1
|
Choi SM, Cho BH, Cho SH, Kim BC. Restless Legs Syndrome Affects Sleep in de novo Parkinson's Disease Patients. Neurol India 2024; 72:768-771. [PMID: 39216031 DOI: 10.4103/neurol-india.ni_342_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 07/10/2020] [Indexed: 09/04/2024]
Abstract
BACKGROUND Restless legs syndrome (RLS) is common in Parkinson's disease (PD) patients and can affect the motor symptoms and non-motor symptoms (NMSs) of PD patients. OBJECTIVE This study aimed to identify the clinical factors affected by RLS in patients with PD. METHODS We included 369 de novo PD patients. RLS was assessed by face-to-face interviews and the motor symptoms and NMSs of the patients were assessed using relevant scales. RESULTS RLS frequency in the patients was 12.2% (45/369). PD patients with RLS (PD-RLS) exhibited a greater global Pittsburgh Sleep Quality Index (PSQI) score than those without RLS (PD-No RLS). PD-RLS exhibited significantly greater scores in the daytime dysfunction and sleep disturbances components of the PSQI than PD-No RLS. PD-RLS exhibited a significantly greater score in the sleep/fatigue domain of the Non-Motor Symptoms Scale than PD-No RLS. The International RLS Study Group rating scale score was significantly related to PSQI components scores in the sleep disturbances, sleep latency, habitual sleep efficiency, and subjective sleep quality. CONCLUSIONS RLS frequency in de novo PD patients is higher than that in the general population, and the main NMS affected by RLS in these patients is sleep disturbances. Therefore, it is necessary to manage RLS in PD patients with sleep disturbances.
Collapse
Affiliation(s)
- Seong-Min Choi
- Department of Neurology, Chonnam National University Medical School and Hospital, Gwangju, South Korea
- National Research Center for Dementia, Gwangju, South Korea
| | - Bang-Hoon Cho
- Department of Neurology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, South Korea
| | - Soo H Cho
- Department of Neurology, Chonnam National University Hospital, Gwangju, South Korea
| | - Byeong C Kim
- Department of Neurology, Chonnam National University Medical School and Hospital, Gwangju, South Korea
- National Research Center for Dementia, Gwangju, South Korea
| |
Collapse
|
2
|
Liang R, Zhu W, Gao Y, Zhao C, Zhang C, Xu L, Zuo Y, Lv Y, Zhao M, Li C, Gao J, Mei J, Gong X, Zhang L, Shen S, Yang C, Ren J, Liu Y, Wang Z, Wang P, Zhou J, Wang F, Wu J, Chen J, Zhu Y, Zhang C, Dong X, Han F. Clinical features, polysomnography, and genetics association study of restless legs syndrome in clinic based Chinese patients: A multicenter observational study. Sleep Med 2024; 117:123-130. [PMID: 38531167 DOI: 10.1016/j.sleep.2024.03.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 03/15/2024] [Accepted: 03/15/2024] [Indexed: 03/28/2024]
Abstract
STUDY OBJECTIVES To systemically describe the clinical features, polysomnography (PSG) finding, laboratory tests and single-nucleotide polymorphisms (SNPs) in a clinic based Chinese primary restless legs syndrome (RLS) population. METHODS This observational study, conducted from January 2020 to October 2021 across 22 sleep labs in China, recruited 771 patients diagnosed with RLS following the 2014 RLSSG criteria. Clinical data, PSG testing, and laboratory examination and SNPs of patients with RLS were collected. A total of 32 SNPs in 24 loci were replicated using the Asian Screening Array chip, employing data from the Han Chinese Genomes Initiative as controls. RESULTS In this study with 771 RLS patients, 645 had primary RLS, and 617 has DNA available for SNP study. Among the 645 primary RLS, 59.7% were women. 33% had a family history of RLS, with stronger familial influence in early-onset cases. Clinical evaluations showed 10.4% had discomfort in body parts other than legs. PSG showed that 57.1% of RLS patients had periodic leg movement index (PLMI) of >5/h and 39.1% had PLMI >15/h, respectively; 73.8% of RLS patients had an Apnea-Hypopnea Index (AHI) > 5/h, and 45.3% had an AHI >15/h. The laboratory examinations revealed serum ferritin levels <75 ng/ml in 31.6%, and transferrin saturation (TSAT) of <45% in 88.7% of RLS patients. Seven new SNPs in 5 genes showed a significant allelic association with Chinese primary RLS, with one previously reported (BTBD9) and four new findings (TOX3, PRMT6, DCDC2C, NOS1). CONCLUSIONS Chinese RLS patients has specific characters in many aspects. A high family history with RLS not only indicates strong genetic influence, but also reminds us to consider the familial effect in the epidemiological study. Newly developed sequencing technique with large samples remains to be done.
Collapse
Affiliation(s)
- Ruiling Liang
- Division of Sleep Medicine, Peking University People's Hospital, Beijing, China
| | - Wenjun Zhu
- Division of Sleep Medicine, Peking University People's Hospital, Beijing, China
| | - Yinghui Gao
- PKU-UPenn Sleep Center, Peking University International Hospital, Beijing, China
| | - Chen Zhao
- Institute of Neurogenomics, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Neuherberg, Germany
| | - Chi Zhang
- Division of Sleep Medicine, Peking University People's Hospital, Beijing, China
| | - Liyue Xu
- Division of Sleep Medicine, Peking University People's Hospital, Beijing, China
| | - Yuhua Zuo
- Division of Sleep Medicine, Peking University People's Hospital, Beijing, China
| | - Yunhui Lv
- The Sleep Center, The First People's Hospital of Yunnan Province, Kunming, Yunnan, China
| | - Mingming Zhao
- Department of Sleep Medicine, People's Hospital of Guangxi Zhuang Autonomous Region, Nan Ning, China
| | - Chenyu Li
- Department of Neurology, Chongqing Traditional Chinese Medicine Hospital, Chongqing, China
| | - Jie Gao
- Department of Neurology, Chongqing Traditional Chinese Medicine Hospital, Chongqing, China
| | - Junhua Mei
- Department of Neurology, Wuhan First Hospital, Wuhan, China
| | - Xue Gong
- Department of Neurology, Wuhan First Hospital, Wuhan, China
| | - Lisan Zhang
- Department of Neurobiology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Shuxia Shen
- Department of Neurology, Yulin No.2 Hospital, Yulin, Shaanxi, China
| | - Chunbin Yang
- The Sleep Center, People's Hospital of JinChang, JinChang, Gansu, China
| | - Jilin Ren
- The Sleep Center, People's Hospital of JinChang, JinChang, Gansu, China
| | - Yan Liu
- The Sleep Center, WeiNan Central Hospital, WeiNan, Shaanxi, China
| | - Zan Wang
- The Sleep Center, Department of Neurology, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Peipei Wang
- Sleep Medicine Department, Sanya Central Hospital, The Third People's Hospital of Hainan, China
| | - Jinxia Zhou
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Feng Wang
- The Sleep Center, General Hospital of the Yangtze River Shipping, Wuhan, Hubei, China
| | - Jun Wu
- Department of Neurology, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Juan Chen
- Department of Neurology, The First Hospital of Changsha, Changsha, Hunan, China
| | - Yanmei Zhu
- Department of Neurology, The 2nd Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Chunrong Zhang
- Department of Neurology, Qinhuangdao HaiGang Hospital, Qinhuangdao, Hebei, China
| | - Xiaosong Dong
- Division of Sleep Medicine, Peking University People's Hospital, Beijing, China
| | - Fang Han
- Division of Sleep Medicine, Peking University People's Hospital, Beijing, China.
| |
Collapse
|
3
|
Zhang Y, Chen Q, Sun Q, Tang M, Yang Y, Guo ZN, Wang Z. Compromised Dynamic Cerebral Autoregulation in Patients with Restless Legs Syndrome. Nat Sci Sleep 2024; 16:431-443. [PMID: 38706925 PMCID: PMC11069370 DOI: 10.2147/nss.s448579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 04/18/2024] [Indexed: 05/07/2024] Open
Abstract
Background Restless legs syndrome (RLS) is a prevalent sensorimotor nervous system disorder in patients accompanied with insomnia, blood pressure fluctuation, and sympathetic dysfunction. These symptoms may disrupt cerebral hemodynamics. Dynamic cerebral autoregulation (dCA) describes the temporary response of cerebrovascular system to abrupt fluctuations in blood pressure, which keep cerebral blood flow stable and serve as a marker of cerebrovascular system ability. Objective This research aimed to assess dCA in RLS patients. Methods In this study, RLS patients were recruited and subsequently classified into four groups (mild, moderate, severe, and very severe) based on the International RLS Rating Scale (IRLS). Healthy controls matched for age and sex were enrolled. All participants were evaluated dCA by assessing phase difference (PD). A portion of patients with RLS was reassessed for dCA after one month of medication therapy (pramipexole [0.125 mg/day] and gabapentin [300 mg/day]). Results There were altogether 120 patients with RLS and 30 controls completed the polysomnography and dCA assessment. PD was lower in the moderate, severe, and very severe RLS groups than that in the controls and mild RLS groups. Periodic limb movement index (PLMI), arousal index, and IRLS all showed a linear correlation with PD in RLS patients. Additionally, PD increased in RLS patients after therapy. Conclusion The dCA was compromised in moderate, severe, and very severe RLS patients and was negatively correlated with the IRLS, arousal index, and PLMI. After 1 month of therapy, dCA improved in RLS patients.
Collapse
Affiliation(s)
- Yanan Zhang
- Sleep Center, Department of Neurology, The First Hospital of Jilin University, Chang Chun, People’s Republic of China
| | - Qianqian Chen
- Sleep Center, Department of Neurology, The First Hospital of Jilin University, Chang Chun, People’s Republic of China
| | - Qingqing Sun
- Sleep Center, Department of Neurology, The First Hospital of Jilin University, Chang Chun, People’s Republic of China
| | - Mingyang Tang
- Sleep Center, Department of Neurology, The First Hospital of Jilin University, Chang Chun, People’s Republic of China
| | - Yi Yang
- Sleep Center, Department of Neurology, The First Hospital of Jilin University, Chang Chun, People’s Republic of China
- Stroke Center, Department of Neurology, The First Hospital of Jilin University, Chang Chun, People’s Republic of China
| | - Zhen-Ni Guo
- Sleep Center, Department of Neurology, The First Hospital of Jilin University, Chang Chun, People’s Republic of China
- Stroke Center, Department of Neurology, The First Hospital of Jilin University, Chang Chun, People’s Republic of China
| | - Zan Wang
- Sleep Center, Department of Neurology, The First Hospital of Jilin University, Chang Chun, People’s Republic of China
- Stroke Center, Department of Neurology, The First Hospital of Jilin University, Chang Chun, People’s Republic of China
| |
Collapse
|
4
|
Johnson CE, Duncan MJ, Murphy MP. Sex and Sleep Disruption as Contributing Factors in Alzheimer's Disease. J Alzheimers Dis 2024; 97:31-74. [PMID: 38007653 PMCID: PMC10842753 DOI: 10.3233/jad-230527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2023]
Abstract
Alzheimer's disease (AD) affects more women than men, with women throughout the menopausal transition potentially being the most under researched and at-risk group. Sleep disruptions, which are an established risk factor for AD, increase in prevalence with normal aging and are exacerbated in women during menopause. Sex differences showing more disrupted sleep patterns and increased AD pathology in women and female animal models have been established in literature, with much emphasis placed on loss of circulating gonadal hormones with age. Interestingly, increases in gonadotropins such as follicle stimulating hormone are emerging to be a major contributor to AD pathogenesis and may also play a role in sleep disruption, perhaps in combination with other lesser studied hormones. Several sleep influencing regions of the brain appear to be affected early in AD progression and some may exhibit sexual dimorphisms that may contribute to increased sleep disruptions in women with age. Additionally, some of the most common sleep disorders, as well as multiple health conditions that impair sleep quality, are more prevalent and more severe in women. These conditions are often comorbid with AD and have bi-directional relationships that contribute synergistically to cognitive decline and neuropathology. The association during aging of increased sleep disruption and sleep disorders, dramatic hormonal changes during and after menopause, and increased AD pathology may be interacting and contributing factors that lead to the increased number of women living with AD.
