In a cohort study among 2751 members (71.5% females) of the German and Swiss RLS patient organizations changes in restless legs syndrome (RLS) severity over time was assessed and the impact on quality of life, sleep quality and depressive symptoms was analysed. A standard set of scales (RLS severity scale IRLS, SF-36, Pittsburgh Sleep Quality Index and the Centre for Epidemiologic Studies Depression Scale) in mailed questionnaires was repeatedly used to assess RLS severity and health status over time and a 7-day diary once to assess short-term variations. A clinically relevant change of the RLS severity was defined by a change of at least 5 points on the IRLS scale. During 36 months follow-up minimal improvement of RLS severity between assessments was observed. Men consistently reported higher severity scores. RLS severity increased with age reaching a plateau in the age group 45–54 years. During 3 years 60.2% of the participants had no relevant (±5 points) change in RLS severity. RLS worsening was significantly related to an increase in depressive symptoms and a decrease in sleep quality and quality of life. The short-term variation showed distinctive circadian patterns with rhythm magnitudes strongly related to RLS severity. The majority of participants had a stable course of severe RLS over three years. An increase in RLS severity was accompanied by a small to moderate negative, a decrease by a small positive influence on quality of life, depressive symptoms and sleep quality.

We report results from three independently conducted studies on the prevalence of cancer in restless legs syndrome (RLS) cases and non RLS cases. Already in 1955 Ekbom observed RLS in patients with subsequently detected cancer. Since then only three case reports and one article assessed the relationship between RLS and cancer patients undergoing chemotherapy. The observed proportion of RLS in these cancer patients (18.3%) was about twice as high as in general population studies. Two of our studies were general population based studies (Dortmund Health Study (DHS); Study of Health in Pomerania (SHIP)) and one was performed among members of the German and Swiss RLS patient organizations (Course of Restless Legs Syndrome-Study (COR-S)). Additionally we used data from the population based, regional cancer registry of the Muenster district for comparisons. Our data show that in all three studies the prevalence of cancer was higher in RLS cases than in non cases for both genders. In two of the studies the increased risk was in part explained by age. The data of the COR-Study revealed a statistically significant higher risk for cancer in RLS subjects compared to the population based data of the regional cancer registry of Muenster. Our results suggest a higher proportion of cancer among RLS cases compared to individuals without RLS. Given an RLS prevalence of about 5 to 10 percent in the general population, a need to rule out cancer in patients with a new onset of RLS, especially among the elderly patients is important.