Language analysis of spontaneous descriptions of restless legs syndrome: Gender differences?

Abstract

Summary Patients with restless legs syndrome (RLS) use various terms when describing their symptoms. Whether gender might influence this has not been investigated so far. The aim of this study was to evaluate possible gender differences in spontaneous descriptions of RLS symptoms. This prospective study, conducted in 100 consecutive German‐speaking RLS patients, used a single standardized question. Answers were digitally recorded and transcribed. A content‐related linguistic analysis of the transcripts was performed by two independent blinded raters. The lengths of the answers and content‐related linguistic features were compared between women and men. Ninety‐eight patients were included in the final analysis, 59 women (60.2%) and 39 men (39.8%), with a median age of 62 (23–94) and 63 (31–82) years, respectively (p = 0.602). Demographic and clinical features, including educational level and RLS treatment class, did not differ between genders (p > 0.05). Total word or sentence count showed no gender differences (p = 0.159 and 0.259, respectively), although men used more words per sentence than women (p = 0.018). More men than women described quiescegenic (i.e., triggered by rest or inactivity) symptoms (p = 0.006) and successful attempts at relief (p = 0.039). There was a non‐significant trend toward a more frequent use of the first‐person perspective in men (median times used = 5 [0–10.5] vs. 3.8 [0–17.5], p = 0.068). The more frequent mention of quiescegenic symptoms and successful attempts at relief in men could indicate differences in phenotypic presentation of RLS between genders, a more precise description of RLS symptoms or a higher experience of self‐efficacy in men compared to women.

Experiences of facilitators and barriers for fulfilment of human needs when living with restless legs syndrome: a qualitative study

“…Our findings are consistent with previous research conducted from the perspective of patients, which indicates that healthcare professionals have a limited understanding of RLS symptoms and do not prioritize the management of RLS symptoms (Harrison et al, 2021 ). In a clinical situation, when the time to provide in-depth information is limited, it might be difficult for the physician and patient to agree upon the best treatment option, partly due to varying anamnestic descriptions by patients (Holzknecht et al, 2022 ) or due to time constraints. In the present study, patients with RLS said that the lack of knowledge and understanding about RLS posed a significant barrier to fulfilling their esteem needs.…”

“…When exploring the clinical presentation of RLS (Didato et al, 2020 ), existing evidence has mostly focused on a biomedical perspective and, even if RLS causes significantly decreased quality of life (Broström et al, 2024 ), only a few studies have tried to gain an in-depth perspective of how symptoms are featured and expressed (Holzknecht et al, 2020 , 2022 ), as well as how RLS treatment impacts on the life situation (Harrison et al, 2021 ). This study fills these gaps in the current literature by adding a deeper holistic understanding of how patients experience and handle their symptoms in relation to various human needs is needed, as well as an understanding of how self-care and pharmacological treatment impact these needs.…”

Validation of two brief instruments (the SURE and CollaboRATE) to measure shared decision‐making in patients with restless legs syndrome

“…Furthermore, women assess their RLS severity as worse than men (Holzknecht et al, 2020). Interestingly, men and women also talk differently about their RLS, where men more frequently mention stable symptoms and successful attempts at relief than women (Holzknecht et al, 2022). Even though there seem to be gender differences in how RLS symptoms are described and experienced, the present study does not present gender‐related DIF for the SURE or CollaboRATE.…”

“…Experiences of disturbed sleep (Harrison et al, 2021), depressive symptoms and a lower quality of life (Svetel et al, 2015) are frequent. Even though diagnostic criteria exist (Allen et al, 2014), RLS is deemed as a difficult condition to both diagnose and treat (Fulda et al, 2021), partly due to varying anamnestic descriptions by patients (Holzknecht et al, 2022), but also due to gender differences in clinical, laboratory and polysomnographic features, where women seem to be more severely affected by symptoms than men (Holzknecht et al, 2020). However, women seem to have a significantly lower degree of periodic leg movements during sleep.…”