Collapse
Affiliation(s)
- Carrie E. Johnson
- University of Kentucky, College of Medicine, Department of Molecular and Cellular Biochemistry, Lexington, KY, USA
| | - Marilyn J. Duncan
- University of Kentucky, College of Medicine, Department of Neuroscience, Lexington, KY, USA
| | - M. Paul Murphy
- University of Kentucky, College of Medicine, Department of Molecular and Cellular Biochemistry, Lexington, KY, USA
- University of Kentucky, Sanders-Brown Center on Aging, Lexington, KY, USA
| |
Collapse
|
5
|
Tutan D, Ulfberg J. An analysis of YouTube videos about restless leg syndrome: Choosing the right guide. Medicine (Baltimore) 2023; 102:e35633. [PMID: 37861537 PMCID: PMC10589519 DOI: 10.1097/md.0000000000035633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 09/22/2023] [Indexed: 10/21/2023] Open
Abstract
Individuals often resort to YouTube as a means of accessing insights into their medical conditions and potential avenues for treatment. Among prevalent and incapacitating afflictions within the general populace, restless leg syndrome assumes significance. The focal objective of this investigation is to scrutinize the caliber inherent in videos pertaining to restless leg syndrome disseminated via the YouTube platform. The sorting of videos was accomplished by gauging their pertinence subsequent to conducting a search for "restless leg syndrome" on YouTube, specifically on the 20th of August, 2023. The evaluation encompassed videos curated from the selection of the top 50 English language videos deemed most relevant. The review process entailed the comprehensive assessment of relevance and content by 2 distinct medical professionals operating independently. Furthermore, pertinent descriptive attributes of each video, such as upload date, view count, likes, dislikes, and comments, were meticulously documented within the dataset. To ascertain video quality, the DISCERN Score, global quality score, and Journal of the American Medical Association rating scales were employed as evaluative tools. Significant statistical disparities were observed in terms of DISCERN scores between videos uploaded by medical doctors and those uploaded by individuals without medical qualifications (P < .001). Correspondingly, upon comparing the 2 aforementioned groups, videos uploaded by healthcare professionals exhibited statistically superior quality scores in both the Journal of the American Medical Association and global quality score assessments (P < .001 for both comparisons). The informational quality regarding restless leg syndrome on YouTube presents a spectrum of variability. Notably, videos that offer valuable insights, as well as those that could potentially mislead viewers, do not display discernible variations in terms of their viewership and popularity. For patients seeking reliable information, a useful and safe approach involves favoring videos uploaded by medical professionals. It is imperative to prioritize the professional identity of the content uploader rather than being swayed by the video's popularity or the quantity of comments it has amassed.
Collapse
Affiliation(s)
- Duygu Tutan
- Erol Olçok Training and Research Hospital, Department of Internal Medicine, Çorum, Turkey
| | | |
Collapse
|
6
|
Ratnani G, Harjpal P. Advancements in Restless Leg Syndrome Management: A Review of Physiotherapeutic Modalities and Their Efficacy. Cureus 2023; 15:e46779. [PMID: 37954781 PMCID: PMC10633497 DOI: 10.7759/cureus.46779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 10/09/2023] [Indexed: 11/14/2023] Open
Abstract
The goal of this review is to compile information on the use of physiotherapeutic treatments for the treatment of restless leg syndrome (RLS) and to classify the effectiveness of conservative methods in relieving the discomfort due to RLS. English literature found on PubMed, Google Scholar, and Scopus was used in the present review. According to the titles and matters of the abstracts, each literature item connected to RLS was retrieved, analyzed, and reviewed. The 24 papers that were considered admissible were those that included manual approaches, exercises, and alternative RLS management, which were then analyzed for data by the authors. A consistent trend in the data demonstrated benefits in lessening RLS symptom severity across the 24 papers that met the selection criteria. Patients were chosen based on clinical diagnostic standards, and the effectiveness of stretching, exercise therapy, yoga, vibration therapy, reflexology and massage, muscular relaxation techniques, and electrical stimulation was determined. Our findings indicated that each type of therapy significantly affected the manifestations of the illness. Stretching, fitness training, and reflexology were very beneficial, with no side effects and shorter intervention periods.
Collapse
Affiliation(s)
- Grisha Ratnani
- Neuro-Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research (DU), Wardha, IND
| | - Pallavi Harjpal
- Neuro-Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research (DU), Wardha, IND
| |
Collapse
|
7
|
Nilles C, Amorelli G, Pringsheim TM, Martino D. "Unvoluntary" Movement Disorders: Distinguishing between Tics, Akathisia, Restless Legs, and Stereotypies. Semin Neurol 2023; 43:123-146. [PMID: 36854394 DOI: 10.1055/s-0043-1764164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
Tics, stereotypies, akathisia, and restless legs fall at different places on the spectrum of discrete, unwanted and potentially disabling motor routines. Unlike tremor, chorea, myoclonus, or dystonia, this subgroup of abnormal movements is characterized by the subject's variable ability to inhibit or release undesired motor patterns on demand. Though it may be sometimes clinically challenging, it is crucial to distinguish these "unvoluntary" motor behaviors because secondary causes and management approaches differ substantially. To this end, physicians must consider the degree of repetitiveness of the movements, the existence of volitional control, and the association with sensory symptoms, or cognitive-ideational antecedent. This review aims to summarize the current existing knowledge on phenomenology, diagnosis, and treatment of tics, stereotypies, akathisia, and restless leg syndrome.
Collapse
Affiliation(s)
- Christelle Nilles
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Gabriel Amorelli
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Tamara M Pringsheim
- Department of Clinical Neurosciences, Psychiatry, Pediatrics and Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.,Mathison Centre for Mental Health Research and Education, Calgary, Alberta, Canada.,Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Davide Martino
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Mathison Centre for Mental Health Research and Education, Calgary, Alberta, Canada.,Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| |
Collapse
|
8
|
Jadidi A, Rezaei Ashtiani A, Khanmohamadi Hezaveh A, Aghaepour SM. Therapeutic effects of magnesium and vitamin B6 in alleviating the symptoms of restless legs syndrome: a randomized controlled clinical trial. BMC Complement Med Ther 2022; 23:1. [PMID: 36587225 PMCID: PMC9804944 DOI: 10.1186/s12906-022-03814-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Accepted: 11/30/2022] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Restless legs syndrome/Willis-Ekbom Disease (RLS/WED) is one of the most prevalent sleep disorders. There are contradicting data about the effectiveness of magnesium and vitamin B6 in alleviating the symptoms of this condition. Therefore, this study aimed to assess the efficacy of magnesium and vitamin B6 in alleviating the symptoms of RLS/WED. METHODS A single-blind study was conducted on individuals with this illness for at least three months. Randomly, 75 patients were assigned into three groups: magnesium, vitamin B6, and placebo. The experimental group received daily doses of 40 mg vitamin B6 or 250 mg magnesium oxide. While others in the control group merely received a placebo. Patients' disease severity and sleep quality were evaluated three times using standard questionnaires (at the beginning of the study, one and two months after therapy). Utilizing SPSS22 software and the ANOVA, t-test, and repeated measure tests, statistical analysis was conducted. RESULTS The mean and standard deviation of sleep quality and disease severity at the beginning of the trial and throughout the first month following the intervention did not differ statistically between the three groups. In the second month following the intervention, the mean and standard deviation of sleep quality and disease severity were significantly different (P = 0.001). CONCLUSION Taking magnesium and vitamin B6 supplements can reduce the severity of symptoms of RLS/WED patients and improve their sleep quality.
Collapse
Affiliation(s)
- Ali Jadidi
- grid.468130.80000 0001 1218 604XSchool of Nursing, Arak University of Medical Sciences, Arak, Iran ,grid.468130.80000 0001 1218 604XTraditional and Complementary Medicine Research Center, Arak University of Medical Sciences, Arak, Iran
| | - Alireza Rezaei Ashtiani
- grid.468130.80000 0001 1218 604XSchool of Medicine, Arak University of Medical Sciences, Arak, Iran
| | - Ali Khanmohamadi Hezaveh
- grid.468130.80000 0001 1218 604XStudent Research Committee, Arak University of Medical Sciences, Arak, Iran
| | - Seyed Mohamad Aghaepour
- grid.468130.80000 0001 1218 604XStudent Research Committee, Arak University of Medical Sciences, Arak, Iran
| |
Collapse
|
9
|
Sharma N. A case of restless legs Syndrome - Ill-ness or ill-spirit? Ind Psychiatry J 2022; 31:382-383. [PMID: 36419683 PMCID: PMC9678168 DOI: 10.4103/ipj.ipj_213_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 01/08/2021] [Accepted: 07/24/2021] [Indexed: 03/14/2023] Open
Affiliation(s)
- Neha Sharma
- Department of Psychiatry, INHS Dhanvantari, Port Blair, Andaman and Nicobar Islands
| |
Collapse
|
10
|
Selfe TK, Montgomery C, Klatt M, Wen S, Sherman KJ, Innes KE. An Exploratory Randomized Controlled Trial of a 12-Week Yoga Versus Educational Film Program for the Management of Restless Legs Syndrome: Feasibility and Acceptability. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2022; 28:309-319. [PMID: 35426733 PMCID: PMC9051873 DOI: 10.1089/jicm.2021.0182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Objectives: The primary objectives of this pilot trial were to assess the study feasibility and acceptability of the 12-week yoga and educational film programs for the management of restless legs syndrome (RLS) in preparation for a future randomized controlled trial (RCT). Materials and Methods: This pilot, parallel-arm, randomized feasibility trial was conducted at two sites, Morgantown, WV and Columbus, OH. Yoga group participants attended 75-min Iyengar yoga classes, twice weekly for 4 weeks, then once a week for 8 weeks (16 total classes), and completed a 30-min homework routine on nonclass days. Educational film group participants attended once weekly, 75-min classes (12 total classes), which included information on RLS and other sleep disorders, RLS management including sleep hygiene practices, and complementary therapies. Feasibility and acceptability outcomes included program satisfaction and recruitment, retention, and adherence rates. In addition, participants were asked their preferences regarding three yoga class schedule scenarios for a future study. Attendance, yoga, and treatment logs were collected weekly. Program evaluation and yoga scheduling questionnaires were collected at week 12. Results: Forty-one adults with moderate to severe RLS were randomized to a 12-week yoga (n = 19) or educational film (n = 22) program. Thirty participants (73%) completed the program. Yoga and education group participants attended an average of 13.0 ± 0.84 (81%) and 10.3 ± 0.3 classes (85%), respectively. Participants from both groups indicated satisfaction with the study. All yoga group respondents to the program evaluation reported they would likely (n = 6) or very likely (n = 7) continue yoga practice; 86.7% of education group respondents (13 of 15) indicated that they were likely (n = 7) or very likely (n = 6) to make lasting changes based on what they had learned. The preferred schedule for a future study was a 16-week study with once-weekly yoga classes. Conclusions: The findings of this study suggest that a larger RCT comparing yoga with an educational film group for the management of RLS is feasible. Trial registration: Clinicaltrials.gov: NCT03570515; 02/01/2017.
