Prospective study of restless legs syndrome and total and cardiovascular mortality among women

Li, Yinge; Li, Yanping; Winkelman, John W.; Walters, Arthur S.; Han, Jiali; Hu, Frank B.; Gao, Xiang

doi:10.1212/wnl.0000000000004814

Cited by 55 publications

(26 citation statements)

References 34 publications

(61 reference statements)

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“…There is considerable comorbidity of RLS with diseases that are particularly common in women [40][41][42][43][44], notably migraine, sleep disorder, depression, and anxiety [3][4][5]44]. The drugs that treat these disorders may, in fact, be the culprits [45][46][47][48][49], as is shown by the fact that RLS symptoms start within days of initiating treatment.…”

Section: Comorbiditymentioning

confidence: 99%

Why Are Women Prone to Restless Legs Syndrome?

Seeman

2020

IJERPH

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Restless legs syndrome is a relatively common neurologic disorder considerably more prevalent in women than in men. It is characterized by an inactivity-induced, mostly nocturnal, uncomfortable sensation in the legs and an urge to move them to make the disagreeable sensation disappear. Some known genes contribute to this disorder and the same genes contribute to an overlapping condition—periodic leg movements that occur during sleep and result in insomnia. Dopamine and glutamate transmission in the central nervous system are involved in the pathophysiology, and an iron deficiency has been shown in region-specific areas of the brain. A review of the literature shows that pregnant women are at particular risk and that increased parity is a predisposing factor. Paradoxically, menopause increases the prevalence and severity of symptoms. This implies a complex role for reproductive hormones. It suggests that changes rather than absolute levels of estrogen may be responsible for the initiation of symptoms. Both iron (at relatively low levels in women) and estrogen (at relatively high oscillating levels in women) influence dopamine and glutamate transmission, which may help to explain women’s vulnerability to this condition. The syndrome is comorbid with several disorders (such as migraine, depression, and anxiety) to which women are particularly prone. This implies that the comorbid condition or its treatment, or both, contribute to the much higher prevalence in women than in men of restless legs syndrome.

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Section: Comorbiditymentioning

confidence: 99%

Why Are Women Prone to Restless Legs Syndrome?

Seeman

2020

IJERPH

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“…Several studies showed that RLS might be a prognostic factor for stroke, although others obtained conflicting results ( Table 3 ) [ 230 - 234 ]. In a large prospective cohort study, RLS tended to be associated with an elevated risk of total and cardiovascular mortality, and this association between RLS and mortality increased in women with a longer duration of RLS diagnosis [ 235 , 236 ]. However, two meta-analyses assessing RLS as a risk factor for incident cardiovascular events and all-cause mortality were inconclusive [ 163 , 164 ].…”

Section: Sleep Duration and Insomniamentioning

confidence: 99%

Sleep Disturbances as a Risk Factor for Stroke

et al. 2018

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Sleep, a vital process of human being, is carefully orchestrated by the brain and consists of cyclic transitions between rapid eye movement (REM) and non-REM (NREM) sleep. Autonomic tranquility during NREM sleep is characterized by vagal dominance and stable breathing, providing an opportunity for the cardiovascular-neural axis to restore homeostasis, in response to use, distress or fatigue inflicted during wakefulness. Abrupt irregular swings in sympathovagal balance during REM sleep act as phasic loads on the resting cardiovascular system. Any causes of sleep curtailment or fragmentation such as sleep restriction, sleep apnea, insomnia, periodic limb movements during sleep, and shift work, not only impair cardiovascular restoration but also impose a stress on the cardiovascular system. Sleep disturbances have been reported to play a role in the development of stroke and other cardiovascular disorders. This review aims to provide updated information on the role of abnormal sleep in the development of stroke, to discuss the implications of recent research findings, and to help both stroke clinicians and researchers understand the importance of identification and management of sleep pathology for stroke prevention and care.

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“…The diagnosis of RLS was established using the International Restless Legs Syndrome Study Group (IRLSSG) diagnostic criteria 30 in five studies (35.7%). 31 – 35 In nine studies (64.3%), the diagnosis of RLS was based on self-administered questionnaires, 4 , 36 – 38 ICD-9 codes, 5 , 39 and other sleep quesionnaires. 40 , 41 The results of 11 studies (78.6%) 4 , 5 , 31 – 34 , 36 , 37 , 40 , 41 supported RLS as a risk factor for increased mortality.…”

Section: Resultsmentioning

confidence: 99%