LBF, Prado GF. Opioids for restless legs syndrome. Cochrane Database Syst Rev 2016; 2016:CD006941. [PMID: 27355187 PMCID: PMC6885031 DOI: 10.1002/14651858.cd006941.pub2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Restless legs syndrome (RLS) is a distressing and common neurological disorder that may have a huge impact in the quality of life of those with frequent and intense symptoms. Patients complain of unpleasant sensations in the legs, at or before bedtime, and feel an urge to move the legs, which improves with movement, such as walking. Symptoms start with the patient at rest (e.g. sitting or lying down), and follow a circadian pattern, increasing during the evening or at night. Many pharmacological intervention are available for RLS, including drugs used to treat Parkinson's disease (L-Dopa and dopaminergic agonists), epilepsy (anticonvulsants), anxiety (benzodiazepines), and pain (opioids). Dopaminergic drugs are those most frequently used for treatment of RLS, but some patients do not respond effectively and require other medication. Opioids, a class of medications used to treat severe pain, seem to be effective in treating RLS symptoms, and are recommended for patients with severe symptoms, because RLS and pain appear to share the same mechanism in the central nervous system. All available drugs are associated to some degree with side effects, which can impede treatment. Opioids are associated with adverse events such as constipation, tolerance, and dependence. This justifies the conduct of a systematic review to ascertain whether opioids are safe and effective for treatment of RLS. OBJECTIVES To asses the effects of opioids compared to placebo treatment for restless legs syndrome in adults. SEARCH METHODS We searched the Cochrane Central Register of Controlled trials, CENTRAL 2016, issue 4 and MEDLINE, EMBASE, and LILACS up to April 2016, using a search strategy adapted by Cochraneto identify randomised clinical trials. We checked the references of each study and established personal communication with other authors to identify any additional studies. We considered publications in all languages. SELECTION CRITERIA Randomised controlled clinical trials of opioid treatment in adults with idiopathic RLS. DATA COLLECTION AND ANALYSIS Two review authors independently screened articles, independently extracted data into a standard form, and assessed for risk of bias. If necessary, they discussed discrepancies with a third researcher to resolve any doubts. MAIN RESULTS We included one randomised clinical trial (N = 304 randomised; 204 completed; 276 analysed) that evaluated opioids (prolonged release oxycodone/naloxone) versus placebo. After 12 weeks, RSL symptoms had improved more in the drug group than in the placebo group (using the IRLSSS: MD -7.0; 95% CI -9.69 to -4.31 and the CGI: MD -1.11; 95% CI -1.49 to -0.73). More patients in the drug group than in the placebo group were drug responders (using the IRLSSS: RR 1.82; 95% CI 1.37 to 2.42 and the CGI: RR1.92; 95% ICI 1.49 to 2.48). The proportion of remitters was greater in the drug group than in the placebo group (using the IRLSSS: RR 2.14; 95% CI 1.45 to 3.16). Quality of life scores also improved more in the drug group than in the placebo group (MD -0.73; 95% CI -1.1 to -0.36). Quality of sleep was improved more in the drug group measured by sleep adequacy (MD -0.74; 95% CI -1.15 to -0.33), and sleep quantity (MD 0.89; 95% CI 0.52 to 1.26).There was no difference between groups for daytime somnolence, trouble staying awake during the day, or naps during the day. More adverse events were reported in the drug group (RR 1.22; 95% CI 1.07 to 1.39). The major adverse events were gastrointestinal problems, fatigue, and headache. AUTHORS' CONCLUSIONS Opioids seem to be effective for treating RLS symptoms, but there are no definitive data regarding the important problem of safety. This conclusion is based on only one study with a high dropout rate (moderate quality evidence).
Collapse
Affiliation(s)
- César Osório de Oliveira
- Escola Paulista de Medicina, Universidade Federal de São PauloDepartment of NeurologySão PauloBrazil
| | - Luciane BC Carvalho
- Universidade Federal de São PauloDepartment of NeurologyRua Claudio Rossi, 394São PauloSão PauloBrazilCEP 01547‐000
| | - Karla Carlos
- Escola Paulista de Medicina, Universidade Federal de São PauloDepartment of NeurologySão PauloBrazil
| | - Cristiane Conti
- Universidade Federal do MaranhãoDepartment of MorphologyAv. dos Portugueses, 1966BacangaSão LuisMaranhãoBrazil65080‐805
| | - Marcio M de Oliveira
- Universidade Federal do MaranhãoDepartment of MorphologyAv. dos Portugueses, 1966BacangaSão LuisMaranhãoBrazil65080‐805
| | - Lucila BF Prado
- Universidade Federal de São PauloDepartment of NeurologyRua Claudio Rossi, 394São PauloSão PauloBrazilCEP 01547‐000
| | - Gilmar F Prado
- Escola Paulista de Medicina, Universidade Federal de São PauloDepartment of NeurologySão PauloBrazil
| | | |
Collapse
|
75
|
Maung SC, El Sara A, Chapman C, Cohen D, Cukor D. Sleep disorders and chronic kidney disease. World J Nephrol 2016; 5:224-232. [PMID: 27152260 PMCID: PMC4848147 DOI: 10.5527/wjn.v5.i3.224] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Revised: 11/26/2015] [Accepted: 03/09/2016] [Indexed: 02/06/2023] Open
Abstract
Sleep disorders have a profound and well-documented impact on overall health and quality of life in the general population. In patients with chronic disease, sleep disorders are more prevalent, with an additional morbidity and mortality burden. The complex and dynamic relationship between sleep disorders and chronic kidney disease (CKD) remain relatively little investigated. This article presents an overview of sleep disorders in patients with CKD, with emphasis on relevant pathophysiologic underpinnings and clinical presentations. Evidence-based interventions will be discussed, in the context of individual sleep disorders, namely sleep apnea, insomnia, restless leg syndrome and excessive daytime sleepiness. Limitations of the current knowledge as well as future research directions will be highlighted, with a final discussion of different conceptual frameworks of the relationship between sleep disorders and CKD.