Collapse
Affiliation(s)
- Terry Kit Selfe
- Academic Research Consulting & Services, Health Science Center Libraries, University of Florida, Gainesville, FL, USA
| | - Caitlin Montgomery
- Department of Epidemiology, School of Public Health, West Virginia University, Morgantown, WV, USA
| | - Maryanna Klatt
- Department of Family and Community Medicine, College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Sijin Wen
- Department of Biostatistics, School of Public Health, West Virginia University, Morgantown, WV, USA
| | - Karen J. Sherman
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | - Kim E. Innes
- Department of Epidemiology, School of Public Health, West Virginia University, Morgantown, WV, USA
| |
Collapse
|
11
|
Vlasie A, Trifu S, Lupuleac C, Kohn B, Cristea M. Restless legs syndrome: An overview of pathophysiology, comorbidities and therapeutic approaches (Review). Exp Ther Med 2021; 23:185. [PMID: 35069866 PMCID: PMC8764906 DOI: 10.3892/etm.2021.11108] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 08/05/2021] [Indexed: 11/06/2022] Open
Affiliation(s)
- Andrei Vlasie
- Department of Psychiatry, ‘Prof. Dr. Alexandru Obregia’ Clinical Hospital of Psychiatry, Bucharest 041914, Romania
| | - Simona Trifu
- Department of Clinical Neurosciences, ‘Carol Davila’ University of Medicine and Pharmacy, Bucharest 020021, Romania
| | - Cristiana Lupuleac
- Department of Psychiatry, ‘Prof. Dr. Alexandru Obregia’ Clinical Hospital of Psychiatry, Bucharest 041914, Romania
| | - Bianca Kohn
- Department of Psychiatry, ‘Prof. Dr. Alexandru Obregia’ Clinical Hospital of Psychiatry, Bucharest 041914, Romania
| | - Mihai Cristea
- Department of Morphological Sciences, ‘Carol Davila’ University of Medicine and Pharmacy, Bucharest 020021, Romania
| |
Collapse
|
12
|
Restless legs syndrome during pregnancy: an overview. SOMNOLOGIE 2021. [DOI: 10.1007/s11818-021-00337-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
13
|
Wang SH, Chen XY, Wang XP. Jidong Restless Legs Syndrome Cohort Study: Objectives, Design, and Baseline Screening. Front Neurol 2021; 12:682448. [PMID: 34721252 PMCID: PMC8548385 DOI: 10.3389/fneur.2021.682448] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 09/07/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Restless legs syndrome (RLS) is a common neurological disorder with unpleasant leg sensations and serious negative effects on mental and physical health. Many observational studies showed that people with RLS had a high risk of vascular diseases, including cerebrovascular and cardiovascular diseases (CVD), but the findings were conflicting. The Jidong RLS Cohort Study is a prospective cohort study designed to mainly examine whether or not RLS is associated with an increased risk of CVD. Methods and Design: The study recruited 8,867 healthy participants older than 18 years from October 2014 to December 2015. Participants received a physical examination in the Staff Hospital, Jidong Oilfield Branch, China National Petroleum Corporation. Baseline data and blood samples were collected. Restless legs syndrome was assessed using the international RLS diagnostic criteria. All of subjects would be followed up until December 2025. Major cardiovascular/cerebrovascular events including cardiac death, myocardial infarction, ischemic heart disease, heart failure, atrial fibrillation, ischemic, and hemorrhagic stroke will be the primary outcomes. Secondary outcomes include all-cause mortality, the decline in quality of life, cognitive impairment, and depression. Discussion: This study will contribute to the scientific evidence on the association between RLS and cardiovascular risks and also provide an unprecedented opportunity for early detection and prevention of CVD.
Collapse
Affiliation(s)
- Shu-Hong Wang
- Department of Neurology, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xue-Yu Chen
- Department of Biostatistics, Public Health Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Shandong, China
| | - Xiao-Ping Wang
- Department of Neurology, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| |
Collapse
|
14
|
Xu Y, Wen H, Li J, Yang J, Luo K, Chang L. The relationship between sleep disorders, anxiety, depression, and cognitive function with restless legs syndrome (RLS) in the elderly. Sleep Breath 2021; 26:1309-1318. [PMID: 34436711 DOI: 10.1007/s11325-021-02477-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 08/01/2021] [Accepted: 08/11/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Restless legs syndrome (RLS) has a significant effect on sleep and quality of life. Delays in diagnosis and treatment are frequent due to a lack of awareness. In this study, a clinical analysis was performed to examine the relationship between sleep, mood, and cognitive function in RLS. METHODS According to the Pittsburgh Sleep Quality Index score (PSQI), patients with RLS were divided into a sleep disorders group (SD, PSQI > 7) and non-sleep disorders group (NSD, PSQI ≤ 7). Healthy controls were selected as a control group matched for age, cultural background, and marital status. We compared differences between the three groups using the Hamilton Anxiety Scale (HAMA), Hamilton Depression (HAMD), Mini-Mental State Examination (MMSE), and Montreal Cognitive Assessment (MoCA). The SD and NSD groups were also assessed with the Restless Leg Syndrome Rating Scale (RLSRS) and the severity of RLS between the two groups was compared. The analysis used t-test, ANOVA, and Pearson correlation. RESULTS (1) Among the 54 RLS patients, 30 people in the control group, 35 patients with sleep disorders (SD, 65%), and 19 patients without sleep disorders (NSD, 35%), there were no significant differences in age, educational level, marital status, or trauma history. (2) The comparison results of the case group (SD and NSD) and the control group showed highly significant differences (P < 0.01) in the PSQI-HAMA-HAMD score but no significant differences between the NSD group, the SD group, and the control group in MMSE score. There was no difference between the NSD group and the control group in the MoCA, but a significant difference (P < 0.05) between the SD group and the control group was found. (3) The comparison between the NSD and the SD groups revealed significant differences in the RLSRS, HAMA, and HAMD scores (P < 0.05), but there were no statistical differences (P > 0.05) between two groups on MMSE and MoCA score. (4) Correlation and regression showed that there was a linear correlation between PSQI scores and RLSRS and HAMD scores in patients with RLS (P < 0.05). The regression equation was PSQI = - 2.393 + 0.494 RLSRS + 0.170 HAMD. CONCLUSIONS RLS patients were prone to sleep disorders, anxiety, and depression. Sleep disorders increased with the severity of the RLS and had some influence on the patient's cognitive function. Sleep disorders were closely related to RLSRS and HAMD.
Collapse
Affiliation(s)
- Yuan Xu
- Department of Neurology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, People's Republic of China.,Comprehensive Stroke Center, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, People's Republic of China
| | - Hongbin Wen
- Department of Neurology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, People's Republic of China.,Comprehensive Stroke Center, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, People's Republic of China
| | - Jie Li
- Department of Neurology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, People's Republic of China.,Comprehensive Stroke Center, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, People's Republic of China
| | - Jing Yang
- Department of Neurology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, People's Republic of China
| | - Kai Luo
- School of Food Science and Technology & School of Chemical Engineering, Hubei University of Arts and Science, Xiangyang, 441053, People's Republic of China.
| | - Liying Chang
- Department of Neurology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, People's Republic of China.,Comprehensive Stroke Center, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, People's Republic of China
| |
Collapse
|
15
|
Innes KE, Selfe TK, Montgomery C, Hollingshead N, Huysmans Z, Srinivasan R, Wen S, Hausmann MJ, Sherman K, Klatt M. Effects of a 12-week yoga versus a 12-week educational film intervention on symptoms of restless legs syndrome and related outcomes: an exploratory randomized controlled trial. J Clin Sleep Med 2021; 16:107-119. [PMID: 31957638 DOI: 10.5664/jcsm.8134] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
STUDY OBJECTIVES To assess the effects of a yoga versus educational film (EF) program on restless legs syndrome (RLS) symptoms and related outcomes in adults with RLS. METHODS Forty-one community-dwelling, ambulatory nonpregnant adults with moderate to severe RLS were randomized to a 12-week yoga (n = 19) or EF program (n = 22). In addition to attending classes, all participants completed practice/treatment logs. Yoga group participants were asked to practice at home 30 minutes per day on nonclass days; EF participants were instructed to record any RLS treatments used on their daily logs. Core outcomes assessed pretreatment and posttreatment were RLS symptoms and symptom severity (International RLS Study Group Scale (IRLS) and RLS ordinal scale), sleep quality, mood, perceived stress, and quality of life (QOL). RESULTS Thirty adults (13 yoga, 17 EF), aged 24 to 73 (mean = 50.4 ± 2.4 years), completed the 12-week study (78% female, 80.5% white). Post-intervention, both groups showed significant improvement in RLS symptoms and severity, perceived stress, mood, and QOL-mental health (P ≤ .04). Relative to the EF group, yoga participants demonstrated significantly greater reductions in RLS symptoms and symptom severity (P ≤ .01), and greater improvements in perceived stress and mood (P ≤ .04), as well as sleep quality (P = .09); RLS symptoms decreased to minimal/mild in 77% of yoga group participants, with none scoring in the severe range by week 12, versus 24% and 12%, respectively, in EF participants. In the yoga group, IRLS and RLS severity scores declined with increasing minutes of homework practice (r = .7, P = .009 and r = .6, P = .03, respectively), suggesting a possible dose-response relationship. CONCLUSIONS Findings of this exploratory RCT suggest that yoga may be effective in reducing RLS symptoms and symptom severity, decreasing perceived stress, and improving mood and sleep in adults with RLS. CLINICAL TRIAL REGISTRATION Registry: Clinicaltrials.gov; Title: Yoga vs. Education for Restless Legs: a Feasibility Study; Identifier: NCT03570515; URL: https://clinicaltrials.gov/ct2/show/NCT03570515.
