Restless legs syndrome and its relationship with insomnia symptoms and daytime distress: Epidemiological survey in Sweden

Abstract

To investigate prevalence estimates of restless legs syndrome (RLS) in relation to insomnia complaints and daytime distress a questionnaire was sent to a randomly selected sample of 1962 inhabitants of Uppsala, Sweden. The questionnaire included questions about sleep and daytime distress and the standardized four-question set for epidemiological settings recommended by the International RLS Study Group. A positive diagnosis of RLS was established in 18.8% of all responders. When the optional question about frequency was applied 5.8% reported frequent symptoms. Insomnia symptoms and daytime distress were significantly associated with the frequency of RLS symptoms.Key words: anxiety, depression, insomnia, prevalence, restless legs syndrome. R ESTLESS LEGS SYNDROME (RLS) is a sensorimotor disorder characterized by an almost irresistible urge to move the legs that may cause considerable sleep disruption and insomnia complaints.1 Surveys of the general population have shown that RLS is a common disorder, and has a prevalence ranging between 2.5 and 10%. when a four-question set recommended for epidemiological surveys also was presented. The first three questions were built upon those validated by Rothdach et al. 5 and a positive diagnosis requires affirmative answers to each of these three questions. The fourth, optional question was designed as a convenient measure of severity and had seven response categories.The proposed four-question set does not yet seem to have been used in epidemiological surveys in the normal population. Therefore, the aims of the present study were (i) to estimate the prevalence of RLS according to the proposed four-question set; and (ii) to further investigate the frequency of RLS symptoms, and the relationship between frequency of RLS symptoms and sleep disruption and daytime distress. METHODSA questionnaire was sent out by post to a randomly selected sample of 1962 subjects aged 20-59 years living in Uppsala Municipality. Approximately every 50th person was drawn from the national registration records. Responses were obtained from 586 men and 749 women, with mean (ϮSD) ages of 39 Ϯ 12 years and 38 Ϯ 11 years, respectively.The questionnaire consisted of items from the Uppsala Sleep Inventory. 6 The four-question set recommended for use in epidemiological settings by the IRLSSG 3 was also included. These questions had been translated into Swedish by a professional translator, discussed in an expert group, and adequately

Prevalence of Restless Legs Syndrome among Psoriasis Patients and Association with Depression and Sleep Quality

“…RA is the most examined inflammatory disease and frequency of RLS in patients with RA range from 15% to 30% (23,24). Number of studies that examining the prevalence of RLS in chronic inflammatory connective tissue disease even more limited compared with RA (10,(12)(13)(14)(15). This association was thought to be related to inflammatory processes, iron deficiency, neurochemical predisposition arising from chronic pain, or neuropathies in rheumatologic diseases (24), although it is not certain.…”

“…In addition, sleep loss and fragmentation of sleep due to RLS has a major impact on health and daytime functioning (10). Poor restorative sleep has been connected with pain, fatigability, stress and disease activity in rheumatic disease population (11).…”

Mood Disorders in Restless Legs Syndrome (Willis-Ekbom Disease)

“…Similarly, a Swedish questionnaire study 48 reported associations between RLS and anxiety and depression in individuals whose RLS symptoms occurred at least twice a week; no such associations were observed among individuals with infrequent symptoms (occurring less than twice a week). A Turkish study 47 showed a correlation between the severity of RLS (as assessed by the International Restless Legs Syndrome Study Group Rating Scale [IRLS]) and the severity of anxiety and depression symptoms.…”

Co-Morbidity, Mortality, Quality of Life and the Healthcare/Welfare/Social Costs of Disordered Sleep: A Rapid Review

“…A high incidence of co-morbid medical conditions was also found for narcolepsy, a disorder of unknown etiology that is characterized by excessive sleepiness that typically is associated with cataplexy and other rapid eye movement (REM) sleep phenomena, such as sleep paralysis and hypnagogic hallucinations, as well as for other sleep disorders (e.g., restless leg syndrome (RLS) 15%), OSAS (25%)), obesity, cognitive deficit, psychiatric disorders (depression and anxiety), chronic pain, gastrointestinal disorders, hypercholesterolemia, and blood hypertension [11,12,13,14,15,16]. Patients with moderate to severe RLS report an increased incidence of sleep-related problems (up to 2–5 fold) [17,18], while severe RLS is frequently associated with depression, anxiety, obesity, OSAS, cardiovascular disorders, diabetes, erectile dysfunction, and end-stage renal disorders [19]. Research on twins has shown that sleep disorders often co-occur in a family in association with emotional, behavioral and health-related problems resulting from environmental rather than genetic factors [20].…”