Collapse
|
76
|
Abstract
Idiopathic restless legs syndrome (RLS)--also known as Willis-Ekbom disease--is a neurological condition characterised by an overwhelming urge to move the legs, occurring during rest or inactivity, especially at night. Symptoms are highly variable in frequency and severity, and can affect sleep and quality of life. First-line management includes addressing precipitating or aggravating factors and providing explanation, reassurance and advice on self-help strategies. Drug therapy (e.g. a dopamine agonist) is used for patients with more severe symptoms. In December 2014, the marketing authorisation for a modified-release preparation containing oxycodone and naloxone (Targinact-Napp Pharmaceuticals) was expanded to include use in the treatment of severe to very severe RLS after failure of dopaminergic therapy.(10)Here we review the management of adults with RLS, including the place of oxycodone/naloxone.
Collapse
|
77
|
Innes KE, Kandati S, Flack KL, Agarwal P, Selfe TK. The Relationship of Restless Legs Syndrome to History of Pregnancy-Induced Hypertension. J Womens Health (Larchmt) 2016; 25:397-408. [PMID: 26913940 DOI: 10.1089/jwh.2015.5484] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Restless legs syndrome (RLS), a burdensome sleep disorder, has been associated with cardiovascular disease (CVD), hypertension, diabetes, and related disorders. However, the relationship of RLS to history of pregnancy-induced hypertension (PIH), a predictor of subsequent CVD, diabetes, and associated conditions, remains little explored. In this study, we investigated the relationship of RLS to history of PIH in a sample of primary care patients. METHODS Participants were women aged ≥40 years drawn from an anonymous survey study of West Virginia primary care patients. Data collected included detailed information on demographics, lifestyle factors, sleep patterns, and reproductive/medical history; the survey also included an RLS diagnostic questionnaire. Women who were pregnant or unsure about their pregnancy status were excluded from the analyses. RESULTS Of the 498 participants in the final analytic sample, 24.5% met diagnostic criteria for RLS (17.9% with symptoms ≥once/week, 11.9% with symptoms ≥3 times/week); 73 (16.5% of parous women) reported a history of PIH, defined as physician-diagnosed preeclampsia or gestational hypertension. After adjustment for demographics, lifestyle characteristics, obesity, reproductive history, health conditions, and other factors, those reporting a history of PIH were approximately twice as likely to meet criteria for RLS (odds ratio [OR] = 1.9; 95% confidence interval [CI] = 1.1, 3.6). These associations increased in magnitude with increasing symptom frequency (adjusted OR for RLS with symptoms ≥3 times/week = 3.8; CI 1.9, 7.6; p for trend = 0.003). CONCLUSIONS History of PIH was strongly and positively related to current RLS in this study of primary care patients; these findings further support a possible role for metabolic dysregulation in RLS etiology.
Collapse
Affiliation(s)
- Kim E Innes
- 1 Department of Epidemiology, West Virginia University School of Public Health , Morgantown, West Virginia.,2 Center for the Study of Complementary and Alternative Therapies, University of Virginia Health System , Charlottesville, Virginia.,3 Department of Physical Medicine and Rehabilitation, University of Virginia Health System , Charlottesville, Virginia
| | - Sahiti Kandati
- 1 Department of Epidemiology, West Virginia University School of Public Health , Morgantown, West Virginia
| | - Kathryn L Flack
- 1 Department of Epidemiology, West Virginia University School of Public Health , Morgantown, West Virginia.,4 WV Focus: Reproductive Education & Equality , Charleston, West Virginia
| | - Parul Agarwal
- 5 Department of Pharmaceutical Systems and Policy, West Virginia University School of Pharmacy , Morgantown, West Virginia
| | - Terry Kit Selfe
- 1 Department of Epidemiology, West Virginia University School of Public Health , Morgantown, West Virginia.,2 Center for the Study of Complementary and Alternative Therapies, University of Virginia Health System , Charlottesville, Virginia
| |
Collapse
|
78
|
Kubo K, Sugawara N, Kaneda A, Takahashi I, Nakamura K, Nakaji S, Yasui-Furukori N. Relationship between quality of life and restless legs syndrome among a community-dwelling population in Japan. Neuropsychiatr Dis Treat 2016; 12:809-15. [PMID: 27110114 PMCID: PMC4835115 DOI: 10.2147/ndt.s102089] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES Restless legs syndrome (RLS) is a sensorimotor disturbance that causes the production of impulses and dysesthesia and makes the patients feel as though they must move their lower extremities. Because the symptoms of RLS in the lower limbs tend to develop at night, RLS could cause sleep disorders. We investigated an association between the symptoms of RLS and the health-related quality of life among community-dwelling individuals in Japan. METHODS In this cross-sectional survey, we enrolled 985 volunteers who participated in the Iwaki Health Promotion Project in 2013. The symptoms of RLS were evaluated by the criteria of the International Restless Legs Syndrome Study Group. The assessments included an interview to obtain sociodemographic data, the second version of the Short Form Health Survey, the Center for Epidemiological Studies Depression scale, and the Pittsburgh Sleep Quality Index. A multiple regression analysis was used to assess the relationship between the symptoms of RLS and subscores of the Short Form Health Survey, Version 2. RESULTS The overall prevalence of RLS in our participants was 1.0%. We found a significant and negative association between symptoms of RLS and physical functioning, role - physical functioning, bodily pain, social functioning, and the physical composite summary score. CONCLUSION After adjusting for confounders such as age, sex, and comorbidity, the burden of RLS appears to be mainly a physical problem. Impaired health-related quality of life among community individuals with RLS emphasizes the importance of screening for these symptoms and evaluating the need for treatment.
