Prevalence and Sleep Related Disorders of Restless Leg Syndrome in Hemodialysis Patients

Abstract

Background:Despite being frequently described, Restless Leg Syndrome (RLS) in patients, who are on hemodialysis, is a common disease which, has not been well documented in Iran.Objectives:The current study aimed to investigate the prevalence of RLS and its sleep disorders in Iranian patients on hemodialysis.Patients and Methods:In this multicenter cross sectional study, 397 consecutive patients on hemodialysis were evaluated by face-to-face interviews. RLS was diagnosed using the International RLS Study Group (IRLSS) criteria. In addition, three validated sleep disorder questionnaires (Insomnia Severity Index, Epworth sleepiness scale and Pittsburgh sleep quality index) were completed by the patients.Results:One hundred-twenty-six patients with RLS (31.7%; mean age 57.6 ± 15.4 years) participated in the current study. RLS mostly occurs in females (P < 0.001). RLS cases showed poorer quality of sleep (Pittsburgh Sleep Quality Index > 5, P = 0.001), higher scores of Epworth Sleepiness Scale (P < 0.001) and insomnia severity index (P = 0.001). Except thyroid gland dysfunction (P < 0.03, OR ≈ 2.50) and anti-hypertensive medications (P < 0.01, OR ≈ 1.7), there were no significant differences between age, duration of dialysis, etiology of renal insufficiency, intake of nicotine, alcohol or caffeine, and other associated comorbidities between the patients with and without RLS.Conclusions:In the current study, prevalence of RLS was near the weighted-mean prevalence of other studies (mean 30%, range 8%t-52%). This is not just racial variability and may attribute to narrow or wide definition of the disease, plus variations of the prevalence recording time, and sometimes not using the standard criteria or standard interview.

Restless leg syndrome in chronic hemodialysis patients in Mashhad hemodialysis centers

“…Chavoshi et al reported the prevalence of RLS was about 31.7% in hemodialysis patients in Tehran, Iran (2). Al-Jahdali et al evaluated 227 ESRD patients in Jeddah, Saudi Arabia.…”

Restless leg syndrome: Does various geographic area have any effect on its different prevalence?

“…[1] We also found no significant relationship between them in our study of 397 HD patients. [10] We did find a significant correlation between endocrine glandular disorders and antihypertensive drugs (p=0.03 and p=0.01, respectively) with RLS, which Demircioğlu et al did not look at in their study. [1] Several studies have demonstrated indicative association between RLS and higher risk of nocturnal hypertension, heart disease and stroke, as well as association with other sleep disturbances that could lead to anxiety and depression.…”

“…[9] We have observed a prevalence rate of 31.7% in Iran. [10] Thus, it seems this variation in prevalence may be due to geographic and racial differences, as well as diversity in lifestyle and in criteria, and physicians' experience diagnosing RLS.…”

Update on Research and Practices in Major Sleep Disorders: Part II—Insomnia, Willis‐Ekbom Disease (Restless Leg Syndrome), and Narcolepsy

“…RLS/WED is common among patients with end‐stage renal disease, with prevalence higher than in the general population (Tachibana, ). One cross‐sectional study of patients on hemodialysis revealed that the prevalence of RLS/WED was 31.7% and was dominant in females (Chavoshi, Einollahi, Sadeghniat Haghighi, Saraei, & Izadianmehr, ).…”

“…Awakened by the sensations, patients get out of bed to walk to relieve the symptoms during the night, which disrupts their sleep (Einollahi & Izadianmehr, ). In patients on hemodialysis with RLS, daytime sleepiness, insomnia, and low sleep quality were commonly reported when compared with those without RLS (Chavoshi et al, ). Moreover, RLS symptoms that start early during the day may prevent patients from keeping still during hemodialysis, affecting their participation (Tachibana, ).…”