Polysomnographic and health-related quality of life correlates of restless legs syndrome in the Sleep Heart Health Study

Harvard Medical School, Boston, MA, USA.
Sleep (Impact Factor: 4.59). 06/2009; 32(6):772-8.
Source: PubMed


Sleep disturbance is the primary clinical morbidity of restless legs syndrome (RLS). To date, sleep disturbance in RLS has been measured in (1) clinical samples with polysomnography (PSG) or (2) population-based samples by self-report. The objective of this study was to analyze sleep by PSG in a population-based sample with symptoms of RLS.
Cross-sectional observational study.
3433 older men and women.
RLS was evaluated using an 8-item self-administered questionnaire based on NIH diagnostic criteria and required symptoms occurring > or = five times per month and associated with at least moderate distress. Health-related quality of life (HRQOL) was determined using the SF-36. Unattended, in-home PSG was performed. Data were assessed using general linear models with adjustment for demographic, health-related variables, and apnea-hypopnea index (AHI). Subjects with RLS had longer adjusted mean sleep latency (39.8 vs 26.4 min, P < 0.0001) and higher arousal index (20.1 vs 18.0, P = 0.0145) than those without RLS. Sleep latency increased progressively as the frequency of RLS symptoms increased from 5-15 days per month to 6-7 days per week. No differences in sleep stage percentages were observed between participants with and without RLS. Subjects with RLS also reported poorer HRQOL in all physical domains as well as in the Mental Health and Vitality domains.
These novel PSG data from a nonclinical, community-based sample of individuals with RLS document sleep disturbance in the home even in individuals with intermittent symptoms.

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    • "Please cite this article in press as: Calandra-Buonaura G, et al., Cardiovascular autonomic dysfunctions and sleep disorders, Sleep Medicine Reviews (2015), http://dx.doi.org/10.1016/j.smrv.2015.05.005 latency, shorter sleep duration, higher prevalence of insomnia, poor sleep quality and increased daytime sleepiness [91]. A significantly positive correlation between RLS and cardiovascular diseases has been demonstrated in several large populationbased cross-sectional studies [92]. "
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    ABSTRACT: Animal and human studies have shown that disorders of the autonomic nervous system may influence sleep physiology. Conversely, sleep disorders may be associated with autonomic dysfunctions. The current review describes the clinical presentation, supposed pathogenetic mechanisms and the diagnostic and prognostic implications of impaired cardiovascular autonomic control in sleep disorders. This dysfunction may result from a common pathogenetic mechanism affecting both autonomic cardiovascular control and sleep, as in fatal familial insomnia, or it may be mainly caused by the sleep disorder, as observed in obstructive sleep apnoea. For other sleep disorders, like primary insomnia, restless legs syndrome, narcolepsy type 1 and rapid eye movement sleep behaviour disorder, the causal link with the autonomic dysfunction and its possible impact on health remains unsettled. Given its clinical implications, most of the data available suggest that a systematic assessment of the association between sleep disorders and impaired autonomic control of the cardiovascular system is warranted. Understanding the mechanism of this association may also yield insights into the interaction between the autonomic nervous system and sleep. Copyright © 2015 Elsevier Ltd. All rights reserved.
    Sleep Medicine Reviews 06/2015; DOI:10.1016/j.smrv.2015.05.005 · 8.51 Impact Factor
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    • "Comparision between patients with RLS symptoms and without RLS symptoms showed that the former had more sleep problems, however there were no statistical significances (Fig. 2). Polysomnographic studies of RLS reported increased sleep latency23), but in the present study, patients with RLS showed decreased sleep latency. This study was based on sleep questionnaires, so objective examinations such as PSG or actigraphy are needed to verify these results. "
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    ABSTRACT: Purpose Attention deficit hyperactivity disorder (ADHD) is a common disorder in school-aged children. Patients with restless legs syndrome (RLS) often present with ADHD symptoms and vice versa. This study was the first to attempt to identify the prevalence of RLS and sleep problems in children with ADHD in Korea. Methods Patients diagnosed with ADHD were asked to complete a sleep questionnaire. The sleep questionnaire included items to help identify the presence of four typical symptoms that are used as diagnostic criteria for RLS. Results A total of 56 patients, including 51 boys and 5 girls (mean age, 10.7 years old) participated. Of these, 24 complained of pain, discomfort, or an unpleasant sensation in the legs. Based on the RLS diagnostic criteria, 2 patients were diagnosed with definite RLS and 4 with probable RLS. There were no significant differences in age, medication dosage, or neuropsychological test scores between the patients with and without RLS symptoms. Conclusion Approximately 42.9% of patients with ADHD presented with RLS symptoms and 7.1% of these were diagnosed with RLS. Patients with ADHD also experienced various other sleep disorders. Thus, appropriate assessment and treatment for sleep disorders in patients with ADHD is essential.
    Korean Journal of Pediatrics 07/2014; 57(7):317-322. DOI:10.3345/kjp.2014.57.7.317
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    • "However, as indicated above, we did screen for RLS at baseline and assess change in sleep quality and mood, which are outcomes that have been recommended for inclusion in clinical trials of RLS [7] and often used as secondary endpoints in pharmaceutical trials of RLS patients [112–116]. Significant sleep and mood impairment have been repeatedly documented in studies of RLS [7, 117, 118]. Sleep loss is the most common presenting complaint of patients seeking medical care for RLS [118, 119] and is thought to explain, in large part, the negative effects of RLS on health and quality of life [80]. "
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    ABSTRACT: Objective. To examine the effects of yoga versus an educational film program on sleep, mood, perceived stress, and sympathetic activation in older women with RLS. Methods. Participants were drawn from a larger trial regarding the effects of yoga on cardiovascular disease risk profiles in overweight, sedentary postmenopausal women. Seventy-five women were randomized to receive either an 8-week yoga (n = 38) or educational film (n = 37) program. All 75 participants completed an RLS screening questionnaire. The 20 women who met all four diagnostic criteria for RLS (n = 10 yoga, 10 film group) comprised the population for this nested study. Main outcomes assessed pre- and post-treatment included: sleep (Pittsburgh Sleep Quality Index), stress (Perceived Stress Scale), mood (Profile of Mood States, State-Trait Anxiety Inventory), blood pressure, and heart rate. Results. The yoga group demonstrated significantly greater improvements than controls in multiple domains of sleep quality and mood, and significantly greater reductions in insomnia prevalence, anxiety, perceived stress, and blood pressure (all P's≤0.05). Adjusted intergroup effect sizes for psychosocial variables were large, ranging from 1.9 for state anxiety to 2.6 for sleep quality. Conclusions. These preliminary findings suggest yoga may offer an effective intervention for improving sleep, mood, perceived stress, and blood pressure in older women with RLS.
    Evidence-based Complementary and Alternative Medicine 02/2012; 2012(1741-427X):294058. DOI:10.1155/2012/294058 · 1.88 Impact Factor
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