Collapse
Affiliation(s)
- Kazutoshi Kubo
- Department of Neuropsychiatry, Hirosaki University School of Medicine, Hirosaki, Japan
| | - Norio Sugawara
- Department of Neuropsychiatry, Hirosaki University School of Medicine, Hirosaki, Japan; Department of Psychiatry, Aomori Prefectural Center for Mental Health and Welfare, Aomori, Japan
| | - Ayako Kaneda
- Department of Neuropsychiatry, Hirosaki University School of Medicine, Hirosaki, Japan
| | - Ippei Takahashi
- Department of Social Medicine, Hirosaki University School of Medicine, Hirosaki, Japan
| | - Kazuhiko Nakamura
- Department of Neuropsychiatry, Hirosaki University School of Medicine, Hirosaki, Japan
| | - Shigeyuki Nakaji
- Department of Social Medicine, Hirosaki University School of Medicine, Hirosaki, Japan
| | - Norio Yasui-Furukori
- Department of Neuropsychiatry, Hirosaki University School of Medicine, Hirosaki, Japan
| |
Collapse
|
79
|
Abstract
Sleep disturbances are a common presenting symptom of older-age adults to their physicians. This article explores normal changes in sleep pattern with aging and primary sleep disorders in the elderly. Behavioral factors and primary psychiatric disorders affecting sleep in this population are reviewed. Further discussion examines sleep changes associated with 2 common forms of neurocognitive disorder: Alzheimer disease and Lewy Body Dementia. Common medical illnesses in the elderly are discussed in relation to sleep symptoms. Nonpharmacological and pharmacologic treatment strategies are summarized, with emphasis placed on risk of side effects in older adults. Future targets are considered.
Collapse
Affiliation(s)
- Kristina F Zdanys
- Department of Psychiatry, University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT 06030, USA.
| | - David C Steffens
- Department of Psychiatry, University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT 06030, USA
| |
Collapse
|
80
|
Efficacy of Pramipexole for the Treatment of Primary Restless Leg Syndrome: A Systematic Review and Meta-analysis of Randomized Clinical Trials. Clin Ther 2015; 38:162-179.e6. [PMID: 26572941 DOI: 10.1016/j.clinthera.2015.10.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Revised: 10/06/2015] [Accepted: 10/07/2015] [Indexed: 01/22/2023]
Abstract
PURPOSE The objective of this meta-analysis was to systematically evaluate the efficacy of pramipexole for the treatment of primary moderate-to-severe restless leg syndrome (RLS). METHODS Databases of PubMed, OVID, ScienceDirect, SpringerLink, Thomson Reuters Web of Science, the Cochrane Library, the Wiley Online Library, ArticleFirst, CALIS, Study, CNKI, and WanFang were searched to identify randomized controlled trials (RCTs) investigating pramipexole for the treatment of primary moderate-to-severe RLS. A meta-analysis was then conducted to pool results. FINDINGS Twelve RCTs involving 3286 participants were included in this study. The mean (SD) treatment duration was 11.12 (5.72) weeks/person. The meta-analysis found that the post-treatment change in the International Restless Leg Syndrome Study Group Rating Scale (IRLS) score of the pramipexole group was significantly superior to that of the placebo group (weighted mean difference [WMD] = -4.64; 95% CI, -5.95 to -3.33; n = 8). More patients in the pramipexole group reported at least a 50% reduction in the IRLS score after treatment (risk ratio [RR] = 1.57; 95% CI, 1.43 to 1.73; n = 8). In terms of the scores for the Clinical Global Impression of Improvement scale (RR = 1.48; 95% CI, 1.31 to 1.66; n = 11) and the Patient Global Impression scale (RR = 1.54; 95% CI, 1.31 to 1.81; n = 9), treatment outcomes of the pramipexole group were significantly superior to those of the placebo group. In terms of the change in quality of life (WMD = 5.39; 95% CI, 2.28 to 8.50; n = 4), the change in daytime tiredness (WMD = -0.61; 95% CI, -1.21 to -0.01; n = 4), the change in the number of periodic limb movements per hour of sleep (WMD = -35.95; 95% CI, -56.42 to -15.48; n = 3), and the change in the quality of sleep (WMD = 3.60; 95% CI, 1.69 to 5.50; n = 6), the treatment outcomes of the pramipexole group were significantly superior to those of the placebo group. IMPLICATIONS This meta-analysis study indicated that pramipexole could effectively improve the symptoms of patients with primary moderate-to-severe RLS, although the quality of evidence was relatively low. Future clinical trials focusing on the medium-term and long-term treatment outcomes and using mainly objective indicators for evaluation are warranted. It is also necessary to pay close attention to augmentation during medication.
Collapse
|
81
|
Luyster FS, Choi J, Yeh CH, Imes CC, Johansson AEE, Chasens ER. Screening and evaluation tools for sleep disorders in older adults. Appl Nurs Res 2015; 28:334-40. [PMID: 26608435 PMCID: PMC4661454 DOI: 10.1016/j.apnr.2014.12.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2014] [Revised: 12/19/2014] [Accepted: 12/20/2014] [Indexed: 10/23/2022]
Abstract
The negative effects of impaired sleep on physical and mental well-being in older adults have recently been recognized by health care professionals. However, researchers and clinicians may be unaware of reliable and valid screening and evaluation tools for evaluating sleep disorders in older adults. The purpose of this article is to present subjective and objective instruments that measure sleep quality, excessive daytime sleepiness, obstructive sleep apnea, insomnia and restless leg syndrome that are appropriate for use in adult and older adult patients.
