Increased Frequency of Restless Legs Syndrome in Myasthenia Gravis

Abstract

Background/Aims: The objective of this study was to assess the prevalence of restless legs syndrome (RLS) in patients with myasthenia gravis (MG). Methods: We interviewed 73 MG patients and 65 healthy controls by using a structured diagnostic questionnaire based on the International Restless Legs Syndrome Study Group diagnostic criteria. We also collected data about the course of MG therapy, the presence of other comorbidities, sleep complaints, and demographic characteristics. All of the MG patients underwent neurological assessment. Results: RLS was present in 43.2% of the MG patients and in 20% of the controls (p = 0.0029). We failed to identify a relationship between the prevalence of RLS and the duration and type of MG therapy, other comorbidities, age or sex of the patients. Patients with MG more frequently reported daytime sleepiness. For 9.4% of the RLS-positive MG patients, RLS symptoms represented the most disturbing health problem; for 46.9% of them, RLS was as problematic as other diseases. Conclusions: RLS is common in MG patients. MG patients consider RLS symptoms as a troublesome health problem.

Sleep Related Conditions with Myasthenia Gravis: Evidence, Causes and Implications

“…Excessive daytime sleepiness was reported in 25% (21/84) [9] and 31.5% (6/19) [12] of patients with MG. Studies reported no relationship between stable MG and excessive daytime sleepiness [6,9,12] and lack of effect of plasmapheresis treatment on polysomnographic abnormalities despite improved clinical weakness and decreased MG score and AChR Abs concentration [46]. Also RLS was not found to correlate with the disease duration, type of therapy of MG, age, sex or associated comorbidities with MG [14]. All patients (n=20) had evidence of daytime diaphragmatic weakness as demonstrated by transdiaphragmatic pressure measurements, independent of the degree of autonomy and functional capacity and activity level.…”

“…Many observational, cross-sectional and clinical studies reported that patients with MG may suffer from excessive daytime sleepiness [6,9,11,12,45], reduced sleep and awakening quality, reduced sleep efficiency, reduced REM-sleep, increased number of nocturnal awakenings, microarousals, poor sleep quality index scores [13], morning drowsiness, headaches [11,13], altered sleep perception and dreaming, increased dream recall frequency, increased tactile sensations during dreaming and dreamed less often visually [11] and restless leg syndrome (RLS) [14]. Excessive daytime sleepiness was reported in 25% (21/84) [9] and 31.5% (6/19) [12] of patients with MG. Studies reported no relationship between stable MG and excessive daytime sleepiness [6,9,12] and lack of effect of plasmapheresis treatment on polysomnographic abnormalities despite improved clinical weakness and decreased MG score and AChR Abs concentration [46].…”

“…central sleep apnea (CSA), obstructive sleep apnea (OSA), mixed apnea (OSA and CSA), sleep-related hypoventilation or hypoxemic syndromes] [5][6][7][8][9][10], poor sleep quality, reduced sleep efficiency, reduced sleep and awakening quality, increased number of nocturnal awakenings, excessive daytime sleepiness, reduced rapid eye movement sleep (REM sleep) and altered sleep perception and dreaming [6,8,[11][12][13] and excessive limb movements during sleep [e.g. restless leg syndrome (RLS)] [14]. Symptoms of SDB and other sleep abnormalities usually develop gradually in patients with MG which often make patients unaware of them.…”

Restless Legs Syndrome In Multiple Sclerosis Patients – Patient Experience Atlipik Special Hospital For Medical Rehabilitation

“…RLS can be idiopathic or due to secondary causes. Secondary RLS is associated with various pathological conditions such as iron defi ciency, peripheral neuropathy, Parkinson's disease, essential tremor, renal failure, spinocerebellar ataxias, myelopathies, and myasthenia gravis [3][4][5][6][7][8][9] . Although the pathophysiology remains unclear, brain iron defi ciency and dysfunctions of the dopaminergic system seem to play an important role 10 .…”

Restless Legs Syndrome in Patients with Myasthenia Gravis

“…I read with interest the recent article by Sieminski et al [1 ]reporting an increased frequency of restless legs syndrome (RLS) in patients with myasthenia gravis. A recent spate of articles have reported an increased frequency of RLS in various seemingly disparate conditions such as multiple sclerosis, Parkinson’s disease, obstructive sleep apnea and now myasthenia gravis [2].…”