Collapse
Affiliation(s)
- Kim E Innes
- Department of Epidemiology, West Virginia University School of Public Health, Morgantown, West Virginia
| | - Terry Kit Selfe
- Health Science Center Libraries, University of Florida, Gainesville, Florida
| | - Caitlin Montgomery
- Department of Epidemiology, West Virginia University School of Public Health, Morgantown, West Virginia
| | - Nicole Hollingshead
- Department of Family Medicine, The Ohio State University College of Medicine, Columbus, Ohio
| | - Zenzi Huysmans
- West Virginia University College of Physical Activity and Sport Sciences, Morgantown, West Virginia
| | - Roshini Srinivasan
- Department of Family Medicine, The Ohio State University College of Medicine, Columbus, Ohio
| | - Sijin Wen
- Department of Biostatistics, West Virginia University School of Public Health, Morgantown, West Virginia
| | - Madeleine J Hausmann
- Department of Family Medicine, The Ohio State University College of Medicine, Columbus, Ohio
| | - Karen Sherman
- Kaiser Permanente Washington Health Research Institute, Seattle, Washington
| | - Maryanna Klatt
- Department of Family Medicine, The Ohio State University College of Medicine, Columbus, Ohio
| |
Collapse
|
16
|
So S, Brennan FP, Brown MA. Cognitive Biases in Medicine: The Potential Impact on the Diagnosis of Restless Legs Syndrome in Chronic Kidney Disease. J Pain Symptom Manage 2021; 61:870-877. [PMID: 33035652 DOI: 10.1016/j.jpainsymman.2020.09.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 09/26/2020] [Accepted: 09/30/2020] [Indexed: 11/12/2022]
Affiliation(s)
- Sarah So
- Department of Palliative Care, St George Hospital, Kogarah, Sydney, Australia; St George & Sutherland Clinical Schools, University of NSW, Sydney, New South Wales, Australia.
| | - Frank P Brennan
- Department of Palliative Care, St George Hospital, Kogarah, Sydney, Australia; Department of Renal Medicine, St George Hospital, Kogarah, Sydney, Australia; St George & Sutherland Clinical Schools, University of NSW, Sydney, New South Wales, Australia
| | - Mark A Brown
- Department of Renal Medicine, St George Hospital, Kogarah, Sydney, Australia; St George & Sutherland Clinical Schools, University of NSW, Sydney, New South Wales, Australia
| |
Collapse
|
17
|
Thi Truong BE, Sung FC, Lin CL, Hang LW, Teng YK, Tzeng YL. A follow-up study on restless legs syndrome in chronic obstructive pulmonary disease population. Sleep Med 2021; 80:9-15. [PMID: 33545488 DOI: 10.1016/j.sleep.2021.01.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 12/29/2020] [Accepted: 01/12/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Restless legs syndrome (RLS) is prevalent in patients with chronic obstructive pulmonary disease (COPD). No large population-based cohort study has assessed the relationship. We evaluated the incidence of RLS among COPD patients by sociodemographic status (SES) and comorbidity using insurance claims data of Taiwan. METHODS From the database, we established a cohort consisting of 77,831 individuals aged ≥ 20 years newly diagnosed with COPD from 2000 to 2013. We also identified same number of individuals without COPD as the comparison cohort, frequency matched by sex, age and index year. Both cohorts were followed up to the end of 2013 to estimate the incidence and hazard ratio (HR) of developing RLS. RESULTS The incidence of RLS was 2.2-fold higher in COPD patients than in those free of COPD (6.67 and 3.08 per 10,000 person-years), with an adjusted HR (aHR) 1.68 (95% CI 1.41-2.01) after controlling for covariates. The incidence rates in both cohorts increased with age and higher in low socioeconomic group. The risk of RLS increased further among COPD patients with additional comorbidities. Compared to those without COPD and comorbidity, the aHR was 7.93 (95% CI 1.11-57.8) for those with iron deficiency, 3.95 (96% CI 1.92-8.13) with Parkinson's disease, 2.85 (95% CI 1.05-7.72) with polyneuropathy, or 1.81 (95% CI 1.14-2.87) with diabetes. CONCLUSION Patients with COPD are at an increased risk of developing RLS regardless of gender, age and occupation. The COPD patients with comorbidities should be particularly cautious about the RLS risk.
Collapse
Affiliation(s)
| | - Fung-Chang Sung
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan; Department of Health Services Administration, China Medical University College of Public Health, Taichung, Taiwan; Department of Food Nutrition and Health Biotechnology, Asia University, Taichung, Taiwan
| | - Cheng-Li Lin
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Liang-Wen Hang
- School of Nursing, China Medical University, Taichung, Taiwan; Center of Sleep Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Yu-Kuei Teng
- School of Nursing, China Medical University, Taichung, Taiwan; Department of Nursing, China Medical University Hospital, Taichung, Taiwan.
| | - Ya-Ling Tzeng
- School of Nursing, China Medical University, Taichung, Taiwan; Department of Nursing, China Medical University Hospital, Taichung, Taiwan.
| |
Collapse
|
18
|
Demir S, Kucuk A, Altas M, Cure E. Restless Leg Syndrome and Sleep Disorders in Patients with Rheumatoid Arthritis and Its Relation with Anemia Parameters. ACTA MEDICA (HRADEC KRALOVE) 2021; 64:137-144. [PMID: 34779378 DOI: 10.14712/18059694.2021.24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVES We aimed to investigate the prevalence of restless legs syndrome (RLS) and sleep disorders in patients with rheumatoid arthritis (RA), and the association of iron deficiency with them. MATERIALS AND METHODS The study included 72 patients with RA (59 females, 13 males), and 50 healthy control subjects (57 females, 15 males). Assessments were made using the International RLS Rating Scale, Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale, Fatigue Severity Scale (FSS), Beck anxiety and depression index and the SF-36 quality of life scores. RESULTS We found that the frequency of RLS in RA patients was 29.1% and 13.8% in healthy control (p = 0.021). RA patients had 44.4% iron deficiency and 5.5% anemia of chronic disease. We found that 52.3% of patients with iron deficiency had RLS. There was an independent relationship between present of RLS and FSS (Beta [β] = 0.317, p = 0.005) and total iron binding capacity (TIBC) (β = 0.244, p = 0.031). There was an independent relationship between RLS severity score and PSQI (β = 0.264, p = 0.025) and social functionality (β = 0.302, p = 0.009). CONCLUSION The prevalence of iron deficiency is high in RA in the developing countries. Analysis obtained in patients with RA is suggestive of an association between iron deficiency and increased frequency of RLS. The presence of RLS in patients with RA negatively affects sleep quality, psychiatric status, and quality of life of patients with RA. TIBC value may be a predictive marker for early detection of RLS in patients with RA.
Collapse
Affiliation(s)
- Salih Demir
- Department of Internal Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Adem Kucuk
- Division of Rheumatology, Department of Internal Medicine, Necmettin Erbakan University, Konya, Turkey.
| | - Mustafa Altas
- Department of Neurology, Necmettin Erbakan University, Konya, Turkey
| | - Erkan Cure
- Department of Internal Medicine, Ota & Jinemed Hospital, Istanbul, Turkey
| |
Collapse
|
19
|
Guo J, Pei L, Chen L, Chen H, Gu D, Peng Y, Sun J. Bidirectional association between irritable bowel syndrome and restless legs syndrome: a systematic review and meta-analysis. Sleep Med 2020; 77:104-111. [PMID: 33348297 DOI: 10.1016/j.sleep.2020.12.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 11/03/2020] [Accepted: 12/01/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Several observational studies have shown that patients with irritable bowel syndrome (IBS) may have a high risk of restless legs syndrome (RLS). This systematic review and meta-analysis aimed to comprehensively investigate the bidirectional association between IBS and RLS. METHODS All conservational studies on IBS and RLS were searched in MEDLINE (assessed by PubMed), Embase, Web of Science, CINAHL, the Cochrane Library database and Google Scholar from inception to June 14, 2020. The Newcastle-Ottawa Scale and Agency for Healthcare Research and Quality were used to assess the methodological quality of the cohort and cross-sectional studies, respectively. The pooled odds ratio (OR) and 95% confidence interval (CI) were calculated using Reviewer Manager 5.3. RESULT A total of five cross-sectional studies of moderate methodological quality and one cohort study of high methodological quality were included in our review. Four cross-sectional studies and one cohort study involving 86 438 individuals met the criteria of IBS predicating the onset of RLS. Patients with IBS had a nearly three-fold increased odds of RLS compared with controls (OR = 2.60, 95%CI: 2.17-3.12, P < 0.00001; I2 = 48%, P = 0.11). Three sensitivity analyses confirmed the robustness of the pooled result. Two cross-sectional studies involving 3581 individuals met the criteria of RLS predicating the onset of IBS. RLS patients had a nearly four-fold increased odds of IBS compared with controls without RLS (OR = 3.87, 95%CI: 1.73-8.66, P = 0.0010; I2 = 77%, P = 0.04). CONCLUSION In this systematic review and meta-analysis, we found a substantial bidirectional association between IBS and RLS. More prospective, high-quality, population-based studies are warranted in the future.
Collapse
Affiliation(s)
- Jing Guo
- The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Lixia Pei
- The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Lu Chen
- The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Hao Chen
- Nanjing University of Chinese Medicine, Nanjing, China
| | - Dongmei Gu
- The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Yongjun Peng
- The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China.
| | - Jianhua Sun
- The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China.
| |
Collapse
|
20
|
Salib M, Memon AN, Gowda AS, Rallabhandi B, Bidika E, Fayyaz H, Cancarevic I. Dialysis Patients With Restless Leg Syndrome: Can We Relieve Their Suffering? Cureus 2020; 12:e10053. [PMID: 32999776 PMCID: PMC7520405 DOI: 10.7759/cureus.10053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Restless leg syndrome (RLS), also called Willis Ekbom disease, can be described as an unpleasant feeling that intensely urges the patients to move their lower limbs. RLS is classified into primary and secondary. It is one of the common complications in hemodialysis patients, and it impairs patients’ quality of life. Unfortunately, it is an underdiagnosed and undertreated disorder. In this review article, we performed a literature search using the PubMed database to compare different treatment modalities for RLS in patients with end-stage renal disease (ESRD) on regular hemodialysis. Many of the non-pharmacologic modalities of treatment are cost-effective and safer than pharmacologic therapy. Given the small sample size of the studies and short follow up duration, we should consider conducting studies on a larger number of patients and for longer periods of time to assess the efficacy and safety of different treatment patterns for RLS in hemodialysis patients. We hope to raise awareness about this neurologic condition in hemodialysis patients.
Collapse
Affiliation(s)
- Marina Salib
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Areeba N Memon
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Asavari S Gowda
- Research, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Bhavana Rallabhandi
- Neurology, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Erjola Bidika
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Hafsa Fayyaz
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Ivan Cancarevic
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| |
Collapse
|
21
|
Mosli MH, Bukhari LM, Khoja AA, Ashour NA, Aljahdali HR, Khoja OA, Alhejaili FF, Saadah OI. Inflammatory bowel disease and restless leg syndrome. NEUROSCIENCES (RIYADH, SAUDI ARABIA) 2020; 25:301-307. [PMID: 33130811 PMCID: PMC8015615 DOI: 10.17712/nsj.2020.4.20200021] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Objectives: Inflammatory bowel disease (IBD) has been associated with restless leg syndrome (RLS). This study aims to explore the prevalence, clinical predictors, and severity of RLS in IBD patients compared to controls. Methods: We conducted a case-control study between January and December of 2019 comparing IBD patients with controls. Assessment of RLS was performed using the previously validated diagnostic restless leg syndrome questionnaire (RLSQ). Logistic regression analyses were applied to investigate associations between patient demographics and clinical features and RLS diagnosis. Results: A total of 218 IBD patients and 211 healthy controls were incorporated after excluding 6 patients with positional discomfort and 4 patients with habitual foot tapping. The mean age was 30.2±11.7 and 64% were females. The prevalence of RLS was 16/218 (7.34%) and 17/211 (8.06%) among cases and controls, respectively. Based on the RLSQ severity score, 6/16 (37.5%), 4/16 (25%) and 1/16 (6.3%) of the IBD patients with RLS had mild, moderate and severe RLS; respectively. The odds of IBD were lower among patients with confirmed RLS (OR=0.90, 95% CI=0.44-1.84, p = 0.78). In the logistic regression analysis, only vitamin B12 deficiency (OR=10.20, 95% CI=1.40-74.10, p = 0.022) was associated with RLS diagnosis among IBD patients. Conclusion: No difference was found in the prevalence of RLS between IBD patients and non-IBD controls. Vitamin B12 deficiency was associated with RLS diagnosis among patients with IBD.