Collapse
Affiliation(s)
- Faith S Luyster
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA.
| | - JiYeon Choi
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA
| | - Chao-Hsing Yeh
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA
| | | | | | - Eileen R Chasens
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA
| |
Collapse
|
82
|
Yennurajalingam S, Balachandran D, Pedraza Cardozo SL, Berg EA, Chisholm GB, Reddy A, DeLa Cruz V, Williams JL, Bruera E. Patient-reported sleep disturbance in advanced cancer: frequency, predictors and screening performance of the Edmonton Symptom Assessment System sleep item. BMJ Support Palliat Care 2015; 7:274-280. [PMID: 26475092 DOI: 10.1136/bmjspcare-2015-000847] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Revised: 07/23/2015] [Accepted: 09/16/2015] [Indexed: 12/16/2022]
Affiliation(s)
- Sriram Yennurajalingam
- Department of Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center, Houston Texas, USA
| | - Dave Balachandran
- Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Sandra L Pedraza Cardozo
- Department of Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center, Houston Texas, USA
| | - Elyssa A Berg
- Department of Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center, Houston Texas, USA
| | - Gary B Chisholm
- The University of Texas MD Anderson Cancer Center, Biostatistics, Houston, Texas, USA
| | - Akhila Reddy
- Department of Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center, Houston Texas, USA
| | - Vera DeLa Cruz
- Department of Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center, Houston Texas, USA
| | - Janet L Williams
- Department of Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center, Houston Texas, USA
| | - Eduardo Bruera
- Department of Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center, Houston Texas, USA
| |
Collapse
|
83
|
Askenasy N, Askenasy JJ. Restless Leg Syndrome in Neurologic and Medical Disorders. Sleep Med Clin 2015; 10:343-50, xv. [DOI: 10.1016/j.jsmc.2015.05.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
84
|
|
85
|
Mery V, Kimoff R, Suarez I, Benedetti A, Kaminska M, Robinson A, Lapierre Y, Bar-Or A, Trojan D. High false-positive rate of questionnaire-based restless legs syndrome diagnosis in multiple sclerosis. Sleep Med 2015; 16:877-82. [DOI: 10.1016/j.sleep.2015.02.529] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Revised: 02/08/2015] [Accepted: 02/22/2015] [Indexed: 12/01/2022]
|
86
|
Surani S, Brito V, Surani A, Ghamande S. Effect of diabetes mellitus on sleep quality. World J Diabetes 2015; 6:868-873. [PMID: 26131327 PMCID: PMC4478581 DOI: 10.4239/wjd.v6.i6.868] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2014] [Revised: 02/21/2015] [Accepted: 05/18/2015] [Indexed: 02/05/2023] Open
Abstract
Diabetes mellitus (DM) is a highly prevalent condition affecting about 347 million people worldwide. In addition to its numerous clinical implications, DM also exerts a negative effect on patient’s sleep quality. Impaired sleep quality disrupts the adequate glycemic control regarded as corner stone in DM management and also lead to many deleterious effects causing a profound impact on health related quality of life. This article outlines various factors leading to impaired sleep quality among diabetics and delineates how individual factor influences sleep. The article also discusses potential interventions and lifestyle changes to promote healthy sleep among diabetics.
Collapse
|
87
|
Abstract
Sleep disorders are a pervasive problem throughout all patient populations but represent an especially important health problem for the elderly. Alterations in sleep architecture that occur as a part of normal aging will contribute to sleep problems as we grow older. Other contributing factors-including comorbid medical conditions, changes in lifestyle and schedule, altered circadian rhythm, among a host of others-can have detrimental effects on the health of the elderly. Coupled with a number of sleep disorders that either emerge or exacerbate with age, the effects of poor sleep often result in an overall worsening of quality of life. Treatment options can be unique in this population and often more difficult due to the effects of normal aging, as well as polypharmacy and possible medication interactions. The following article will focus on the common sleep disorders that can besiege this population, symptoms to aid in diagnosis, and specific treatment options to help improve quality of life in the elderly.
Collapse
Affiliation(s)
- Kevin Gleason
- Department of Psychiatry and Health Behavior, Medical College of Georgia, 997 St. Sebastian Way, Augusta, GA, 30912, USA,
| | | |
Collapse
|
88
|
Abstract
An oral, fixed-dose combination of prolonged-release (PR) oxycodone with PR naloxone (Targin(®), Targiniq(®), Targinact(®); hereafter referred to as oxycodone/naloxone PR) is approved in Europe for the second-line symptomatic treatment of patients with severe to very severe idiopathic restless legs syndrome (RLS), after failure of dopaminergic therapy. Coadministration of naloxone represents a targeted approach to counteracting opioid-induced bowel dysfunction without compromising therapeutic efficacy; because of its very low oral bioavailability, naloxone blocks the action of oxycodone at opioid receptors locally in the gut. The efficacy of oxycodone/naloxone PR in patients with severe RLS inadequately controlled by previous (mainly dopaminergic) treatment has been demonstrated in RELOXYN, a 12-week, randomized, double-blind study with a 40-week open-label extension. In this pivotal study, oxycodone/naloxone PR significantly improved RLS symptoms compared with placebo from week 2 onwards; a beneficial effect of oxycodone/naloxone PR was maintained through 1 year of treatment. Furthermore, improvements in RLS symptoms in oxycodone/naloxone PR recipients were accompanied by similarly sustained improvements in disease-specific quality of life and subjective sleep variables. Oxycodone/naloxone PR was generally well tolerated, with a treatment-related adverse event profile (e.g. gastrointestinal disorders, CNS disorders, fatigue and pruritus) that was consistent with that expected for opioid therapy. Notably, there were no confirmed cases of augmentation among oxycodone/naloxone PR recipients throughout the course of the study. Results from the well-designed RELOXYN trial have thus demonstrated the value of oxycodone/naloxone PR as a second-line therapy for severe refractory RLS; further investigation of this combination product as a first-line treatment for severe RLS is now warranted.
