Restless legs syndrome: From clinic to personalized medicine

Primary healthcare nurses' experiences of symptoms and treatment needs of patients with RLS-associated symptoms at telephone nursing - an abductive analysis based on the Four Habits communication model

BACKGROUND

Restless legs syndrome (RLS) is a common, neurological disease. Primary healthcare (PHC) nurses are often the patient's first contact, but studies regarding their experience assessing RLS-associated symptoms and treatment needs in telephone nursing (TN) are lacking.

PURPOSE

To describe how PHC nurses experience symptoms and treatment needs of patients with RLS-associated symptoms during TN.

METHODS

A descriptive abductive design, including semi-structured interviews with 18 PHC nurses from six Swedish regions. Data was deductively analyzed using the Four Habits communication model. Facilitators and barriers were inductively identified.

RESULTS

Invest in the beginning included the use of professional competence, interpretation of influencing factors at the start of the conversation and initial understanding of the patient's RLS symptoms. Elicit the patient's perspective involved originate from the patient's perception of the symptoms and comprehending the symptoms' impact on the patient's life situation. Relate to the patient's situation and the importance of trust in the patient meeting described demonstrating empathy. Invest in the end involved triaging patients with RLS-associated symptoms, providing self-care advice to patients with RLS-associated symptoms and achieving consensus at the end of the conversation.

CONCLUSION

Using the Four Habits communication model could enrich communication regarding RLS-associated symptoms and treatment needs during TN.

Prerequisites for self-care actions in individuals with restless legs syndrome-A deductive qualitative analysis based on the COM-B model

Restless Legs Syndrome (RLS) affects 3% of the world's population, causing tingling sensations primarily in the legs. Incorporating self-care activities could improve the management of RLS symptoms, yet knowledge about effective self-care actions is limited. This study employs the Capability, Opportunity, and Motivation-Behaviour (COM-B) model to explore self-care behaviours in individuals with RLS, as research in this area is sparse. Qualitative content analysis of interviews with 28 participants with RLS, 26 subcategories emerged, aligning with the COM-B model's components. The first part, Capability, highlighted the importance of being able to be in motion, while the second, Opportunity referred to situations where there was a lack of trust and guidance for self-care. The third part, Motivation, emphasised the importance of fixed routines of sleep, rest, and activity. These identified prerequisites can inform the development of screening instruments and patient-reported outcome measures to evaluate self-care needs and interventions for individuals with RLS.

Restless Legs Syndrome Secondary to Iron Deficiency Anaemia: A Case Report

Leg pain, particularly restless legs, is one of Australia's most common complaints in general practice. Iron deficiency anaemia (IDA) is a possible cause of restless legs syndrome (RLS). We present the case of a 35-year-old Aboriginal man who initially presented for general health assessment, which was required every nine months for Aboriginal and Torres Strait Islanders in Australia. He complained of restless legs at night; however, he denied any other symptoms such as tiredness and weakness. Blood tests revealed severe IDA and dyslipidaemia. After initiating iron replacement therapy, the patient's restless leg symptoms improved significantly. This case emphasises the importance of investigating secondary causes, especially IDA. Addressing these underlying medical conditions can lead to significant improvements in patient well-being.

Sleep disorders and risk of alzheimer's disease: A two-way road

Substantial sleep impairment in patients with Alzheimer's disease (AD) is one of the emerging points for continued efforts to better understand the disease. Individuals without cognitive decline, an important marker of the clinical phase of AD, may show early alterations in the sleep-wake cycle. The objective of this critical narrative review is to explore the bidirectional pathophysiological correlation between sleep disturbances and Alzheimer's Disease. Specifically, it examines how the disruption of sleep homeostasis in individuals without dementia could contribute to the pathogenesis of AD, and conversely, how neurodegeneration in individuals with Alzheimer's Disease might lead to dysregulation of the sleep-wake cycle. Recent scientific results indicate that sleep disturbances, particularly those related to impaired glymphatic clearance, may act as an important mechanism associated with the genesis of Alzheimer's Disease. Additionally, amyloid deposition and tau protein hyperphosphorylation, along with astrocytic hyperactivation, appear to trigger changes in neurotransmission dynamics in areas related to sleep, which may explain the onset of sleep disturbances in individuals with AD. Disruption of sleep homeostasis appears to be a modifiable risk factor in Alzheimer's disease. Whenever possible, the use of non-pharmacological strategies becomes important in this context. From a different perspective, additional research is needed to understand and treat the dysfunction of the sleep-wake cycle in individuals already affected by AD. Early recognition and correction of sleep disturbances in this population could potentially mitigate the progression of dementia and improve the quality of life for those with AD.

Waking Up the Sleep Field: An Overview on the Implications of Genetics and Bioinformatics of Sleep

Sleep genetics is an intriguing, as yet less understood, understudied, emerging area of biological and medical discipline. A generalist may not be aware of the current status of the field given the variety of journals that have published studies on the genetics of sleep and the circadian clock over the years. For researchers venturing into this fascinating area, this review thus includes fundamental features of circadian rhythm and genetic variables impacting sleep-wake cycles. Sleep/wake pathway medication exposure and susceptibility are influenced by genetic variations, and the responsiveness of sleep-related medicines is influenced by several functional polymorphisms. This review highlights the features of the circadian timing system and then a genetic perspective on wakefulness and sleep, as well as the relationship between sleep genetics and sleep disorders. Neurotransmission genes, as well as circadian and sleep/wake receptors, exhibit functional variability. Experiments on animals and humans have shown that these genetic variants impact clock systems, signaling pathways, nature, amount, duration, type, intensity, quality, and quantity of sleep. In this regard, the overview covers research on sleep genetics, the genomic properties of several popular model species used in sleep studies, homologs of mammalian genes, sleep disorders, and related genes. In addition, the study includes a brief discussion of sleep, narcolepsy, and restless legs syndrome from the viewpoint of a model organism. It is suggested that the understanding of genetic clues on sleep function and sleep disorders may, in future, result in an evidence-based, personalized treatment of sleep disorders.