Collapse
Affiliation(s)
- Mahmoud H Mosli
- Department of Medicine, King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia. E-mail:
| | | | | | | | | | | | | | | |
Collapse
|
22
|
Cubo E, Collazo Riobo C, Gallego-Nieto C, Elizari-Roncal M, Barroso-Pérez T, Calvo S, Echavarria A, Marras C. Survival in Restless Legs Syndrome: An 11-Year Surveillance, Community-Based Population Study. Neuroepidemiology 2020; 54:375-382. [DOI: 10.1159/000508855] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 05/20/2020] [Indexed: 11/19/2022] Open
Abstract
<b><i>Background:</i></b> A growing body of evidence relates restless legs syndrome (RLS) to an increased risk of mortality attributable to both cerebrovascular and cardiovascular events. The aim was to investigate survival in patients with RLS. <b><i>Methods:</i></b> This was an observational, retrospective longitudinal study of a cohort of patients followed up for 11 years. RLS was diagnosed by a physician using the International RLS Study Group criteria. Mortality was analyzed using age-standardized mortality ratios (SMR: observed/expected deaths) and Cox regression analysis. <b><i>Results:</i></b> Vital status was studied in a cohort of 232 patients: 181 women (78%), 96 with RLS (41.4%) with a mean age at baseline of 49.8 ± 15.0 years and a mean RLS duration of 14.1 ± 1.9 years, and 136 non-RLS (58.6%) with a mean age of 51.3 ± 14.9 years. This RLS cohort was followed up for a period of 10.4 ± 2.0 years. As of September 2019, 17 (7.3%) patients died (6 with RLS, 6.3%), and the most frequent cause was oncological (66.7%). A total of 944 person-years of observations were available for survival analysis. RLS was not associated with increased mortality in adjusted Cox regression analysis (HR = 1.12, 95% CI: 0.40–3.15), and survival was similar to that expected for the general population (SMR = 0.61, 95% CI: 0.27–1.36). <b><i>Conclusions:</i></b> RLS seems not to be associated with increased mortality compared to the general population. Still, studies with prospective data collection with large samples are needed to study the long-term mortality risk factors in RLS cohorts.
Collapse
|
23
|
Jafarimanesh H, Vakilian K, Mobasseri S. Thermo-therapy and cryotherapy to decrease the symptoms of restless leg syndrome during the pregnancy: A randomized clinical trial. Complement Ther Med 2020; 50:102409. [PMID: 32444058 DOI: 10.1016/j.ctim.2020.102409] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 02/19/2020] [Accepted: 04/10/2020] [Indexed: 10/24/2022] Open
Abstract
BACKGROUND AND PURPOSE Restless legs syndrome (RLS) is a common sensory-motor disorder among the pregnant women. The aim of this study is to compare the impacts of two methods of immersion of legs in cold and warm water on the RLS symptoms among the pregnant women. METHODS This randomized clinical trial was conducted on 80 pregnant women with RLS who referred to Taleghani educational-therapy center. After obtaining their informed consent, they were selected by accessible method and randomly allocated into group 1 (warm water) and group 2 (cold water). Group 1 were asked to put their legs in cold water for 10 min every night for 2 weeks. The group 2 put their legs in warm water under the same condition. The severity of RLS was measured before and after the study. Data analysis was conducted using descriptive as well as the analytical statistics such as Chi-square, independent T test, pair T test, Mann-Whitney U, Wilcoxon and covariance. RESULTS After intervention, mean RLS of the cold water group was11.02 ± 4.93; while this mean was 13.50 ± 4.74 in the warm water group. The difference between the two groups was significant (p = 0.017). Results also revealed that the severity of RLS symptoms at the end of the treatment was different from the beginning of the research in both groups (p = 0.001). The intervention with both warm and cold water declined the RLS symptoms among pregnant women. CONCLUSION The warm and cold water can be used for this purpose depending on the women's preference. However, this article recommends the cold water for more reducing of symptoms.
Collapse
Affiliation(s)
- Hadi Jafarimanesh
- School of Nursing, School of Medicine, Traditional and Complementary Medicine Research Center (TCMRC), Arak University of Medical Sciences, Arak, Sardasht, Iran.
| | - Katayon Vakilian
- Department of Midwifery, School of Medicine, Traditional and Complementary Medicine Research Center(TCMRC), Arak University of Medical Sciences, Arak, Sardasht, Iran.
| | - Shirin Mobasseri
- Traditional and Complementary Medicine Research Center (TCMRC), Arak University of Medical Sciences, Imam Khomeini Street, Taleghani Hospital, Arak, Iran.
| |
Collapse
|
24
|
Aksoy D, Çelik A, Solmaz V, Çevik B, Sümbül O, Kurt S. The prevalence of restless legs syndrome in patients undergoing coronary angiography and its relationship with the severity of coronary artery stenosis. Sleep Breath 2020; 25:257-262. [PMID: 32430676 DOI: 10.1007/s11325-020-02085-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 03/21/2020] [Accepted: 04/13/2020] [Indexed: 11/27/2022]
Abstract
PURPOSE Results from studies on the relationship between restless legs syndrome (RLS) and coronary artery disease (CAD) are conflicting. Some studies associate RLS with CAD by heart rate variability, blood pressure variability, and other autonomic, neuronal reasons, while other studies do not support these observations. The aim of this study was to investigate the prevalence of RLS in patients undergoing coronary angiography for CAD and to assess RLS prevalence with severity of CAD. METHODS After inclusion and exclusion criteria were applied, enrolled patients with less than 50% coronary artery stenosis by angiography (0-49%) were assigned to group 1, and patients with 50% or more coronary artery stenosis were assigned to group 2. Patients were diagnosed with RLS if they met all five essential criteria of the International RLS study group. RLS prevalence and other comorbidities were compared between the two groups. RESULTS Of 126 patients, 74 men (59%), mean age 64.0 ± 8.7 years, mean BMI 29.6 kg/m2, 47 (37%) were assigned to group 1 (no or nonobstructive CAD) and 79 (63%) were assigned to group 2 (obstructive CAD). No significant differences were found between the groups in terms of mean age, BMI, gender, or prevalence of hypertension, hypercholesterolemia, and DM. The prevalence of RLS in group 2 (29%) was significantly higher than in group 1 (15%), p = 0.013. CONCLUSION These results suggest that prevalence of RLS is associated with CAD and with CAD severity. We conjecture that RLS may be related to vascular endothelial dysfunction in cardiovascular disease.
Collapse
Affiliation(s)
- Dürdane Aksoy
- Faculty of Medicine, Department of Neurology, Tokat Gaziosmanpasa University, Kaleardi mah. Muhittin Fusunoglu cad, 60100, Tokat, Turkey.
| | - Ataç Çelik
- Faculty of Medicine, Department of Cardiology, Tokat Gaziosmanpaşa University, Tokat, Turkey
| | - Volkan Solmaz
- Memorial Hizmet Hospital, Department of Neurology, Bahcelievler/Istanbul, Turkey
| | - Betül Çevik
- Faculty of Medicine, Department of Neurology, Tokat Gaziosmanpasa University, Kaleardi mah. Muhittin Fusunoglu cad, 60100, Tokat, Turkey
| | - Orhan Sümbül
- Faculty of Medicine, Department of Neurology, Tokat Gaziosmanpasa University, Kaleardi mah. Muhittin Fusunoglu cad, 60100, Tokat, Turkey
| | - Semiha Kurt
- Faculty of Medicine, Department of Neurology, Tokat Gaziosmanpasa University, Kaleardi mah. Muhittin Fusunoglu cad, 60100, Tokat, Turkey
| |
Collapse
|
25
|
Majumder P. Development of Restless Leg Syndrome in a Pediatric Patient Treated with Sertraline. Indian J Psychol Med 2020; 42:311-312. [PMID: 32612338 PMCID: PMC7320729 DOI: 10.4103/ijpsym.ijpsym_6_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Revised: 01/18/2020] [Accepted: 02/09/2020] [Indexed: 11/04/2022] Open
Affiliation(s)
- Pradipta Majumder
- Attending Psychiatrist, WellSpan Health, York, Pennsylvania, 17402, USA
| |
Collapse
|
26
|
Telarović S, Čondić L. Frequency of iron deficiency anemia in pregnant and non-pregnant women suffering from restless legs syndrome. ACTA ACUST UNITED AC 2020; 24:263-267. [PMID: 31793405 DOI: 10.1080/16078454.2018.1560935] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objectives. Restless Legs Syndrome is a movement disorder characterized by unpleasant sensations in the legs described as a burning, tingling, etc. Symptoms become worse in the evening and are relieved by moving the limbs. The idiopathic form of the disease is associated with a lack of dopamine, and the secondary form is associated with iron deficiency anemia, pregnancy, and kidney disease. The aim of this study was to investigate the incidence of iron deficiency anemia in pregnant women and non-pregnant women suffering from RLS.Methods. The study was conducted on a sample of 231 pregnant women aged 18-50. The pregnant women were interviewed at the outpatient clinic of the Department of Gynaecology and Obstetrics. This study also included a control group of 231 age-compatible non-pregnant women. Women who met the international criteria for diagnosing the syndrome filled in a sociodemographic questionnaire.Results. A statistically significant association between the existence of iron deficiency anemia and RLS in the sample of the examined women was proven (p < 0.001). It was also shown that RLS is more frequent in a sample of anemic pregnant women than non-anemic pregnant women (p = 0.008).Conclusion. Iron deficiency anemia is related with RLS. Pregnant women with RLS are more likely to be anemic than pregnant women without RLS.
Collapse
Affiliation(s)
- Srdjana Telarović
- Medical School, University of Zagreb, Zagreb, Croatia.,Department of Neurology, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Lucija Čondić
- Medical School, University of Zagreb, Zagreb, Croatia
| |
Collapse
|
27
|
Pradella-Hallinan M, Pereira JC, Martins JRM. Restless Legs Syndrome, and symptoms of Restless Syndrome in patients with Graves' disease: a cross-sectional survey. Clinics (Sao Paulo) 2020; 75:e2140. [PMID: 33206764 PMCID: PMC7603292 DOI: 10.6061/clinics/2020/e2140] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 08/26/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES Restless legs syndrome (RLS) is a frequent comorbid condition associated with distinct unrelated diseases. While the incidence of RLS has not been definitively confirmed, RLS-like symptoms have been reported in a section of Asian population who also had hyperthyroidism. The prevalence of RLS is generally low in Asian populations. Under these circumstances, we hypothesized that in a population where RLS is common, such as in Brazil, RLS could manifest as a comorbid ailment alongside Graves' disease, a common hyperthyroid condition. METHODS In a cross-sectional survey, 108 patients who presented with Graves' disease were analyzed for restless legs or associated symptoms. RESULTS Twelve patients (11.1%) displayed symptoms of RLS prior to the incidence of Graves' disease. These patients experienced worsening of the symptoms during their hyperthyroid state. Six patients (5.6%) developed RLS, consequent upon the incidence of Graves' disease as per the consensus of the panel of the experts. Fifteen patients (13.9%) also presented with RLS-like symptoms without any discernible circadian feature of the syndrome. CONCLUSION Our findings confirm that Graves' disease might trigger restless legs-like symptoms, while the condition of hyperthyroidism could also be complicated by definite RLS.
