Risk factors of primary and secondary restless legs syndrome among a middle-aged population in Saudi Arabia: A community-based study

Abstract

INTRODUCTION:Restless legs syndrome (RLS) is etiologically divided into primary and secondary syndromes. However, a comparative description of both types is lacking in the literature. We compared primary and secondary RLS with respect to demographic determinants, associated risk factors, and comorbidities.METHODS:Following a cross-sectional survey on the prevalence of RLS in a Saudi population, RLS cases were identified using the International RLS Study Group (IRLSSG) criteria. Cases were assessed with an interview-based questionnaire regarding baseline characteristics, risk factors, and comorbidities and with lower limb examinations and laboratory measurements. RLS severity was assessed using the IRLSSG Severity Rating Scale.RESULTS:In total, 78 patients with RLS, including 50 (64.1%) primary and 28 (35.9%) secondary cases, were examined. Of the primary cases, 35 (70%) were male; of the secondary cases, 25 (89.3%) were female (P < 0.001). Multivariate regression confirmed the association of male gender with primary RLS (odds ratio = 14.53, 95% confidence interval [2.9–75], P = 0.001). There were more dark- and black-skinned participants in the primary RLS group (38, 72%) than in the secondary group (15, 28%) (P = 0.042). Iron deficiency was observed in most (26, 92%) of the secondary cases. More severe symptoms were reported in secondary than in primary RLS cases (P < 0.05).CONCLUSIONS:Primary RLS is more common but less severe than secondary RLS. Male gender and ethnicity play significant roles in primary RLS, whereas female gender and iron deficiency may be the main risk factors associated with secondary RLS.

Sleep disorders and associated factors among medical students in the Middle East and North Africa: a systematic review and meta-analysis

“…The synthesis of reported factors associated with SDs suggested that the female sex was associated with the occurrence of insomnia disorders, nightmares, periodic limb movement disorder, and RLS; and the male sex was associated with the occurrence of OSA. The higher vulnerability of women to insomnia 5 , 94 – 97 and RLS 5 , 98 , 99 as compared to men is consistent with previous findings in the general population, suggesting the need to target female students when planning interventions.…”

<p>Frequency of sleep disorders in patients with rheumatoid arthritis</p>

“…In this study, the prevalence of RLS in the RA patients (63%) was much higher than that in the general Saudi population (8.4%) 17. This higher prevalence can be explained by the high risk of iron deficiency anemia secondary to the chronic use of NSAIDs in the RA patients,18 which was identified as the main risk factor for secondary RLS 19. Iron deficiency was further confirmed in our study population by the presence of low serum ferritin in patients with RLS.…”

Prevalence of sleep disorders among university students and its impact on academic performance

“…RLS to be 30.7% among medical students in Iraq (Piro et al, 2018). Another study conducted in Saudi Arabia reported prevalence rates of primary and secondary RLS to be 64.1% and 35.9%, respectively (Alsafadi et al, 2018). Insomnia was the third commonest disorder in our study, with a prevalence rate of 36.4%.…”

“…In addition, RLS was not found to correlate significantly with unsatisfactory academic performance; this could be because secondary RLS is more severe than the primary form of this disorder (Alsafadi et al, 2018). As we excluded students suffering from other health conditions or taking medications, it is possible that our participants were more likely to have primary RLS, which therefore had less of an impact on their academic performance.…”