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

Abstract

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.

Leg cramps, its associated factors and quality of life among pregnant mothers: A cross-sectional study in a Malaysian suburban health clinic

“…Our study highlights that LCs may be more common among pregnant mothers who were overweight or obese compared to those with normal weight and the association between BMI and LCs were statistically signi icant. A similar signi icant association was found among the non-pregnant general population (Grandner and Winkelman, 2017). Since overweight and obesity appear to be common among pregnant women, it highlights the importance of healthcare providers to manage the prepregnancy weight of the reproductive women before they conceive.…”

“…Alternatively, 30% of the general population in a study reported of having night time LCs with higher frequency (more than ive per month). They were signi icantly associated with co-morbidities like hypertension, diabetes, heart failure, angina, depression and respiratory diseases (Grandner and Winkelman, 2017). Furthermore, LCs associated with co-morbidities are usually identi ied as secondary causes, whilst benign LCs in pregnancy are thought to be either idiopathic, metabolic or physiological, which explains the low magnitude of LC comorbidities in this study.…”

“…As a result, this causes an increased risk of early labour with possible fetal asphyxia and postpartum haemorrhage (Dayan et al, 2002;Rondo et al, 2003). Other co-morbidities that LCs have been associated with especially when occurring at night are female sex, leg claudication, angina, arthritis, peripheral neuropathy, peripheral vascular disease and certain medications like statins, diuretics and long-acting beta-blockers (Grandner and Winkelman, 2017).…”

The Relationship Between Leg Muscle Cramps and Sleep Quality in Pregnant Women Visited the Health Centers in Tabriz

“…In a systematic review of women and men aged 51 -75 by Hallegraeff et al, LMCs had an association with sleep disturbances (22). An examination of 18 to 80 years old women by Grandner and Winkelman revealed the relationship between LMCs and sleep disorder such as difficulty in falling asleep (sleep latency), difficulty in the continuation of sleep, daytime sleepiness, taking sleep medications and duration of sleep (23). The results of the study by Hawke et al on the relationship of LMCs with reduced sleep efficiency (25) and the results of the study of Grandner and Winkelman on the relationship of foot LMCs with sub-scales of sleep disturbances, sleep latency, difficulty in continuation of sleep, taking sleep medications and the duration of sleep (23) are not consistent with the results of the present study, which may be due to the reduction in the length of nightly sleep during pregnancy (11) and the reduced use of medications during pregnancy due to concerns about injury to the fetus.…”

The Endocannabinoid System May Modulate Sleep Disorders in Aging

“…The movement of limbs across night induces recurrent awakenings that limit sleep consolidation and eventually, causes drowsiness on the next day. The prevalence of PLMD is higher among older adults [51][52][53].…”