Collapse
Affiliation(s)
| | - José Carlos Pereira
- Departamento de Psicobiologia, Universidade Federal de Sao Paulo (UNIFESP), SP, BR e Hospital Sirio-Libanes, Sao Paulo, SP, BR
- *Corresponding author. E-mail:
| | | |
Collapse
|
28
|
Riar SK, Greenbaum LA, Bliwise DL, Leu RM. Restless Legs Syndrome in Chronic Kidney Disease: Is Iron or Inflammatory Status To Blame? J Clin Sleep Med 2019; 15:1629-1634. [PMID: 31739853 PMCID: PMC6853406 DOI: 10.5664/jcsm.8028] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 07/20/2019] [Accepted: 07/22/2019] [Indexed: 01/28/2023]
Abstract
STUDY OBJECTIVES Restless legs syndrome (RLS) is increased in pediatric chronic kidney disease (CKD). In adults without CKD, central nervous system iron deficiency is involved in RLS pathogenesis and a low serum ferritin levels is consequently an indication for initiation of iron therapy. However, children with CKD are at risk for iron deficiency and inflammation, which raises serum ferritin. We examined the role of iron deficiency and inflammation in RLS in pediatric CKD. METHODS This cross-sectional study examined RLS prevalence in three groups of pediatric patients with CKD: nontransplant, nondialysis CKD (estimated GFR < 60 mL/min/1.73 m²) (n = 27); renal transplant recipients (n = 65); and dialysis (n = 32). RLS was diagnosed using a validated questionnaire. Serum ferritin < 100 ng/mL or transferrin saturation < 20% defined iron deficiency. Serum high sensitivity C-reactive protein ≥ 1 mg/L defined inflammation. RESULTS Among 124 patients, RLS prevalence was 15.3%; this did not differ across groups. There was no significant difference in RLS prevalence between those with and without iron deficiency, defined by either reduced ferritin or transferrin. Median ferritin levels in patients with RLS tended to be higher than in those without RLS (51.2 versus 40.1 ng/mL; P = .08). Inflammation (elevated CRP) also did not differ significantly by RLS status (57.9% [with RLS] versus 41.2% [without RLS], P = .18). CONCLUSIONS Neither ferritin nor inflammation differentiated pediatric patients with CKD with and without RLS. This study suggests that the factors mediating the pathogenesis and, potentially, treatment, of RLS in pediatric CKD may be different from non-CKD populations.
Collapse
Affiliation(s)
- Sandeep K Riar
- Pediatrics, Nephrology Division, University of Kansas Medical Center, Kansas City, Kansas
| | - Larry A Greenbaum
- Pediatrics, Nephrology Division, Emory University and Children's Healthcare of Atlanta, Atlanta, Georgia
| | - Donald L Bliwise
- Neurology, Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
| | - Roberta M Leu
- Division of Pulmonology, Allergy, Cystic Fibrosis and Sleep Medicine, Emory University and Children's Healthcare of Atlanta, Atlanta, Georgia
| |
Collapse
|
29
|
Affiliation(s)
- Helmut Frohnhofen
- Alfried Krupp Krankenhaus Rittenscheid, Alfried-Krupp-Straße 21, D-45131, Essen, Deutschland.
| |
Collapse
|
30
|
Youssef MK. Efficacy of neuromuscular electric stimulation versus aerobic exercise on uraemic restless legs syndrome. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2019. [DOI: 10.12968/ijtr.2017.0132] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BackgroundThe prevalence of restless legs syndrome in haemodialysis patients is approximately ~30%, and it is significantly higher than in the general population. Restless legs syndrome is a sensory-motor disorder with negative effects on sleep and daytime activities that affect personal, family and occupational life. The overall impact of restless legs syndrome on quality of life is comparable to that of chronic and frustrating conditions such as depression and diabetes. The present study was conducted to compare the effect of neuromuscular electric stimulation with aerobic exercise on cases of uraemic restless legs syndrome.MethodsA total of 60 chronic renal failure patients with uraemic restless legs syndrome aged 20 to 65 years participated in this study. Participants were allocated to receive neuromuscular electric stimulation or aerobic exercises. All participants were evaluated before the first session of treatment and after 3 months, at the end of the treatment. Normal and fast walk gait speed tests and the Five Times Sit-to-Stand Test and 60 second Sit-to-Stand Test were used to assess participants' physical status. The Restless Legs Syndrome Rating Scale was used to determine the level of restless legs syndrome severity.ResultsNeuromuscular electric stimulation resulted in significant improvements in all measures of physical performance and in Restless Legs Syndrome Rating Scale score when compared to baseline. Aerobic exercise produced significant improvements in all tests. At the end of the study, aerobic exercise had greater responses than neuromuscular electric stimulation in all parameters measured except the Five Times Sit-to-Stand Test.ConclusionsNeuromuscular electrical stimulation may be used as an alternative to aerobic exercise to improve physical performance in cases of less severe restless legs syndrome in those unable or unwilling to participate in physical training.
Collapse
Affiliation(s)
- Manal K Youssef
- Assistant Professor, Physical Therapy, Department of Internal Medicine, Cairo University Hospitals, Giza, Egypt
| |
Collapse
|
31
|
Cubo E, Gallego-Nieto C, Elizari-Roncal M, Barroso-Pérez T, Collazo C, Calvo S, Delgado-López PD. Is Restless Legs Syndrome Associated with an Increased Risk of Mortality? A Meta-Analysis of Cohort Studies. Tremor Other Hyperkinet Mov (N Y) 2019; 9:650. [PMID: 31413895 PMCID: PMC6691746 DOI: 10.7916/tohm.v0.650] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Accepted: 04/06/2019] [Indexed: 12/01/2022] Open
Abstract
Background Restless legs syndrome (RLS) is a common sleep disorder,. although controversial, growing evidence relates the presence of RLS to an increased risk of mortality, mainly due to cardiovascular events. The aim of this article was to review the role of RLS as a risk factor of mortality according to independent cohort studies. Methods We performed a literature review via PubMed database for articles relating RLS and mortality. We used the random-effects model to calculate the pooled effect estimates on mortality. Heterogeneity between studies was assessed using quantitative and qualitative analysis. Results Out of 100 articles identified, 13 were finally included. Although studies were heterogeneous (p = 0.001), no significant publication bias was found. When all cohort studies were considered, the random-effects model yielded a significantly increased risk of mortality in RLS versus non-RLS patients (13 studies, hazard ratio [HR] = 1.52, 95% confidence interval [CI] 1.28-1.80). However, this association was not statistically significant when only cohort studies using the international RLS diagnostic criteria were considered (5 studies, HR = 1.63, 95% CI 0.94-2.81). Discussion The results of this meta-analysis suggest that RLS seems to be a risk factor of mortality, although this association is conditioned by the diagnostic criteria used in the studies. Future long-term follow-up standardized mortality studies are needed to address this important question that carries potential impact on population global health.
Collapse
Affiliation(s)
- Esther Cubo
- Neurology Department, Hospital Universitario Burgos, ES
- Health Science Department, University of Burgos, ES
| | | | | | | | | | - Sara Calvo
- Research Unit, Hospital Universitario Burgos, ES
| | | |
Collapse
|
32
|
Doan TT, Koo BB, Ogilvie RP, Redline S, Lutsey PL. Restless legs syndrome and periodic limb movements during sleep in the Multi-Ethnic Study of Atherosclerosis. Sleep 2019; 41:5026504. [PMID: 29860522 DOI: 10.1093/sleep/zsy106] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Indexed: 01/24/2023] Open
Abstract
Study Objectives To investigate the prevalence of concurrent periodic limb movements during sleep (PLMS) and restless leg syndrome (RLS), as well as the prevalence of PLMS and RLS separately. Additionally, we document these prevalences by age, race/ethnicity, sex, and obesity status. Methods Cross-sectional data from 2041 Multi-Ethnic Study of Atherosclerosis (MESA) Sleep ancillary study participants were used. PLMS (>15 periodic limb movements per hour of sleep) was measured by polysomnography. RLS symptoms were assessed using the 2009 International Restless Legs Syndrome Study Group clinical criteria. Results The prevalence of RLS with PLMS was 6.7%, RLS alone 16.1%, and PLMS alone 21.2%. RLS with PLMS was prevalent in 7.0% of whites, 4.9% of blacks, 10.1% of Hispanics, and 3.3% of Chinese-Americans. In adjusted models, odds of RLS with PLMS was higher for those older than 67 years versus those younger (odds ratio [OR] [95% confidence interval [CI]] = 1.62 [1.09-2.40]). Relative to white participants, the prevalence of RLS with PLMS tended to be lower among blacks (0.56 [0.32-0.96]). The prevalence of concurrent RLS and PLMS did not statistically differ by sex or obesity status. RLS alone was more common in women. Conclusions Approximately 7% of our sample had RLS with PLMS ("electro-clinical RLS"). This condition was more common among older individuals, did not vary by sex, and was less common among blacks. The findings provide some of the first information about the prevalence of concurrent RLS and PLMS in a community-based sample and show distinct sex and race associations for RLS versus electro-clinical RLS.
Collapse
Affiliation(s)
- Thu T Doan
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Brian B Koo
- Department of Neurology, Yale University School of Medicine, New Haven, CT.,Department of Neurology, Connecticut Veterans Affairs Health System, West Haven, CT
| | - Rachel P Ogilvie
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Susan Redline
- Division of Sleep Medicine, Harvard Medical School, Brigham and Women's Hospital and Beth Israel Deaconess Medical Center, Boston, MA
| | - Pamela L Lutsey
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
| |
Collapse
|
33
|
Sunwoo JS, Kim WJ, Chu MK, Yang KI. Association between Restless Legs Syndrome Symptoms and Self-Reported Hypertension: a Nationwide Questionnaire Study in Korea. J Korean Med Sci 2019; 34:e130. [PMID: 31020817 PMCID: PMC6484175 DOI: 10.3346/jkms.2019.34.e130] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Accepted: 04/14/2019] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The association between restless legs syndrome (RLS) and hypertension remains controversial. We investigated the relationship between RLS and hypertension in a nationwide sample of the Korean adult population. METHODS This was a cross-sectional questionnaire-based study including 2,740 adults aged 19 years or more. Subjects who met the four essential International RLS Study Group criteria and reported symptoms occurring at least once a week were defined as the RLS group. The presence of hypertension was defined as a self-reported history of physician-diagnosed hypertension. We conducted multiple logistic regression analysis to determine the independent association between RLS symptoms and self-reported hypertension after adjusting for potential confounding factors. RESULTS Among the 2,740 subjects, 68 (2.5%; 95% confidence interval [CI], 1.9%-3.1%) were found to have RLS with a symptom frequency of at least once a week. The prevalence of self-reported hypertension was 30.9% (95% CI, 20.5%-42.0%) in the RLS group, which was significantly higher than that in controls (12.4%; 95% CI, 11.2%-13.6%; P < 0.001). Multiple logistic regression analysis showed that the adjusted odds ratio for self-reported hypertension in the RLS group was 2.10 (95% CI, 1.12-3.93) compared to controls. In addition to RLS symptoms, old age, being overweight, low education level, diabetes mellitus, and short sleep duration were significantly associated with self-reported hypertension. CONCLUSION RLS symptoms occurring at least once a week is independently associated with a higher prevalence of self-reported hypertension in the adult Korean population. Further research will confirm the clinical implication of the present results and the causal relationship between RLS and hypertension.
