High Prevalence of Restless Legs Syndrome among Patients with Fibromyalgia: A Controlled Cross-Sectional Study

Abstract

Study Objectives: To investigate the prevalence of restless legs syndrome (RLS) in fibromyalgia (FM) and determine the presence and amount of sleep disruption in FM patients with RLS. RLS and FM have been associated in uncontrolled studies using a variety of RLS definitions. We explored this relationship using a cross-sectional study design. Methods: FM cases that met the American College of Rheumatology diagnostic criteria were recruited through an academic referral clinic and advertising. Pain-and fatigue-free controls were recruited from the Seattle metropolitan area. We enrolled 172 FM patients (mean age 50 years, 93% female) and 63 pain-and fatigue-free controls (mean age 41 years, 56% female). RLS was ascertained by a self-administered validated diagnostic interview. Results: The age-and gender-adjusted prevalence of RLS was higher in the FM group than the control group (33.0%; 95% CI: 25.9, 40.1 vs. 3.1%; 95% CI: 0.0, 7.4; p = 0.001).Likewise, the FM group was more likely to report RLS (OR = 11.7; 95% CI: 2.6, 53.0), even after adjusting for age and gender. The mean Pittsburgh Sleep Quality Index score was higher among FM patients with RLS than those without (11.8 vs. 9.9; p = 0.01) but subjective limb pain measures did not differ between these 2 groups. Conclusions: There is a higher prevalence and odds of RLS in those with FM compared to controls. Clinicians should routinely query FM patients regarding RLS symptoms because treatment of RLS can potentially improve sleep and quality of life in these patients.

Association between irritable bowel syndrome and restless legs syndrome in the general population

“…There is evidence suggesting that genetic influence and disturbed iron metabolism contribute to dopaminergic dysfunction (Connor et al, 2003(Connor et al, , 2011Winkelmann et al, 2007). Other pathophysiological mechanisms in RLS could be inferred from the high prevalence of RLS in certain conditions such as peripheral neuropathy, end-stage renal disease, pregnancy and fibromyalgia (Gemignani et al, 2006;Hening and Caivano, 2008;Manconi et al, 2004;Viola-Saltzman et al, 2010;Winkelman et al, 1996). Central or peripheral reorganization of nociceptions, secondary iron deficiency or an altered dopamine response have been suggested as the linking mechanisms (Bachmann et al, 2010;Manconi et al, 2004;Viola-Saltzman et al, 2010;Wood et al, 2007).…”

“…Other pathophysiological mechanisms in RLS could be inferred from the high prevalence of RLS in certain conditions such as peripheral neuropathy, end-stage renal disease, pregnancy and fibromyalgia (Gemignani et al, 2006;Hening and Caivano, 2008;Manconi et al, 2004;Viola-Saltzman et al, 2010;Winkelman et al, 1996). Central or peripheral reorganization of nociceptions, secondary iron deficiency or an altered dopamine response have been suggested as the linking mechanisms (Bachmann et al, 2010;Manconi et al, 2004;Viola-Saltzman et al, 2010;Wood et al, 2007). Furthermore, recent case-control studies have documented the association of RLS with gastrointestinal disorders such as inflammatory bowel diseases and irritable bowel syndrome (IBS) (Weinstock et al, 2008(Weinstock et al, , 2010Weinstock and Walters, 2011).…”

Sleep quality and restless legs syndrome in patients with ankylosing spondylitis

“…It is frequently associated with other rheumatic diseases, such as RA and systemic lupus erythematosus (SLE) [28] . Additionally, it is known that a higher prevalence of RLS is observed in patients with FM [29] . However, there are few reports on the prevalence of FM in patients with AS.…”

Hippocampal oscillatory dynamics and sleep atonia are altered in an animal model of fibromyalgia: Implications in the search for biomarkers

“…Loss of atonia during REM is observed in restless legs syndrome (Picchietti & Winkelman, 2005), an alteration that is highly comorbid with insomnia, depressive and anxiety disorders, as well as with pain disorders (Becker & Novak, 2014;Kim, Luedtke, Vincent, Thompson, & Oh, 2012). The very high prevalence of restless legs syndrome in FMS patients and this sleep disorder is associated with more daytime sleepiness and poor quality of life (Civelek, Ciftkaya, & Karatas, 2014;Stehlik, Arvidsson, & Ulfberg, 2009;Viola-Saltzman, Watson, Bogart, Goldberg, & Buchwald, 2010 (Bellato et al, 2012). Therefore, the RIM could be useful for evaluating new treatments in this direction.…”