Diagnosis, comorbidities, and management of restless legs syndrome

Becker, Philip M.; Novák, Márta

doi:10.1185/03007995.2014.918029

Cited by 73 publications

(67 citation statements)

References 216 publications

(257 reference statements)

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“…Abnormal PLMI, or periodic leg movement syndrome, and restless leg syndrome are common afflictions affecting 5-15% of the general population (Earley and Silber 2014;Becker and Novak 2014;Winkelman et al 2013) and associated with insomnia in 50-85% of people (Becker and Novak 2014). We identified only two patients having cortical arousals secondary to periodic leg movement that were greater than expected age norms.…”

Section: Discussionmentioning

confidence: 87%

“…Possible causes include central sleep apnoea (CSA) and obstructive sleep apnoea (OSA), respectively, seen in 22% and 17% of patients (Duning et al 2013), and restless legs secondary to painful peripheral neuropathy, reported in 36% patients (Dominguez et al 2007). In comparison 2-4% of the adult normal population have OSA (Epstein et al 2009), while 5-15% are affected by restless legs (Earley and Silber 2014;Becker and Novak 2014;Winkelman et al 2013). Furthermore, 2.7% of the population meet criteria for clinically significant restless leg syndrome (Winkelman et al 2013).…”

Section: Introductionmentioning

confidence: 99%

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Sleep Disturbance, Obstructive Sleep Apnoea and Abnormal Periodic Leg Movements: Very Common Problems in Fabry Disease

et al. 2016

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Objectives: To assess the prevalence of sleep disorder(s) in males with Fabry disease and explore possible association with disease phenotype.Background: Fabry disease, an X-linked lysosomal storage disease caused by deficiency in a-galactosidase, results in intracellular accumulation of globotriaosylceramide. It causes organ dysfunction, most significantly affecting renal, cerebrovascular and cardiovascular systems. Respiratory involvement may include obstructive lung disease, reduced diffusing capacity and thickened soft and hard palates. Patients commonly develop small-fibre sensory peripheral neuropathy manifested by acroparaesthesia and pain crises. Combined with self-reported sleep disturbance and snoring, these features suggest an increased risk of sleep disorders.Methods: In-laboratory polysomnography (PSG) studies and sleep inventory assessments, including Epworth Sleepiness Scale (ESS), were performed in a cohort of male Fabry patients. PSGs were reviewed by a sleep physician. Sleep-disordered breathing and periodic leg movements were targeted for analysis. Associations with renal, cardiovascular and cerebrovascular function were sought.Results: Twenty males underwent overnight PSG. Patient baseline characteristics included age 43.9 AE 10.7 years, BMI 24.3 AE 3.8 kg/m 2 , neck circumference 39.7 AE 3.3 cm and ESS 9.8 AE 5.1 (7/20, abnormal ESS >10). Abnormal periodic leg movement index (PLMI) was present in 95% (mean frequency 42.4 AE 28.5/min) and sleep-disordered breathing in 50% patients. Periodic leg movements were associated with pain and depression but not with increased cortical arousal.Conclusions: Sleep-disordered breathing and abnormal PLMI are highly prevalent in patients with FD.

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Section: Discussionmentioning

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Sleep Disturbance, Obstructive Sleep Apnoea and Abnormal Periodic Leg Movements: Very Common Problems in Fabry Disease

et al. 2016

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“…10 We found a familial pattern in 68% of our RLS population and a significant correlation between the presence of primary RLS among first-and second-degree relatives, the onset of symptoms before the age of 45 years, and slower progression of the disease. Presence or absence of a genetic component did not preclude patients from developing other disorders, notably hypertension (67%), hyperlipidemia (52%), arthritis (48%), neuropathy with chronic pain (41%), and sleep apnea (37%).…”

mentioning

confidence: 55%

“…3 Several population-based studies report the onset of RLS occurring prior to the age of 10 years in 8%-13%, and 20 years in 27%-38% of the RLS population, respectively. 10 In our small RLS population, 20% of RLS patients reported onset symptomology at the mean age of 14.4 years with sleep-onset insomnia/nocturnal awakenings being early manifestations of the disorder. However, the RLS age of diagnosis in these patients was not until 28 years.…”

Section: Discussionmentioning

confidence: 78%

Restless legs syndrome: associated non-motor symptoms and medical comorbidities: a controlled study