Collapse
Affiliation(s)
- James E Frampton
- Springer, Private Bag 65901, Mairangi Bay 0754, Auckland, New Zealand,
| |
Collapse
|
89
|
Liu G, Li L, Zhang J, Xue R, Zhao X, Zhu K, Wang Y, Xiao L, Shangguan J. Restless legs syndrome and pregnancy or delivery complications in China: a representative survey. Sleep Med 2015; 17:158-62. [PMID: 26847992 DOI: 10.1016/j.sleep.2015.02.541] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Revised: 02/25/2015] [Accepted: 02/27/2015] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To perform a detailed epidemiological study of Chinese women and the relationship between restless legs syndrome (RLS) in pregnancy and any associated complications during delivery. METHODS A total of 3874 pregnant women (18-40 years) who had delivered babies at The First Affiliated Hospital of Zhengzhou University from May 2011 to May 2014 were enrolled in the study. Using a face-to-face interview questionnaire, data were collected pertaining to RLS incidence in pregnancy and any associated complications during delivery. The relationship between RLS frequency and pregnancy or delivery complications was further investigated. RESULTS Among 12.3% of the eligible participants, RLS prevalence occurred at least weekly. Older pregnant women were more likely to suffer from RLS. Individuals who experienced RLS at least weekly reported a statistically higher frequency of excessive daytime sleepiness and an increased prevalence of hypertension, cardiovascular disease, and preeclampsia compared with those without RLS. CONCLUSION The study revealed that RLS was frequent in Chinese pregnant women, especially in those with pregnancy or delivery complications such as hypertension, cardiovascular disease, and preeclampsia. Restless legs syndrome was also associated with excessive daytime sleepiness.
Collapse
Affiliation(s)
- Gangqiong Liu
- Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, No. 1 Jian She Dong Avenue, Zhengzhou 450002, China
| | - Ling Li
- Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, No. 1 Jian She Dong Avenue, Zhengzhou 450002, China.
| | - Jinying Zhang
- Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, No. 1 Jian She Dong Avenue, Zhengzhou 450002, China
| | - Rui Xue
- Department of Urology, The First Affiliated Hospital of Zhengzhou University, No. 1 Jian She Dong Avenue, Zhengzhou 450002, China
| | - Xiaoyan Zhao
- Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, No. 1 Jian She Dong Avenue, Zhengzhou 450002, China
| | - Kui Zhu
- Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, No. 1 Jian She Dong Avenue, Zhengzhou 450002, China
| | - Yunzhe Wang
- Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, No. 1 Jian She Dong Avenue, Zhengzhou 450002, China
| | - Lili Xiao
- Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, No. 1 Jian She Dong Avenue, Zhengzhou 450002, China
| | - Jiahong Shangguan
- Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, No. 1 Jian She Dong Avenue, Zhengzhou 450002, China
| |
Collapse
|
90
|
Schlesinger I, Erikh I, Nassar M, Sprecher E. Restless legs syndrome in stroke patients. Sleep Med 2015; 16:1006-10. [PMID: 26116464 DOI: 10.1016/j.sleep.2014.12.027] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Revised: 11/20/2014] [Accepted: 12/19/2014] [Indexed: 11/15/2022]
Abstract
BACKGROUND Restless legs syndrome (RLS) is associated with cerebrovascular risk factors, but its possible association with cerebrovascular disease has yielded conflicting results. OBJECTIVE This was a case-control, in-hospital study to evaluate the association between RLS and acute stroke or transient ischemic attack (TIA). METHODS We evaluated patients hospitalized with acute stroke/TIA and an age and gender 2:1 frequency-matched control group, for the presence of RLS. RESULTS Twenty-two of 149 patients (15%) and 10 of 298 controls (3%) suffered from RLS (p <0.0001). A multivariate logistic regression model employing cerebrovascular risk factors as predictors, that is, hypertension, hyperlipidemia, diabetes, and body mass index (BMI), determined that stroke/TIA was significantly associated with RLS with odds ratio for RLS among patients with stroke/TIA versus controls of 7.60 (95% confidence interval (CI): 2.07-27.87; p = 0.002). Another multivariate logistic regression model adjusting for possible RLS risk factors, that is, hypertension, hyperlipidemia, diabetes, BMI, anemia, and reduced renal function, determined that stroke/TIA was significantly associated with RLS with odds ratio of 6.85 (95% CI: 6.85-1.79; p = 0.005). Stepwise logistic regression with hypertension, hyperlipidemia, diabetes, BMI, anemia, and reduced renal function as potential predictors revealed that only stroke/TIA predicted RLS with similar odds ratio to the RLS-based multivariate model of 6.54 (95% CI: 2.63-16.27; p <0.0001). CONCLUSIONS Examining stroke patients while in hospital allowed us to conclude that RLS and acute stroke/TIA are significantly associated. However, the cross-sectional design did not allow for the determination of a causative relationship between the two.
Collapse
Affiliation(s)
- I Schlesinger
- Department of Neurology, Rambam Health Care Campus, Haifa, Israel; Technion Faculty of Medicine, Haifa, Israel.
