Is daytime sleepiness a neglected problem in patients with RLS?

Max Planck Institute of Psychiatry, Munich, Germany.
Movement Disorders (Impact Factor: 5.68). 01/2007; 22 Suppl 18(S18):S409-13. DOI: 10.1002/mds.21511
Source: PubMed


The restless legs syndrome (RLS) is a common neurological disorder of sleep/wake motor regulation that is associated with sleep disturbances. Here, we review the evidence that RLS is also associated with increased daytime sleepiness. Summarizing 26 studies that assessed sleepiness by means of the Epworth Sleepiness Scale (ESS) in untreated subjects with idiopathic RLS, we found that 20 to 25% of subjects are at an increased risk for daytime sleepiness.

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    • "Restless legs syndrome has been reported to affect not only sleep quality but also many aspects of quality of life, emotional wellbeing and cognition in older adults (Cuellar et al., 2007; Pearson et al., 2006). In the present study, poor quality of nocturnal sleep was observed more frequently in RLS subjects than non-RLS subjects and 32.8% of RLS subjects showed daytime sleepiness, which is comparable with previous studies (Bassetti et al., 2001; Fulda and Wetter, 2007; Winkelman et al., 2006). Also, MDD was nearly fourfold more prevalent in RLS patients than in non-RLS subjects, which may justify examination of comorbid depression in elderly subjects complaining of RLS symptoms. "
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    ABSTRACT: The aim of this study was to determine the prevalence, neuropsychiatric comorbidities, iron metabolism and potential risk factors of restless legs syndrome (RLS) in the elderly Korean population. As a community-based epidemiological study, a simple random sample of 1118 was drawn from a roster of 61 730 adult individuals aged 65 years and older and 714 participated. The diagnosis of RLS was established in face-to-face interviews using the four minimal diagnostic criteria for RLS recommended by National Institute of Health. Depressive symptoms, nocturnal sleep disturbances, daytime sleepiness and quality of life were evaluated. Laboratory tests of iron metabolism, markers of inflammation, renal and endocrine function, hormones and vitamins were performed. A total of 59 patients (42 women and 17 men) were diagnosed as RLS with a prevalence of 8.3% (95% confidence interval: 6.2-10.3%), with an almost twofold higher prevalence in women (10.2%) than in men (5.7%). Depression was more prevalent among the subjects with RLS than without RLS and poor nocturnal sleep and quality of life were also observed in subjects with RLS. Daytime sleepiness was observed in 32.8% of subjects with RLS. No significant differences were found in iron metabolism or other risk factors between the subjects with and without RLS. The prevalence of RLS in the Korean elderly population was comparable with that in the Caucasian population. RLS had undesirable effects on mood, sleep quality and general wellbeing of elderly individuals.
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    ABSTRACT: The European Restless Legs Syndrome (RLS) Study Group (EURLSSG) is an association of European RLS experts who are actively involved in RLS research. A major aim of the Study Group is the development and continuous improvement of standards for diagnosis and treatment of RLS. Several members developed study designs and evaluation methods in investigator-initiated trials early in the 1990s, and all members have since contributed to many pivotal and nonpivotal drug trials for the treatment of RLS. The recommendations on clinical investigations of pharmacological treatment of RLS patients summarize the group's expertise and knowledge acquired through clinical trials. The recommendations primarily address how to plan and conduct confirmatory, randomized clinical studies in patients with idiopathic RLS. Advice is presented for the diagnosis of RLS and clinical and polysomnographic inclusion and exclusion criteria. Primary and secondary endpoints for an evaluation of efficacy are based on a critical description of validated methods for both short- and long-term trials, also in special populations (children, pregnant women, elderly patients). The recommendations include the assessment of augmentation. Finally, general issues including the evaluation of safety and tolerability, as well as specific neurological and cardiovascular risks and sleep attacks/daytime somnolence, are discussed. The aim of these recommendations is to support research groups or pharmaceutical companies in the design of optimized study protocols. © 2007 Movement Disorder Society
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