Nocturnal Leg Cramps and Prescription Use That Precedes Them

Garrison, Scott

doi:10.1001/archinternmed.2011.1029

Cited by 69 publications

(65 citation statements)

References 19 publications

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“…Other associations with NLC include female sex, leg claudication, electrolyte imbalance, pregnancy, peripheral neuropathy, peripheral vascular disease, angina, and arthritis[8]. Potential medication etiologies include inhaled long-acting beta-agonists, statins, and diuretics[9]. Existing prevalence data suggest that 37–50% of older adults have such leg cramps[4, 5, 10].…”

Section: Introductionmentioning

confidence: 99%

Nocturnal leg cramps: Prevalence and associations with demographics, sleep disturbance symptoms, medical conditions, and cardiometabolic risk factors

Grandner

Winkelman

2017

PLoS ONE

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BackgroundNocturnal leg cramps (NLC) are common and poorly understood.ObjectiveTo determine the prevalence of NLC and associations with cardiometabolic, sleep, and behavioral risk factors in the US population.DesignCross-sectional epidemiology.ParticipantsNational Health and Nutrition Examination Survey, 2005–2006 and 2007–2008 waves.Main outcome(s) and measure(s)NLC were assessed with, “In the past month, how often did you have leg cramps while trying to sleep?” Responses were categorized as None, Mild, or Moderate-Severe. Demographics, medical history, sleep disturbances, and cardiometabolic risk factors were evaluated using the 2005–2006 dataset. Variables that demonstrated significant relationships to NLC after adjusting for age, sex, education, and BMI were assessed in the 2007–2008 dataset. Variables that were still significant were entered into a forward stepwise regression model combining both waves, to determine which variables best explained the variance in NLC.ResultsPrevalence was 24–25% reporting mild and 6% reporting moderate-severe NLC. NLC increased with age, lower education, unemployment, shorter sleep duration, all assessed sleep symptoms (nocturnal "leg jerks", snoring, snorting/gasping, difficulty falling asleep, difficulty maintaining sleep, non-restorative sleep, sleepiness, use of sleep medications), higher BMI, smoking, medical history (hypertension, heart failure, angina, stroke, arthritis, respiratory disease, and cancer), depression symptoms, and biomarkers (CRP, HbA1c, calcium, cadmium, red blood cells). Stepwise analysis showed that moderate-severe nocturnal leg cramps were associated with (in decreasing order of partial R2): leg jerks, poor overall health, arthritis, difficulty falling asleep, age, nonrestorative sleep, red blood cell count, lower education, angina, and difficulty maintaining sleep.Conclusions and relevanceBased on this first large, representative study, NLC occurring >5x per month are reported by 6% of the adult US population. Sleep disturbance symptoms and health conditions are associated with higher frequency of NLC, suggesting that NLC is a marker, and possibly contributor, to poor sleep and general health.

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Section: Introductionmentioning

confidence: 99%

Nocturnal leg cramps: Prevalence and associations with demographics, sleep disturbance symptoms, medical conditions, and cardiometabolic risk factors

Grandner

Winkelman

2017

PLoS ONE

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“…6 Therefore, new quinine prescriptions are an excellent marker for new or escalating treatment of leg cramps, and we previously used these data to assess the potential cramp-promoting effects of commonly used medications. 7 We also looked for evidence of seasonality more generally (i.e., all Seasonal effects on the occurrence of nocturnal leg cramps: a prospective cohort study Background: It has been anecdotally reported that nocturnal leg cramps in pregnant women are worse in summer. We analyzed population-level data to determine whether the symptom burden of nocturnal leg cramps is seasonal in the general population.…”

Section: Data Sourcesmentioning

confidence: 99%

“…7 This is relevant because both of these drug classes can also be assumed to have some seasonality in their use. Specifically, use of β-agonists can be expected to increase in winter, when respiratory infections peak, and use of diuretics can be expected to peak in summer, when patients often mention ankle swelling (unpublished clinical observations).…”

Section: Sensitivity Analysesmentioning

confidence: 99%

Seasonal effects on the occurrence of nocturnal leg cramps: a prospective cohort study

Garrison

Dormuth

Morrow

et al. 2015

CMAJ

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“…All three classes of diuretics can cause muscle cramps, suggesting that reduced potassium and magnesium levels are not the sole cause [62,63]. Volume contraction might be a factor.…”

Section: Muscle Crampsmentioning

confidence: 99%

Personalizing the Diuretic Treatment of Hypertension: the Need for More Clinical and Research Attention

Mann

Ernst

2015

Curr Hypertens Rep

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Neither randomized controlled trials nor efforts to identify genetic markers have been helpful with regard to the goal of individualizing diuretic therapy in the treatment of hypertension, a goal that receives little clinical or research attention. This review will examine, and bring attention to, the considerable yet overlooked information relevant to individualizing diuretic therapy. It will bring attention to clinical, biochemical, and pharmacological clues that can be helpful in identifying who is likely to respond to a diuretic, who needs a stronger diuretic regimen, which diuretic to prescribe, and how to minimize adverse effects. New directions for clinical research aimed at individualizing use in hypertension will be explored. Research and clinical attention to the goal of individualizing diuretic treatment in hypertension need to be renewed, to help us achieve greater hypertension control with fewer adverse effects and lower costs.

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Nocturnal Leg Cramps and Prescription Use That Precedes Them

Cited by 69 publications

References 19 publications

Nocturnal leg cramps: Prevalence and associations with demographics, sleep disturbance symptoms, medical conditions, and cardiometabolic risk factors

Nocturnal leg cramps: Prevalence and associations with demographics, sleep disturbance symptoms, medical conditions, and cardiometabolic risk factors

Seasonal effects on the occurrence of nocturnal leg cramps: a prospective cohort study

Personalizing the Diuretic Treatment of Hypertension: the Need for More Clinical and Research Attention

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