| | - I Erikh
- Department of Neurology, Rambam Health Care Campus, Haifa, Israel
| | - M Nassar
- Department of Neurology, Rambam Health Care Campus, Haifa, Israel
| | - E Sprecher
- Department of Neurology, Rambam Health Care Campus, Haifa, Israel
| |
Collapse
|
91
|
Upper limb function is normal in patients with restless legs syndrome (Willis-Ekbom Disease). Clin Neurophysiol 2015; 126:736-42. [DOI: 10.1016/j.clinph.2014.07.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Revised: 06/27/2014] [Accepted: 07/07/2014] [Indexed: 11/21/2022]
|
92
|
Fereshtehnejad SM, Shafieesabet M, Shahidi GA, Delbari A, Lökk J. Restless legs syndrome in patients with Parkinson's disease: a comparative study on prevalence, clinical characteristics, quality of life and nutritional status. Acta Neurol Scand 2015; 131:211-8. [PMID: 25263328 DOI: 10.1111/ane.12307] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/19/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND Restless legs syndrome (RLS) is a common neurological disorder that can coexist with Parkinson's disease (PD). However, the association between these two movement disorders is quite poorly explored and previous findings are controversial in different aspects. OBJECTIVE To compare prevalence of RLS in Iranian PD population with a matched control group and to investigate the impact of comorbid RLS on quality of life (QoL), nutritional status, and clinical characteristics in PD population. METHODS This study was conducted on 108 individuals with idiopathic PD (IPD) and 424 matched controls. RLS was diagnosed using the International Restless Legs Syndrome Study Group (IRLSSG) criteria. Further assessments were performed on clinical characteristics, PD severity scales, psychiatric features, nutritional status, fatigue, and QoL in PD patients with and without RLS. RESULTS Restless legs syndrome was significantly more common among the patients with IPD (14.8%) compared to the controls (7.5%) [OR = 2.1 (95% CI: 1.1-4.0)]. IPD subjects with RLS had significantly higher anxiety score [10.1 (SD = 5.1) vs 5.9 (SD = 5.0); P = 0.003], worse nutritional status [23.7 (SD = 2.7) vs 25.4 (SD = 3.7); P = 0.008], and poorer QoL [26.9 (SD = 13.1) vs 17.0 (SD = 13.2); P = 0.006]. The number of positive answers to the IRLSSG diagnostic criteria had significant direct correlation with unpredictability of the off periods and the presence of symptomatic orthostasis. CONCLUSIONS Our study demonstrated a higher prevalence of RLS in patients with PD compared to general population. PD patients with RLS suffer from more anxiety, worse nutritional status, and worse QoL. RLS negatively accompanies with psychiatric problems, emotional behaviors, stigma, and cognitive impairment.
Collapse
Affiliation(s)
- S.-M. Fereshtehnejad
- Division of Clinical Geriatrics; Department of Neurobiology, Care Sciences and Society (NVS); Karolinska Institutet; Stockholm Sweden
- Firoozgar Clinical Research Development Center (FCRDC); Firoozgar Hospital; Iran University of Medical Sciences; Tehran Iran
| | - M. Shafieesabet
- Medical Student Research Committee (MSRC); Faculty of Medicine; Iran University of Medical Sciences; Tehran Iran
| | - G. A. Shahidi
- Movement Disorders Clinic; Department of Neurology; Faculty of Medicine; Iran University of Medical Sciences; Tehran Iran
| | - A. Delbari
- Division of Clinical Geriatrics; Department of Neurobiology, Care Sciences and Society (NVS); Karolinska Institutet; Stockholm Sweden
- Iranian Research Center on Aging; University of Social Welfare and Rehabilitation; Tehran Iran
| | - J. Lökk
- Division of Clinical Geriatrics; Department of Neurobiology, Care Sciences and Society (NVS); Karolinska Institutet; Stockholm Sweden
- Department of Geriatric Medicine; Karolinska University Hospital; Stockholm Sweden
| |
Collapse
|
93
|
Gan-Or Z, Alcalay RN, Bar-Shira A, Leblond CS, Postuma RB, Ben-Shachar S, Waters C, Johnson A, Levy O, Mirelman A, Gana-Weisz M, Dupré N, Montplaisir J, Giladi N, Fahn S, Xiong L, Dion PA, Orr-Urtreger A, Rouleau GA. Genetic markers of Restless Legs Syndrome in Parkinson disease. Parkinsonism Relat Disord 2015; 21:582-5. [PMID: 25817513 DOI: 10.1016/j.parkreldis.2015.03.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2015] [Revised: 02/25/2015] [Accepted: 03/08/2015] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Several studies proposed that Restless Legs Syndrome (RLS) and Parkinson disease (PD) may be clinically and/or etiologically related. To examine this hypothesis, we aimed to determine whether the known RLS genetic markers may be associated with PD risk, as well as with PD subtype. METHODS Two case-control cohorts from Tel-Aviv and New-York, including 1133 PD patients and 867 controls were genotyped for four RLS-related SNPs in the genes MEIS1, BTBD9, PTPRD and MAP2K5/SKOR1. The association between genotype, PD risk and phenotype was tested using multivariate regression models. RESULTS None of the tested SNPs was significantly associated with PD risk, neither in any individual cohort nor in the combined analysis after correction for multiple comparisons. The MAP2K5/SKOR1 marker rs12593813 was associated with higher frequency of tremor in the Tel-Aviv cohort (61.0% vs. 46.5%, p = 0.001, dominant model). However, the risk allele for tremor in this gene has been associated with reduced RLS risk. Moreover, this association did not replicate in Tremor-dominant PD patients from New-York. CONCLUSION RLS genetic risk markers are not associated with increased PD risk or subtype in the current study. Together with previous genetic, neuropathological and epidemiologic studies, our results further strengthen the notion that RLS and PD are likely to be distinct entities.
Collapse
Affiliation(s)
- Ziv Gan-Or
- Montreal Neurological Institute, McGill University, Montreal, QC, Canada; Department of Human Genetics, McGill University, Montréal, QC, Canada
| | - Roy N Alcalay
- Department of Neurology and Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Anat Bar-Shira
- The Genetic Institute, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
| | - Claire S Leblond
- Montreal Neurological Institute, McGill University, Montreal, QC, Canada; Department of Human Genetics, McGill University, Montréal, QC, Canada
| | - Ronald B Postuma
- Department of Neurology, Montreal General Hospital, Montréal, QC, Canada
| | - Shay Ben-Shachar
- The Genetic Institute, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
| | - Cheryl Waters
- Department of Neurology and Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Amelie Johnson
- Laboratory of Neurogenetics, Research Centre, Montreal Mental Health University Institute, Montréal, QC, Canada
| | - Oren Levy
- Department of Neurology and Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Anat Mirelman
- Department of Neurology, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
| | - Mali Gana-Weisz
- The Genetic Institute, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
| | - Nicolas Dupré
- Faculté de Médecine, Université Laval, CHU de Québec (Enfant-Jésus), Québec, QC, Canada
| | - Jacques Montplaisir
- Centre d'Études Avancées en Médecine du Sommeil, Hôpital du Sacré-Cœur de Montréal, Montréal, QC, Canada; Department of Psychiatry, Université de Montréal, Montréal, QC, Canada
| | - Nir Giladi
- Department of Neurology, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel; Sackler Faculty of Medicine and Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel
| | - Stanley Fahn
- Department of Neurology and Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Lan Xiong
- Laboratory of Neurogenetics, Research Centre, Montreal Mental Health University Institute, Montréal, QC, Canada; Department of Psychiatry, Université de Montréal, Montréal, QC, Canada; Department of Neurology and Neurosurgery, McGill University, Montréal, QC, Canada
| | - Patrick A Dion
- Montreal Neurological Institute, McGill University, Montreal, QC, Canada; Department of Neurology and Neurosurgery, McGill University, Montréal, QC, Canada
| | - Avi Orr-Urtreger
- The Genetic Institute, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel; Sackler Faculty of Medicine and Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel
| | - Guy A Rouleau
- Montreal Neurological Institute, McGill University, Montreal, QC, Canada; Department of Neurology and Neurosurgery, McGill University, Montréal, QC, Canada.