Collapse
Affiliation(s)
- Jun Sang Sunwoo
- Department of Neurology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Won Joo Kim
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Min Kyung Chu
- Department of Neurology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Kwang Ik Yang
- Sleep Disorders Center, Department of Neurology, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea.
| |
Collapse
|
34
|
Sundaresan S, Migden MR, Silapunt S. Treatment of Leg Veins for Restless Leg Syndrome: A Retrospective Review. Cureus 2019; 11:e4368. [PMID: 31192073 PMCID: PMC6551200 DOI: 10.7759/cureus.4368] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Restless leg syndrome (RLS) and chronic venous insufficiency (CVI) share similar circadian timings and epidemiological characteristics. OBJECTIVE The objective of the study was to investigate whether treating superficial venous reflux (SVR) improves the RLS severity in patients with CVI and whether there is an association of the RLS severity with the number of refluxed veins. MATERIALS AND METHODS Patients with RLS and duplex ultrasound-proven SVR were identified from a database of 134 patients. All patients underwent endovenous radiofrequency ablation and ultrasound-guided foam sclerotherapy. International RLS (IRLS) rating scale questionnaires were reviewed to assess pre- and post-intervention RLS status. RESULTS Thirty-five patients were identified. The average baseline IRLS score was 19.83 (moderate RLS) and improved to 7.89 (mild RLS) after treatment (p < .0001), corresponding to 63% decrease in symptoms. Ten patients (29%) had a follow-up score of 0, indicating complete relief of RLS symptoms. Twenty patients (57%) had decreased IRLS scores of 10 points or more (i.e. 1 grade level of severity). Six patients had no improvement. There was no association of the RLS severity with the number of refluxed veins. CONCLUSION The study found that correcting SVR improves RLS symptoms, suggesting an association between CVI and RLS. Venous ultrasound study and intervention should be considered for potential patients.
Collapse
Affiliation(s)
| | - Michael R Migden
- Dermatology, Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Sirunya Silapunt
- Dermatology, University of Texas McGovern Medical School, Houston, USA
| |
Collapse
|
35
|
Selfe TK, Wen S, Sherman K, Klatt M, Innes KE. Acceptability and feasibility of a 12-week yoga vs. educational film program for the management of restless legs syndrome (RLS): study protocol for a randomized controlled trial. Trials 2019; 20:134. [PMID: 30770767 PMCID: PMC6377785 DOI: 10.1186/s13063-019-3217-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 01/21/2019] [Indexed: 01/28/2023] Open
Abstract
Background Restless legs syndrome (RLS) is a common and burdensome sleep disorder associated with profound impairment of health, well-being, and quality of life. Unfortunately, the medications used for RLS management carry risk of serious side effects, including augmentation of symptoms. Yoga, an ancient mind-body discipline designed to promote physical, emotional, and mental well-being, may offer a viable, low-risk new treatment. The primary objectives of this pilot, parallel-arm, randomized controlled trial (RCT) are to assess the acceptability and feasibility of a 12-week yoga vs. educational film program for the management of RLS. Methods Forty-four adults with confirmed moderate to severe RLS will be recruited and randomized to a 12-week yoga (n = 22) or standardized educational film program (N = 22). Yoga group participants will attend two 75-min Iyengar yoga classes per week for the first 4 weeks, then one 75-min class per week for the remaining 8 weeks, and will complete a 30-min homework routine on non-class days. Educational film group participants will attend one 75-min class per week for 12 weeks and complete a daily RLS treatment log; classes will include information on: RLS management, including sleep hygiene practices; other sleep disorders; and complementary therapies likely to be of interest to those participating in a yoga and sleep education study. Yoga and treatment logs will be collected weekly. Feasibility outcomes will include recruitment, enrollment, and randomization rates, retention, adherence, and program satisfaction. Program evaluation and yoga-dosing questionnaires will be collected at week 12; data on exploratory outcomes (e.g., RLS symptom severity (IRLS), sleep quality (PSQI), mood (POMS, PSS), and health-related quality of life (SF-36)) will be gathered at baseline and week 12. Discussion This study will lay the essential groundwork for a planned larger RCT to determine the efficacy of a yoga program for reducing symptoms and associated burden of RLS. If the findings of the current trial and the subsequent larger RCTs are positive, this study will also help support a new approach to clinical treatment of this challenging disorder, help foster improved understanding of RLS etiology, and ultimately contribute to reducing the individual, societal, and economic burden associated with this condition. Trial registration ClinicalTrials.gov, ID: NCT03570515. Retrospectively registered on 1 February 2017. Electronic supplementary material The online version of this article (10.1186/s13063-019-3217-7) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Terry Kit Selfe
- Health Science Center Libraries, University of Florida, PO Box 100206, Gainesville, FL, 32610, USA.
| | - Sijin Wen
- Department of Biostatistics, West Virginia University School of Public Health, HSC N, PO Box 9190, Morgantown, WV, 26506, USA
| | - Karen Sherman
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | - Maryanna Klatt
- Department of Family Medicine, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Kim E Innes
- Department of Epidemiology, West Virginia University School of Public Health, HSC N, PO Box 9190, Morgantown, WV, 26506, USA
| |
Collapse
|
36
|
Erzurum İli Huzursuz Bacak Sendromu Prevelansının Araştırılması ve Sosyodemografik Özelliklerin İncelenmesi. JOURNAL OF CONTEMPORARY MEDICINE 2019. [DOI: 10.16899/gopctd.448777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
37
|
Mohammadi MM, Raygani AAV, Ghobadi A, Samadzadeh S, Salari N. Effect of Near-Infrared Light Therapy Based on Acupoints on the Severity of Restless Legs Syndrome in Patients Undergoing Hemodialysis: A Single-Blind, Randomized Controlled Trial. Clin Med Res 2018; 16:1-8. [PMID: 29776916 PMCID: PMC6108511 DOI: 10.3121/cmr.2018.1389] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Revised: 12/15/2017] [Accepted: 01/15/2018] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Restless legs syndrome (RLS) is a common disorder in hemodialysis patients. The present study was conducted to determine the effect of near-infrared (NIR) light therapy given to acupoints on the severity of RLS in patients undergoing hemodialysis. METHODS This single-blind, randomized controlled trial was performed on 60 hemodialysis patients with RLS. Participants who met the inclusion criteria were randomly assigned to an intervention group (n = 30) or a control group (n = 30). Data were collected using the International Restless Legs Syndrome Rating Scale (IRLSRS) and demographic information questionnaire. The intervention group received 12 sessions of NIR light therapy (940 nm) to acupoints in the legs and feet during hemodialysis three times a week, while the control group received sham treatment. Data were analyzed using SPSS version 22 software. RESULTS The results indicated that there were statistically and clinically significant differences between the intervention and control groups at the end of the intervention sessions (P < 0.001, mean difference [MD] = 3.8). However, after the treatment was discontinued, the difference was not clinically significant (MD = 2.4). In the within-group compression, the mean RLS scores of the intervention group decreased significantly during the intervention sessions (MD = 3.2, P < 0.001); however, after the treatment was discontinued, the difference was not clinically significant (MD = 1.67). CONCLUSION The present study showed that the application of NIR light to acupoints in the legs and feet was as an effective treatment for attenuating the symptoms of RLS in hemodialysis patients.
Collapse
Affiliation(s)
- Mohammad Mehdi Mohammadi
- School of Nursing and Midwifery, Students Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| | - Ali Akbar Vaisi Raygani
- School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran. ghobadi57.
| | - Akram Ghobadi
- School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran. ghobadi57. . ghobadi57
| | - Soheila Samadzadeh
- Rehabilitation and Sport Medicine Department, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| | - Nader Salari
- Department of Biostatistics and Epidemiology, School of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| |
Collapse
|
38
|
|
39
|
Moretti R, Caruso P, Tecchiolli M, Gazzin S, Tiribelli C. Management of restless legs syndrome in chronic liver disease: A challenge for the correct diagnosis and therapy. World J Hepatol 2018; 10:379-387. [PMID: 29599901 PMCID: PMC5871858 DOI: 10.4254/wjh.v10.i3.379] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 12/27/2017] [Accepted: 01/24/2018] [Indexed: 02/06/2023] Open
Abstract
AIM To investigate the association between restless legs syndrome (RLS) and well-defined chronic liver disease, and the possible therapeutic options.
METHODS Two hundred and eleven patients with chronic liver disease, complaining of sleep disturbances, painful leg sensation and daily sleepiness, were included. Patients with persistent alcohol intake, recent worsening of clinical conditions, or hepatitis C virus were excluded. Diagnosis of RLS was suggested by the Johns Hopkins questionnaire and verified by fulfilling the diagnostic criteria by Allen. All patients were tested, both at baseline and during follow-up, with the Hamilton rating scale for depression, sleep quality assessment (PSQI), Epworth sleepiness scale (ESS), International Restless Legs Syndrome Study Group evaluation, and international RLS severity (IRLS) scoring system. Iron-free level, ferritin, folate, vitamin B12 and D-OH25 were detected. Neurological examinations and blood test occurred at the beginning of the therapy, after 2 wk, and at the 28th, 75th, 105th, 135th, 165th and 205th day. Regarding therapy, pramipexole or gabapentin were used.
RESULTS Patients were moderately depressed, with evident nocturnal sleep problems and concomitant daily sleepiness. Sleep problems and involuntary leg movements had been underestimated, and RLS syndrome had not been considered before the neurological visit. All (211/211) patients fulfilled the RLS diagnostic criteria. Twenty-two patients considered their symptoms as mild, according to IRSL, but 189 found them moderate to very severe. No correlation was found between ammonium level and ESS or PSQI. Augmentation was rather precocious in our patients (135th day), and more frequent (35%) than previous data (8.3%-9.1%). The dosage of dopamine agonists was found to be associated with augmentation and appears in range with the literature. Previous intake of alcohol and lower levels of vitamins have been related to the phenomenon in our study.
CONCLUSION RLS is a common disorder, requiring rapid diagnosis and treatment. Further research is therefore fundamental.
Collapse
Affiliation(s)
- Rita Moretti
- Neurology Clinic, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste 34149, Italy
| | - Paola Caruso
- Neurology Clinic, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste 34149, Italy
| | - Marzia Tecchiolli
- Neurology Clinic, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste 34149, Italy
| | - Silvia Gazzin
- Italian Liver Foundation, Centro Studi Fegato, Trieste 34149, Italy
| | | |
Collapse
|
40
|
Liu Y, Liu G, Li L, Yang J, Ma S. Evaluation of Cardiovascular Risk Factors and Restless Legs Syndrome in Women and Men: A Preliminary Population-Based Study in China. J Clin Sleep Med 2018; 14:445-450. [PMID: 29458704 DOI: 10.5664/jcsm.6996] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Accepted: 12/12/2017] [Indexed: 02/04/2023]
Abstract
STUDY OBJECTIVES Many studies have investigated the association between restless legs syndrome (RLS) and cardiovascular risk factors, leading to conflicting results. Therefore, the aim of the current study was to determine whether RLS is associated with cardiovascular risk factors and disease. METHODS This cross-sectional study included 5,324 consecutive subjects who visited the Physical Examination Center of The First Affiliated Hospital of Zhengzhou University for their yearly routine physical examination. Participants underwent a face-to-face interview with a neurologist for the assessment of RLS, based on the International Restless Legs Study Group criteria. They also completed a questionnaire related to cardiovascular risk factors and other health-related and demographic information. Logistic regression was used to assess which of the demographic and cardiovascular risk factors increased the odds of RLS. Then, unadjusted and adjusted models were designed to determine whether RLS was associated with increased odds of cardiovascular disease, coronary artery disease, or hypertension. RESULTS RLS was observed in 9.2% of the participants. Multivariable logistic regression models, which included the covariates age, sex, body mass index, smoking status, hypercholesterolemia, and Pittsburgh Sleep Quality Index score (dichotomized at 5), demonstrated that female sex (odds ratio [OR]: 2.42, 95% confidence interval [CI]: 1.99-2.95), smoking (OR: 1.96, 95% CI: 1.31-2.92), high cholesterol (OR: 1.30, 95% CI: 1.03-1.64), and PSQI score > 5 (OR: 5.61, 95% CI: 2.14-14.69) are significantly associated with RLS. Additionally, RLS was associated with hypertension, after adjusting for age, sex, body mass index, smoking, hypercholesterolemia, Pittsburgh Sleep Quality Index score > 5, diabetes, anemia, and decreased renal function. CONCLUSIONS RLS is associated with the prevalence of hypertension but not with that of cardiovascular disease or coronary artery disease.