Sanghera¹,

Sales²,

Robinson³

et al. 2015

JPRLS

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Introduction:Restless legs syndrome (RLS) is a chronic sensorimotor disorder characterized by discomfort or pain, predominantly in the legs, resulting in an urge to move during times of rest. These disturbances are often accompanied by sleep fragmentation, which can significantly increase medical comorbidities over time and can have a detrimental effect on a patient's overall quality of life. In this retrospective study, we examined the temporal relationship between the time of RLS diagnosis and the onset of non-motor symptoms (NMS) and medical comorbidities. Patients and methods: Thirty-six RLS patients were evaluated for age at: symptom onset, time of diagnosis, time of occurrence of NMS, and medical comorbidities. We used structured interviews, validated questionnaires, and past medical records to aggregate and verify patient data. There was no clinical evidence to suggest secondary RLS in any patient at time of diagnosis. Results: Twenty-five patients were diagnosed as having RLS alone and eleven were diagnosed with RLS and Parkinson's disease (RLS + PD). In the RLS + PD group, irrespective of which disorder presented first, we found that patients exhibited symptoms of RLS at a significantly later age than those patients with RLS alone (P,0.05). The incidence and severity of NMS were significantly higher in the RLS + PD group compared to RLS alone and controls (P,0.001). Increased risk of RLS was identified in patients exhibiting mood changes and sleep deficits, and these risk factors manifested 5 and 10 years prior, respectively, to their diagnosis. Conclusion: Primary RLS develops earlier in those patients who only have RLS compared to those who later also develop PD. Mood and sleep impairment can be present years prior to the diagnosis of RLS. Other medical comorbidities associated with RLS included hypertension, hyperlipidemia, arthritis, chronic pain, and diabetes.

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“…Headache, fatigue, sleep disturbances, depression and anxiety are common in patients with FM and/or RLS and quality of life is adversely affected (10,34,35,45,46). Looking at the data from our study, the addition of FM symptoms on RLS symptoms causes significantly worse responses to questions ("How do you think your overall health is?"…”

Section: Discussionmentioning

confidence: 80%

The Prevalence of Fibromyalgia in Patients with Restless Legs Syndrome

Yılmaz¹,

Cantürk²,

Düz³

et al. 2016

tnd

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Objective: To determine the prevalence of fibromyalgia (FM) in patients with Restless legs syndrome (RLS), and to evaluate the relationship of FM and the scales of quality of life. Materials and Methods:Thirty patients aged between 18-65 years (20 females, 10 males) with RLS and 30 healthy control subjects (17 female, 13 male) participated in our study. The patients were assessed using the the RLS Severity Rating Scale. The Pittsburg Sleep Quality Index (PSQI), Beck Depression Inventory, Beck Anxiety Questionnaire, and Quality of Life Short form-36 (SF-36) were given to both the patient and control group. The American College of Rheumatology criteria were used to diagnose FM. Results:The average age of the patients was 44.73±11.23 years, the average age of the control group was 46.00±12.23 years. The prevalence of FM was 36.7% in the patient group and 6.7% in the control group (p=0.01). PSQI, depression and anxiety scores were significantly worse in the patient group (p=0.0001; p=0.004; p=0.000). The patients with RLS had higher scores of mental health, social functioning, pain, and general perception of SF-36, and scale for the evaluation of quality of life (p=0.004; p=0.023; p<0.001; p=0.001; p=0.13); the scores for physical and emotional limitations did not differ between the patient and the control group. However, if a patient with RLS had additional FM symptoms, the general perception scores of the body were worse (p=0.029). When we compared the scores of the patients with both RLS and FM with the healthy group, the anxiety scores were the most increased (three times). Conclusion:The prevelance of FM was frequent (36.67%) in patients with moderate and severe RLS. RLS impairs quality of life. However, coexistence of the two diseases only worsened patients' assessments of their own health score, and affected their anxiety scores the most.

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Diagnosis, comorbidities, and management of restless legs syndrome

Cited by 73 publications

References 216 publications

Sleep Disturbance, Obstructive Sleep Apnoea and Abnormal Periodic Leg Movements: Very Common Problems in Fabry Disease

Sleep Disturbance, Obstructive Sleep Apnoea and Abnormal Periodic Leg Movements: Very Common Problems in Fabry Disease

Restless legs syndrome: associated non-motor symptoms and medical comorbidities: a controlled study

The Prevalence of Fibromyalgia in Patients with Restless Legs Syndrome

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