| |
Collapse
|
94
|
Hanewinckel R, Maksimovic A, Verlinden VJA, van der Geest JN, Hofman A, van Doorn PA, Boon AJW, Tiemeier H, Ikram MA. The impact of restless legs syndrome on physical functioning in a community-dwelling population of middle-aged and elderly people. Sleep Med 2015; 16:399-405. [PMID: 25747142 DOI: 10.1016/j.sleep.2014.11.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Revised: 11/24/2014] [Accepted: 11/26/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To investigate whether restless legs syndrome (RLS) is associated with impaired physical functioning using subjective and objective assessments. METHODS From 2006-2013, 5,960 participants (mean age 67.2; 57.5% females) of the prospective population-based Rotterdam Study, aged 45 years and over, were cross-sectionally investigated for presence of restless legs syndrome using a questionnaire. Physical functioning was assessed subjectively with the Stanford Health Assessment Questionnaire (basic activities of daily living) and the Instrumental Activities of Daily living scale (instrumental activities of daily living). Additionally, physical functioning was assessed objectively by quantifying fine motor performance with the Purdue Pegboard Test and by quantifying gait with an electronic walkway. RESULTS Restless legs syndrome was present in 13.7% of the participants. Persons with restless legs had more impairment in basic (difference in score 0.65, 95% CI 0.41;0.90) and instrumental activities of daily living (difference in score 0.28, 95% CI 0.09;0.48) than persons without restless legs. This association was strongest when symptoms were present two or more times a week (basic activities of daily living score difference 1.69, 95% CI 1.28;2.09). The association between restless legs syndrome and activities of daily living attenuated after adjusting for sleep quality or depressive symptoms. There was no association with the Purdue Pegboard Test score nor with gait. CONCLUSIONS Individuals with restless legs syndrome experienced significantly more impairment in activities of daily function than persons without restless legs. This seemed to be (partly) mediated by poor sleep quality and depressive symptoms. No association was found with objectively assessed physical functioning.
Collapse
Affiliation(s)
- Rens Hanewinckel
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands; Department of Neurology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Ana Maksimovic
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Vincent J A Verlinden
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands; Department of Radiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Jos N van der Geest
- Department of Neuroscience, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Albert Hofman
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Pieter A van Doorn
- Department of Neurology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Agnita J W Boon
- Department of Neurology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Henning Tiemeier
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands; Department of Psychiatry, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands; Department of Neurology, Erasmus MC University Medical Center, Rotterdam, The Netherlands; Department of Radiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
| |
Collapse
|
95
|
|
96
|
Jim HSL, Evans B, Jeong JM, Gonzalez BD, Johnston L, Nelson AM, Kesler S, Phillips KM, Barata A, Pidala J, Palesh O. Sleep disruption in hematopoietic cell transplantation recipients: prevalence, severity, and clinical management. Biol Blood Marrow Transplant 2014; 20:1465-84. [PMID: 24747335 PMCID: PMC4163090 DOI: 10.1016/j.bbmt.2014.04.010] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2013] [Accepted: 04/09/2014] [Indexed: 10/25/2022]
Abstract
Sleep disruption is common among hematopoietic cell transplant (HCT) recipients, with over 50% of recipients experiencing sleep disruption pre-transplant, with up to 82% of patients experiencing moderate to severe sleep disruption during hospitalization for transplant and up to 43% after transplant. These rates of sleep disruption are substantially higher than what we see in the general population. Although sleep disruption can be distressing to patients and contribute to diminished quality of life, it is rarely discussed during clinical visits. The goal of the current review is to draw attention to sleep disruption and disorders (ie, insomnia, obstructive sleep apnea, restless legs syndrome) as a clinical problem in HCT in order to facilitate patient education, intervention, and research. We identified 35 observational studies published in the past decade that examined sleep disruption or disorders in HCT. Most studies utilized a single item measure of sleep, had small sample size, and included heterogeneous samples of patients. Six studies of the effects of psychosocial and exercise interventions on sleep in HCT have reported no significant improvements. These results highlight the need for rigorous observational and interventional studies of sleep disruption and disorders in HCT recipients..