Collapse
Affiliation(s)
- Yuqiong Liu
- Department of Pathology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People's Republic of China.,Department of Pathology, School of Basic Medicine, Zhengzhou University, Zhengzhou, People's Republic of China
| | - Gangqiong Liu
- Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People's Republic of China
| | - Ling Li
- Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People's Republic of China
| | - Jing Yang
- Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People's Republic of China.,Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People's Republic of China
| | - Shengli Ma
- Department of Emergency, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People's Republic of China
| |
Collapse
|
41
|
Restless legs syndrome: a rarity in the Nigerian pregnant population? Sleep Med 2018; 43:47-53. [PMID: 29482812 DOI: 10.1016/j.sleep.2018.01.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 12/15/2017] [Accepted: 01/04/2018] [Indexed: 11/23/2022]
Abstract
OBJECTIVES The prevalence of RLS in pregnancy is higher when compared with the general population however it remains unknown among indigenous black Africans. Available data indicate that RLS is uncommon in sub-Saharan Africa. We embarked on this study to determine the prevalence and characteristics of RLS in an antenatal clinic sample of Nigerian pregnant women compared with a primary care sample of non-pregnant women. METHODS A total of 310 pregnant women and non-pregnant women filled out a questionnaire which incorporated the 2014 minimal criteria of the International Restless Legs Syndrome Study Group. Demographic and clinical data, including sleep duration and samples for blood hemoglobin concentration and urinalysis were obtained. RESULTS The mean ages of the pregnant and non-pregnant women were 24.9 ± 5.6 years and 23.6 + 5.4 years, respectively (p = 0.003). There was no case of RLS found among pregnant women while five (1.6%) of the non-pregnant women fulfilled the criteria for RLS. Overall, the prevalence report of RLS symptoms was associated with lower mean habitual nocturnal sleep duration (p < 0.05) coffee (p = 0.013) and kola nut (0.023) consumption, report of leg cramps (p < 0.001) and proteinuria (p = 0.047), Report of leg cramps and proteinuria were independently associated with RLS. CONCLUSION The prevalence of restless legs syndrome is low among women of child-bearing age in the Nigerian population and may be lower in pregnancy. Report of leg cramps and proteinuria are independently associated with RLS.
Collapse
|
42
|
Rad M, Shomoossi N, Mirhosseini Z, Kashani E. Can cool dialysate alleviate restless leg syndrome in hemodialysis patients? JOURNAL OF RESEARCH IN MEDICAL SCIENCES : THE OFFICIAL JOURNAL OF ISFAHAN UNIVERSITY OF MEDICAL SCIENCES 2017; 22:124. [PMID: 29259635 PMCID: PMC5721490 DOI: 10.4103/jrms.jrms_587_17] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- Mostafa Rad
- Department of Nursing, School of Nursing and Midwifery, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Nematullah Shomoossi
- Department of Medicine, School of Medicine, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Zahra Mirhosseini
- Department of Internal Disease, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Ehsan Kashani
- Department of Nursing, School of Nursing and Midwifery, Sabzevar University of Medical Sciences, Sabzevar, Iran
| |
Collapse
|
43
|
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
|
44
|
Restless legs syndrome in maintenance hemodialysis patients: an epidemiologic survey in Hefei. Int Urol Nephrol 2017; 49:1267-1272. [DOI: 10.1007/s11255-017-1573-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Accepted: 03/17/2017] [Indexed: 10/19/2022]
|
45
|
Abstract
Restless legs syndrome (RLS) is a common neurological movement disorder, characterized by restless and unpleasant sensations in the deep inside of legs. The symptoms of RLS are less noticeable during daytime, but more prevalent at night. Therefore, the disorder can induce low quality of life, insomnia, and impairment of daytime activity. RLS in end-stage renal disease (ESRD) patients is especially problematic due to premature discontinuation of dialysis and increased mortality. The prevalence of RLS among dialysis patients is much higher compared to the prevalence of the same disorder in patients with normal renal functions. Even though there are recommended treatment guidelines for the general population established by Medical Advisory Board of the RLS foundation, which include the use of dopamine agonists, levodopa, gabapentin, benzodiazepines, and opioids, limited information is available on the effects of these therapies in ESRD patients. Since the existing clinical data were extrapolated from small sample sizes in short-term clinical trials, further clinical studies are still needed to better assess the efficacy, safety, and tolerability of these medications in patients with ESRD.
Collapse
|
46
|
Semiz M, Solmaz V, Aksoy D, Inanir S, Colak B, Gokbakan MA, Inanir A. Prevalence of Restless Legs Syndrome Among Psychiatric Patients Who are Under Antidepressant or Antipsychotic Monotherapy. ACTA ACUST UNITED AC 2016. [DOI: 10.5455/bcp.20150908024954] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Murat Semiz
- Gulhane Military Medical Faculty, Department of Psychiatry, Ankara - Turkey
| | - Volkan Solmaz
- Turhal State Hospital, Neurology Clinic, Tokat - Turkey
| | - Durdane Aksoy
- Gaziosmanpasa University, Faculty of Medicine, Department of Neurology, Tokat - Turkey
| | - Sema Inanir
- Tokat Mental Health and Diseases Hospital, Tokat - Turkey
| | - Burcin Colak
- Ankara University, Medical Faculty, Department of Psychiatry, Ankara - Turkey
| | - Mehmet Aziz Gokbakan
- Medipol University, Medical Faculty, Department of Psychiatry, Istanbul - Turkey
| | - Ahmet Inanir
- Gaziosmanpasa University, Faculty of Medicine, Department of Physical Therapy and Rehabilitation, Tokat - Turkey
| |
Collapse
|
47
|
Fawale MB, Ismail IA, Mustapha AF, Komolafe MA, Adedeji TA. Restless Legs Syndrome in a Nigerian Elderly Population. J Clin Sleep Med 2016; 12:965-72. [PMID: 27070251 DOI: 10.5664/jcsm.5926] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Accepted: 03/03/2016] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES The prevalence of restless legs syndrome (RLS) is highest in the elderly in Caucasian populations; the prevalence of RLS in elderly Africans is not known. This study aimed at determining the frequency and associations of RLS in a Nigerian elderly population. METHODS The study population comprised of 633 consecutive elderly individuals aged 65-105 years attending the general outpatient clinic of the State Hospital, Ilesa, for minor complaints and routine check-up. The diagnosis of RLS was made using the 2003 minimal criteria of the International Restless Legs Syndrome Study Group. Relevant sociodemographic and clinical data, including sleep duration, were also obtained. RESULTS Restless legs syndrome was found in 3.5% of the study population with a male-female ratio of 2:1. There was no significant age (p = 0.427) or gender (p = 0.178) influence on the prevalence of RLS except in the 75- to 84-year age group where there was significant male preponderance (p = 0.044). A strong independent association between RLS and sleep duration (OR, 3.229; 95% CI, 1.283-8.486; p = 0.013) and past history of head injury (OR, 4.691; 95% CI, 1.750-12.577; p = 0.002) was found. CONCLUSIONS Our finding support previous reports of a possible lower prevalence of RLS in Africans. Restless legs syndrome independently increases the odds of habitual sleep curtailment in elderly individuals. Head injury may be a risk factor for future RLS; this requires further investigation as indirect evidence for a possible link between RLS and traumatic brain injury exists.
Collapse
Affiliation(s)
- Michael B Fawale
- Neurology Unit, Department of Medicine, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
| | | | - Adekunle F Mustapha
- Neurology Unit, Department of Medicine, College of Health Sciences, Ladoke Akintola University of Technology, Osogbo, Nigeria
| | - Morenikeji A Komolafe
- Neurology Unit, Department of Medicine, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Tewogbade A Adedeji
- Department of Chemical Pathology, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
| |
Collapse
|
48
|
Abstract
Sleep disturbances increase with increasing age in both males and females and become fairly common in the older community when compared to their younger counterparts. Even though these sleep disturbances increase with advancing age, there are nevertheless inherent differences in sleep disturbances between males and females. When compared to older men, older women will have a longer sleep latency (number of minutes it takes to fall asleep), more daytime sleepiness, will sleep about 20 min less per day, have less NREM stages 1 and 2 sleep, have more slow-wave sleep, and are more predisposed to REM sleep. Women have at least a 40% increased risk for developing insomnia, are at twice the risk for restless legs syndrome, will have different obstructive sleep apnea symptoms and more partial obstructions during sleep compared to men. They are also less likely to use antidepressants but will metabolize zolpidem 50% slower than men.
Collapse
Affiliation(s)
- F Guidozzi
- a Department of Obstetrics and Gynaecology , Faculty of Health Sciences, University of the Witwatersrand , South Africa
| |
Collapse
|
49
|
Plasma apelin level in patients with restless legs syndrome and its association with periodic leg movements. Sleep Breath 2016; 21:19-24. [DOI: 10.1007/s11325-016-1355-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Revised: 05/01/2016] [Accepted: 05/09/2016] [Indexed: 12/26/2022]
|
50
|
Leon-Sarmiento FE, Peckham E, Leon-Ariza DS, Bara-Jimenez W, Hallett M. Auditory and Lower Limb Tactile Prepulse Inhibition in Primary Restless Legs Syndrome: Clues to Its Pathophysiology. J Clin Neurophysiol 2016; 32:369-74. [PMID: 26241246 DOI: 10.1097/wnp.0000000000000196] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The resting sensory discomfort transiently relieved upon movement of the affected area in restless legs syndrome suggests that sensorimotor integration mechanisms, specifically gating, may be altered in the disease. The authors sought to determine the effects of prepulse auditory and tactile stimulation applied to lower limbs on the blink reflex of patients with restless legs syndrome and healthy subjects. Seventeen patients with restless legs syndrome and 17 age- and sex-matched healthy controls were investigated. Auditory stimuli and tactile lower limb stimulation were applied as prepulses. The R2 response of the blink reflex induced by electrical stimulation applied to the right supraorbital nerve was selected as the test stimulus. Time intervals between prepulses and response-eliciting stimuli were 40, 70, 90, 110, and 200 milliseconds. There were no differences in either the auditory or tactile prepulse conditions between patients and controls and no differences between these measures within subject groups. We concluded that the tactile lower limb and the auditory prepulse effects on the brainstem interneurons mediating the blink reflex share common neural pathways. Because forebrain interneurons mediate these prepulse effects, they are likely not involved in the disordered sensorimotor interaction of restless legs syndrome.
Collapse
Affiliation(s)
- Fidias E Leon-Sarmiento
- *Human Motor Control Section, NINDS, National Institutes of Health, Bethesda, Maryland, U.S.A.; †Smell and Taste Center, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, U.S.A.; ‡Mediciencias Research Group, Unicolciencias/Universidad Nacional, Bogota, Colombia; and §Faculty of Health, Universidad de Santander (UDES), Bucaramanga, Colombia
| | | | | | | | | |
Collapse
|