Sleep disturbances in restless legs syndrome

Jasmina Slobodan Jović; Marina Svetel; Tatjana Pekmezović; Vladimir S Kostić

doi:10.2298/VSP150722325J

Jasmina Slobodan Jović General Hospital „Dr Radivoj Simonović“ Sombor, Serbia
Marina Svetel Clinical Center of Serbia, Clinic of Neurology, Belgrade, Serbia
Tatjana Pekmezović University of Belgrade, Faculty of Medicine, Institute of Epidemiology, Belgrade, Serbia
Vladimir S Kostić Clinical Center of Serbia, Clinic of Neurology, Belgrade, Serbia

DOI: https://doi.org/10.2298/VSP150722325J

Keywords: restless legs syndrome;, sleep disorders; anxiety;, depression;, fatigue;, surveys and questionnaires.

Abstract

Background/Aim. Resteless legs syndrome (RLS) is chronical neurological disorder characterized by urge to move legs that is usually accompanied by unpleasant sensations in the lower extremities. Sleep disturbance is one of the main accompanying symptoms of RLS which exists in approximatelly 90% of patients. Impairment of sleep is related to daily sleepiness, depressive and anxiety disorders. The aim of this study was to detect frequency and characterisitics of sleep-related symptoms in patients with RLS, and its impairrment to daily sleepiness, fatique, anxiety and depression. Methods. We have examinated 94 patients with RLS. The diagnose of RLS was based on questionnaire with 4 specific questions according to the International Restless Legs Syndrome Study Group (IRLSSG) criteria updated in 2003. Severity of symptoms was astimated with IRLSSG Rating Scale, depression and anxiety with Hamilton Depression Rating Scale (HDRS) and Hamilton Anxiety Rating Scale (HARS) and sleepiness with Epworth Sleepiness scale (ESS). We astimated sleep characteristics and disturbances with specific questionnaire. Results. In our study 79.9% of patients had sleep-related symptoms. Average sleep duration was 6.50 ± 1.42 hours, with average frequency of awakening 2.34 ± 1.69 times per night. Average ESS score was 5.12 ± 4.08 (0–17). Patients with more severe symptoms had higher degree of sleepiness (p = 0.005). Patients with higher symptoms frequency, significantly more often had sleep disturbance (p = 0.016), tiredness and daily sleepiness (p = 0.001). Daily sleepiness (ESS) also significantly correlates with depression (p < 0.05) and anxiety (p = 0.012). Conclusion. Our results confirm that sleep disturbances are one of the key accompanying symptoms of RLS which cause daily sleepiness, tiredness, depression and anxiety. Therefore, their early recognition and appropriate treatment must be a priority in RLS patients.

Author Biographies

Jasmina Slobodan Jović, General Hospital „Dr Radivoj Simonović“ Sombor, Serbia

neurology

Marina Svetel, Clinical Center of Serbia, Clinic of Neurology, Belgrade, Serbia

neurolog

Tatjana Pekmezović, University of Belgrade, Faculty of Medicine, Institute of Epidemiology, Belgrade, Serbia

epidemiolog

Vladimir S Kostić, Clinical Center of Serbia, Clinic of Neurology, Belgrade, Serbia

neurolog

References

Reference

Allen RP, Picchietti D, Hening WA, Trenkwalder C, Walters AS, Montplaisi J. Restless Legs Syndrome Diagnosis and Epidemi-ology workshop at the National Institutes of Health; Interna-tional Restless Legs Syndrome Study Group. Restless legs syn-drome: diagnostic criteria, special considerations, and epide-miology. Areport from the restless legs syndrome diagnosis and epidemiology workshop at theNational Institutes of Health. Sleep Med 2003; 4(2): 101−19.

Ohayon MM, O’hara R, Vitiello MV. Epidemiology of restless legs syndrome: A synthesis of the literature. Sleep Med Rev 2012; 16(4): 283−95.

Pekmezovic T, Jovic J, Svetel M, Kostic VS. Prevalence of restless legs syndrome among adult population in a Serbian district: A community-based study. Eur J Epidemiol 2013; 28(11): 927−30.

Mathis J. Update on restless legs. Swiss Med Wkly 2005; 135(47−48): 687−96.

Earley CJ, Silber MH. Restless legs syndrome: Understanding its consequences and the need for better treatment. Sleep Med 2010; 11(9): 807−15.

Fulda S, Szesny N, Ising M, Heck A, Grübl A, Lieb R, et al. Fur-ther evidence for executive dysfunction in subjects with RLS from a non-clinical sample. Sleep Med 2011; 12(10): 1003−7.

Hamilton M. A rating scale for depression. J Neurol Neurosurg Psychiatry 1960; 23: 56−62.

Hamilton M. A diagnosis and rating of anxiety. Br J Psychiatry 1969; 3: 76−9.

Johns MW. A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep 1991; 14(6): 540−5.

Garcia-Borreguero D. Time to REST: epidemiology and burden. Eur J Neurol 2006; 13(Suppl 3): 15−20.

Allen RP, Walters AS, Montplaisir J, Hening W, Myers A, Bell TJ, et al. Restless legs syndrome prevalence and impact: REST general population study. Arch Intern Med 2005; 165(11): 1286−92.

Allen RP, Montplaisir J, Ulfberg J. Restless legs. New insights. Kristianstad, Sweden: Rafael Bokförlag; 2003.

Lasch KE, Abraham L, Patrick J, Piault EC, Tully SE, Treglia M. Development of a next day functioning measure to assess the impact of sleep disturbance due to restless legs syndrome: the restless legs syndrome-next day impact questionnaire. Sleep Med 2011; 12(8): 754−61.

Provini F, Antelmi E, Vignatelli L, Zaniboni A, Naldi G, Calandra-Buonaura G, et al. Increased prevalence of nocturnal smoking in restless legs syndrome (RLS). Sleep Med 2010; 11(2): 218−20.

Fulda S, Wetter TC. Is daytime sleepiness a neglected problem in patients with restless legs syndrome? Mov Disord 2007; 22 Suppl 18: S409−13.

Kim JB, Koo YS, Eun MY, Park KW, Jung KY. Psychosomatic symptom profiles in patients with restless legs syndrome. Sleep Breath 2013; 17(3): 1055−61.

Li Y, Mirzaei F, O’Reilly EJ, Winkelman J, Malhotra A, Okereke OI, et al. Prospective study of restless legs syndrome and risk of depression in women. Am J Epidemiol 2012; 176(4): 279−88.

Innes KE, Selfe TK, Agarwal P. Restless legs syndrome and con-ditions associated with metabolic dysregulation, sym-pathoadrenal dysfunction, and cardiovascular disease risk: A systematic review. Sleep Med Rev 2012; 16(4): 309−39.