Prevalence of Restless Leg Syndrome, Associated Variables and Impact on Sleep Quality in a Cohort of Patients with Neuropsychiatric Disorders
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Keywords
Neuropsychiatric, Psychiatric Patients, Restless Leg Syndrome, Sleep Disorder, Sleep Quality
Abstract
Background: Restless leg syndrome is a sensorimotor, sleep-related neurological disorder that is still an underdiagnosed condition characterized by an irresistible urge to move legs at rest, especially at night. Sleep being a vital component of comprehensive health is affected in RLS. The study was conducted to estimate the prevalence of restless leg syndrome (RLS) and its impact on sleep disturbance in patients presenting to the psychiatry clinic (outpatient psychiatric department).
Methodology: The present study was a cross-sectional, observational, single-center, interview-based study, conducted on 600 patients diagnosed with psychiatric illness. A questionnaire of the International Restless Leg Syndrome Scale (IRLS) was applied to assess the severity of RLS and sleep disturbance was assessed using the Pittsburgh Sleep Quality Index (PSQI) scale.
Results: It was found that among 600 psychiatric patients, the prevalence of RLS was 41.2% (247 patients). Major depressive disorder, migraine, and anxiety disorders show a high prevalence of RLS with a prevalence of 42.9%, 19.40%, and 15%respectively whereas alcohol use disorder has a low prevalence of 2.4%. The association between sleep and RLS was found to be statistically significant.
Conclusion: RLS is a highly prevalent disorder, and it needs to be evaluated in patients with sleep disturbance especially those presenting with symptoms of mood, migraine, and anxiety. Individuals with RLS suffer difficulty falling asleep and have shorter and more fragmented sleep experiences, leading to poorer overall sleep quality.
References
2. Vlasie A, Trifu SC, Lupuleac C, Kohn B, Cristea MB. Restless legs syndrome: An overview of pathophysiology, comorbidities and therapeutic approaches (Review). Exp Ther Med. 2022 Feb;23(2):185. doi: 10.3892/etm.2021.11108.
3. Picchietti DL, Wang VC, Picchietti MA. Intravenous iron given prior to pregnancy for restless legs syndrome is associated with remission of symptoms. J Clin Sleep Med. 2012;8(5):585
4. Bevan HS, Slater SC, Clarke H, Cahill PA, Mathieson PW, Welsh GI, Satchell SC. Acute laminar shear stress reversibly increases human glomerular endothelial cell permeability via activation of endothelial nitric oxide synthase. Am J Physiol Renal Physiol. 2011 Oct;301(4):F733-42. doi: 10.1152/ajprenal.00458.2010.
5. Tuovinen N, Stefani A, Mitterling T, Heidbreder A, Frauscher B, Gizewski ER, Poewe W, Högl B, Scherfler C. Functional connectivity and topology in patients with restless legs syndrome: a case-control resting-state functional magnetic resonance imaging study. Eur J Neurol. 2021 Feb;28(2):448-458. doi: 10.1111/ene.14577.
6. Steardo L Jr, de Filippis R, Carbone EA, Segura-Garcia C, Verkhratsky A, De Fazio P. Sleep Disturbance in Bipolar Disorder: Neuroglia and Circadian Rhythms. Front Psychiatry. 2019 Jul 18;10:501. doi: 10.3389/fpsyt.2019.00501.
7. Kwatra V, Khan MA, Quadri SA, Cook TS. Differential Diagnosis and Treatment of Restless Legs Syndrome: A Literature Review. Cureus. 2018 Sep 13;10(9):e3297. doi: 10.7759/cureus.3297.
8. Gupta R, Lahan V, Goel D. Prevalence of restless leg syndrome in subjects with depressive disorder. Indian J Psychiatry. 2013 Jan;55(1):70-3. doi: 10.4103/0019-5545.105515.
9. Broström A, Alimoradi Z, Lind J, Ulander M, Lundin F, Pakpour A. Worldwide estimation of restless legs syndrome: a systematic review and meta-analysis of prevalence in the general adult population. J Sleep Res. 2023 Jun;32(3):e13783. doi: 10.1111/jsr.13783.
10. Weber FC, Danker-Hopfe H, Dogan-Sander E, Frase L, Hansel A, Mauche N, Mikutta C, Nemeth D, Richter K, Schilling C, Sebestova M. Restless Legs Syndrome Prevalence and Clinical Correlates Among Psychiatric Inpatients: A Multicenter Study. Frontiers in psychiatry2022 Mar 14;13:846165. doi: 10.3389/fpsyt.2022.846165.
11. Carlos K, Prado GF, Teixeira CD, Conti C, de Oliveira MM, Prado LB, Carvalho LB. Benzodiazepines for restless legs syndrome. Cochrane Database Syst Rev. 2017 Mar 20;3(3):CD006939. doi: 10.1002/14651858.CD006939.