Collapse
Affiliation(s)
| | - Bryan Evans
- Department of Psychology, University of South Florida, Tampa, Florida
| | - Jiyeon M Jeong
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California
| | | | - Laura Johnston
- Division of Blood and Marrow Transplantation, Stanford University School of Medicine, Stanford, California
| | - Ashley M Nelson
- Department of Psychology, University of South Florida, Tampa, Florida
| | - Shelli Kesler
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California
| | | | - Anna Barata
- Moffitt Cancer Center, Tampa, Florida; Psychiatry and Legal Medicine PhD Program, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Joseph Pidala
- Department of Blood and Marrow Transplantation, Moffitt Cancer Center, Tampa, Florida
| | - Oxana Palesh
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California
| |
Collapse
|
97
|
|
98
|
Oran M, Unsal C, Albayrak Y, Tulubas F, Oguz K, Avci O, Turgut N, Alp R, Gurel A. Possible association between vitamin D deficiency and restless legs syndrome. Neuropsychiatr Dis Treat 2014; 10:953-8. [PMID: 24899811 PMCID: PMC4039397 DOI: 10.2147/ndt.s63599] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND AND AIM Restless legs syndrome (RLS) is a distressing sleep disorder that occurs worldwide. Although there have been recent developments in understanding the pathophysiology of RLS, the exact mechanism of the disease has not been well elucidated. An increased prevalence of neurologic and psychiatric diseases involving dopaminergic dysfunction in vitamin D-deficient patients led us to hypothesize that vitamin D deficiency might result in dopaminergic dysfunction and consequently, the development of RLS (in which dopaminergic dysfunction plays a pivotal role). Thus, the aim of this study was to evaluate the relationship between vitamin D deficiency and RLS. METHODS One hundred and fifty-five consecutive patients, 18-65 years of age, who were admitted to the Department of Internal Medicine with musculoskeletal symptoms and who subsequently underwent neurological and electromyography (EMG) examination by the same senior neurologist, were included in this study. The patients were divided into two groups according to serum 25-hydroxyvitamin D (25(OH)D) (a vitamin D metabolite used as a measure of vitamin D status) level: 36 patients with serum 25(OH)D levels ≥20 ng/mL comprised the normal vitamin D group, and 119 patients with serum 25(OH)D levels <20 ng/mL comprised the vitamin D deficiency group. The two groups were compared for the presence of RLS and associated factors. RESULTS The two groups were similar in terms of mean age, sex, mean body mass index (BMI), and serum levels of calcium, phosphate, alkaline phosphatase (ALP), and ferritin. The presence of RLS was significantly higher in the vitamin D deficiency group (χ (2)=12.87, P<0.001). Regression analysis showed vitamin D deficiency and serum 25(OH)D level to be significantly associated with the presence of RLS (odds ratio [OR] 5.085, P<0.001 and OR 1.047, P=0.006, respectively). CONCLUSION The present study demonstrated a possible association between vitamin D deficiency and RLS. Given the dopaminergic effects of vitamin D, 25(OH)D depletion may lead to dopaminergic dysfunction and may have a place in the etiology of RLS. Prospective vitamin D treatment studies are needed to confirm this relationship and to evaluate the efficacy of vitamin D as a treatment for RLS patients.
Collapse
Affiliation(s)
- Mustafa Oran
- Department of Internal Medicine, Namik Kemal University, Faculty of Medicine, Tekirdağ, Turkey
| | - Cuneyt Unsal
- Department of Psychiatry, Namik Kemal University, Faculty of Medicine, Tekirdağ, Turkey
| | - Yakup Albayrak
- Department of Psychiatry, Namik Kemal University, Faculty of Medicine, Tekirdağ, Turkey
| | - Feti Tulubas
- Department of Biochemistry, Namik Kemal University, Faculty of Medicine, Tekirdağ, Turkey
| | - Keriman Oguz
- Department of Neurology, Namik Kemal University, Faculty of Medicine, Tekirdağ, Turkey
| | - Okan Avci
- Department of Internal Medicine, Namik Kemal University, Faculty of Medicine, Tekirdağ, Turkey
| | - Nilda Turgut
- Department of Neurology, Namik Kemal University, Faculty of Medicine, Tekirdağ, Turkey
| | - Recep Alp
- Department of Neurology, Namik Kemal University, Faculty of Medicine, Tekirdağ, Turkey
| | - Ahmet Gurel
- Department of Biochemistry, Namik Kemal University, Faculty of Medicine, Tekirdağ, Turkey
| |
Collapse
|
99
|
Srivanitchapoom P, Pandey S, Hallett M. Restless legs syndrome and pregnancy: a review. Parkinsonism Relat Disord 2014; 20:716-22. [PMID: 24768121 DOI: 10.1016/j.parkreldis.2014.03.027] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Revised: 03/27/2014] [Accepted: 03/28/2014] [Indexed: 11/17/2022]
Abstract
Restless legs syndrome (RLS) is a common sensorimotor neurological disorder that is diagnosed according to the revised criteria of the International RLS Study Group (IRLSSG). The pathophysiology of RLS is still unknown and its prevalence is influenced by ethnicity, age, and gender. RLS is divided into two types by etiology: primary or idiopathic and secondary. Primary RLS is strongly influenced by a genetic component while secondary RLS is caused by other associated conditions such as end-stage renal disease or peripheral neuropathy. Another common condition associated with RLS is pregnancy. The prevalence of RLS during pregnancy is two to three times higher than in the normal population and is influenced by the trimester and the number of parity. The main mechanisms that may contribute to the pathophysiology of RLS during pregnancy are hormonal changes and iron and folate status. Standard medications for treating RLS during pregnancy are not established. Most medications have been used according to the evidence from non-pregnant patients. Therefore, consideration of the medical treatment for treating RLS during pregnancy should be balanced between the benefit of relieving the symptoms and maternal and fetal risk. In general, the prognosis of RLS during pregnancy is good and symptoms are usually relieved after delivery.
Collapse
Affiliation(s)
- Prachaya Srivanitchapoom
- Division of Neurology, Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, 10700, Thailand; Human Motor Control Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20892, USA
| | - Sanjay Pandey
- Human Motor Control Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20892, USA; Govind Ballabh Pant Hospital, New Delhi 110002, India
| | - Mark Hallett
- Human Motor Control Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20892, USA.
| |
Collapse
|
100
|
Restless legs syndrome is related to obstructive sleep apnea symptoms during pregnancy. Sleep Breath 2014; 19:73-8. [DOI: 10.1007/s11325-014-0964-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2013] [Revised: 02/18/2014] [Accepted: 02/22/2014] [Indexed: 01/02/2023]
|