12. Walters AS, LeBrocq C, Dhar A, Hening W, Rosen R, Allen RP, Trenkwalder C, & International Restless Legs Syndrome Study Group. Validation of the International Restless Legs Syndrome Study Group rating scale for restless legs syndrome. Sleep Medicine 2003;4 (2):121–132
13. Buysse DJ, Reynolds CF, Charles F, Monk TH, Berman SR., Kupfer D.J. The Pittsburgh sleep quality index: a new instrument for psychiatric practice and research. Psychiatry Research 1989;28 (2):193–213
14. Broström A, Alimoradi Z, Lind J, Ulander M, Lundin F, Pakpour A. Worldwide estimation of restless legs syndrome: a systematic review and meta-analysis of prevalence in the general adult population. J Sleep Res. 2023 Jun;32(3):e13783. doi: 10.1111/jsr.13783.
15. Nichols DA, Allen RP, Grauke JH, Brown JB, Rice ML, Hyde PR, Dement WC, Kushida CA. Restless legs syndrome symptoms in primary care: a prevalence study. Archives of internal medicine. 2003 Oct 27;163(19):2323-9
16. Sorbi MH, Issazadegan A, Soleimani E, Mirhosseini SH. Prevalence of Restless Legs Syndrome in Iran: A Systematic Review and Meta-Analysis. Journal of Community Health Research. 2020 Sep 10;9(3):191-202
17. Rangarajan S, Rangarajan S, D’Souza GA. Restless legs syndrome in an Indian urban population. Sleep medicine. 2007 Dec 1;9(1):88- 93
18. Joseph N, Suresh S, Prasad S, Malwee SM, Brittas A, Gupta V. Study on restless leg syndrome and its relationship with quality of sleep among the general population of Mangalore, India. The Egyptian Journal of Neurology, Psychiatry and Neurosurgery2022 Dec;58(1):1-9
19. Kushida CA. Clinical presentation, diagnosis, and quality of life issues in restless legs syndrome. The American journal of medicine 2007 Jan 1;120(1):S4-12
20. Winkelmann J, Schormair B, Lichtner P et al. Genome-wide association study of restless legs syndrome identifies common variants in three genomic regions. Nat Genet 2007; 39: 1000–6
21. Pichler I, Hicks AA, Pramstaller PP. Restless legs syndrome: an update on genetics and future perspectives. Clin Genet2008; 73: 297– 305
22. Chen PK, Fuh JL, Chen SP, Wang SJ. Association between restless legs syndrome and migraine. Journal of Neurology, Neurosurgery & Psychiatry. 2010 May 1;81(5):524-8
23. Kallweit U, Werth E, Seiz A, Sefidan S, Dahmen N, Manconi M, Ehlert U, Bassetti CL. Psychiatric comorbidities in restless legs syndrome. The Journal of neuropsychiatry and clinical neurosciences. 2016 Jul;28(3):239-42
24. Celle S, Roche F, Kerleroux J, Thomas-Anterion C, Laurent B, Rouch I, Pichot V, Barthélémy JC, Sforza E. Prevalence and clinical correlates of restless legs syndrome in an elderly French population: the synapse study. Journals of Gerontology Series A: Biomedical Sciences and Medical Sciences. 2010 Feb 1;65(2):167- 73
25. Koo BB, Blackwell T, Lee HB, Stone KL, Louis ED, Redline S; Osteoporotic Fractures in Men (MrOS) Study Group. Restless Legs Syndrome and Depression: Effect Mediation by Disturbed Sleep and Periodic Limb Movements. Am J Geriatr Psychiatry. 2016 Nov;24(11):1105-1116. doi: 10.1016/j.jagp.2016.04.003.
26. Sun ER, Chen CA, Ho G, Earley CJ, Allen RP. Iron and the restless legs syndrome. Sleep. 1998 Jun 1;21(4):381-7
27. Ghasemi H, Khaledi-Paveh B, Abdi A, Jalali R, Salari N, VaisiRaygani A, Mohammadi M. The prevalence of restless legs syndrome in patients with migraine: a systematic review and metaanalysis. Pain Research and Management 2020; 2020:2763808. doi: 10.1155/2020/2763808
28. Schürks M, Buse DC, Wang SJ. 10 Comorbidities of Headache Disorders. Handbook of Headache: Practical Management. 2011 Aug 14:137
29. Cho SJ, Hong JP, Hahm BJ, Jeon HJ, Chang SM, Cho MJ, Lee HB. Restless legs syndrome in a community sample of Korean adults: prevalence, impact on quality of life, and association with DSM-IV psychiatric disorders. Sleep. 2009 Aug 1;32(8):1069-76
30. Kang S-G, Lee HJ, Jung SW, Cho SN, Han C, Kim YK, et al. Characteristic and clinical correlates of restless legs syndrome in schizophrenia. Prog Neuropsychopharmacol Biol Psychiatry 2007; 31:1078–83.
31. Jiménez-Jiménez FJ, Gómez-Tabales J, Alonso-Navarro H, Zurdo M, Turpín-Fenoll L, Millán-Pascual J, et al. Association Between the rs1229984 Polymorphism in the Alcohol Dehydrogenase 1B Gene and Risk for Restless Legs Syndrome. Sleep 2017 Dec 1;40(12). doi: 10.1093/sleep/zsx174.
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