Epidemiology of restless legs syndrome: A synthesis of the literature

Stanford Sleep Epidemiology Research Center, Stanford University, School of Medicine, 3430 West Bayshore Road, Palo Alto, CA 94303, USA.
Sleep Medicine Reviews (Impact Factor: 8.51). 07/2011; 16(4):283-95. DOI: 10.1016/j.smrv.2011.05.002
Source: PubMed


Restless legs syndrome (RLS) has gained considerable attention in the recent years: nearly 50 community-based studies have been published in the last decade around the world. The development of strict diagnostic criteria in 1995 and their revision in 2003 helped to stimulate research interest on this syndrome. In community-based surveys, RLS has been studied as: 1) a symptom only, 2) a set of symptoms meeting minimal diagnostic criteria of the international restless legs syndrome study group (IRLSSG), 3) meeting minimal criteria accompanied with a specific frequency and/or severity, and 4) a differential diagnosis. In the first case, prevalence estimates in the general adult population ranged from 9.4% to 15%. In the second case, prevalence ranged from 3.9% to 14.3%. When frequency/severity is added, prevalence ranged from 2.2% to 7.9% and when differential diagnosis is applied prevalence estimates are between 1.9% and 4.6%. In all instances, RLS prevalence is higher in women than in men. It also increases with age in European and North American countries but not in Asian countries. Symptoms of anxiety and depression have been consistently associated with RLS. Overall, individuals with RLS have a poorer health than non-RLS but evidence for specific disease associations is mixed. Future epidemiological studies should focus on systematically adding frequency and severity in the definition of the syndrome in order to minimize the inclusion of cases mimicking RLS.

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Available from: Maurice Moyses Ohayon, Mar 05, 2014
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    • "Restless legs syndrome (RLS) is a common, age-related disorder , with a prevalence of up to 15% in various populations, and a higher prevalence among women [1] [2]. Patients with RLS suffer from lower limb discomfort, which typically occurs during the evening or night, and they can be alleviated by moving the legs or by walking. "
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    ABSTRACT: Background: Restless Legs Syndrome (RLS) is a common, age- and gender-related disorder. Although several genetic risk factors were identified, the actual genetic causes are unclear. Methods: Whole exome sequencing (WES) was performed in seven families with RLS, focusing on potential genetic causes around six known genetic loci; MEIS1, BTBD9, PTPRD, MAP2K5/SKOR1, TOX3 and the intergenic rs6747972. Subsequently, genotyping using specific TaqMan assays was performed in two case-control cohorts (627 patients and 410 controls), and in a familial cohort (718 individuals). Results: WES identified two potential candidate variants in the GLO1 gene (within the BTBD9 locus), the p.E111A variant and the promoter variant c.-7C>T, both co-segregated with the disease in four families. The GLO1 p.E111A variant was associated with RLS in the French-Canadian cohort (OR 1.38, p=0.02), demonstrated a similar trend in the US cohort (OR 1.26. p=0.09, combined analysis OR=1.28 and p=0.009). However, the original GWAS marker, BTBD9 rs9357271 was more strongly associated with RLS (OR=1.84, p=0.0003), and conditional haplotype analysis, controlling for the effect of the BTBD9 SNP, demonstrated that the association of GLO1 p.E111A turned insignificant (p=0.54). In the familial cohort, the two GLO1 variants were not associated with RLS. Other variants, identified using WES in the SKOR1 (p.W200R, p.A672V) and PTPRD (p.R995C, p.Q447E p.T781A, p.Q447E and c.551-4C>G) genes, did not co-segregate with the disease. Conclusions: The GLO1 variations studied here are not the source of association of the BTBD9 locus with RLS. It is likely that the genetic variants affecting RLS susceptibility are located in regulatory regions.
    Sleep Medicine 06/2015; 16(9). DOI:10.1016/j.sleep.2015.06.002 · 3.15 Impact Factor
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    • "Restless leg syndrome (RLS) is a sensorimotor sleep-related movement disorder manifesting with an urge to move the legs and unpleasant sensation in the lower limbs. The prevalence of RLS in the general population is 5 to 15% [1] [2]. RLS may be primary or secondary, the latter is associated with a number of disorders like diabetes mellitus, renal failure, iron deficiency and peripheral neuropathy , rendering the diagnosis difficult [3]. "
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    ABSTRACT: This study aims to evaluate the types of neuropathy in a cohort of restless leg syndrome (RLS) patients and compare them with primary RLS. RLS symptoms can occur in peripheral neuropathy and may cause diagnostic confusion, and there is a paucity of studies comparing neuropathic RLS and primary RLS. Patients with RLS diagnosed according to the international restless legs syndrome study group criteria were categorized as primary RLS or secondary. Those with evidence of peripheral neuropathy were categorized as neuropathic RLS. The demographic, clinical, laboratory profile and therapeutic response to dopamine agonists at 6months and 1year of neuropathic RLS patients were compared between primary and secondary RLS patients. There were 82 patients with RLS of whom 22 had peripheral neuropathy and 28 had primary RLS. The etiology of neuropathic RLS was diabetes mellitus in 13, renal failure in six, hypothyroidism in five, demyelinating in two, nutritional deficiency in three, leprosy in one, and miscellaneous etiologies in four patients. The neuropathic RLS patients were older (46.0±14.1 versus 35.8±15.4years), had shorter duration of illness (1.4±1.4 versus 6.2±6.2years) and were more frequently symptomatic. RLS symptoms were asymmetric in primary RLS patients compared to neuropathic RLS (25% versus 0%). The therapeutic response was similar in both groups. Copyright © 2015 Elsevier Ltd. All rights reserved.
    Journal of Clinical Neuroscience 06/2015; 22(8). DOI:10.1016/j.jocn.2015.01.032 · 1.38 Impact Factor
    • "An iron insufficient state appears to exist in the brains of RLS patients, probably due to the reduced expression and activity of iron management proteins, including transferrin and its receptor, in the choroid plexus and brain microvasculature in postmortem RLS brains [30]. Periodic leg movements (PLMs) are present in up to 80% of patients with RLS and are characterized by periodic episodes of repetitive and stereotyped limb movements occurring during sleep [31]. Interestingly, AD and RLS shared some risk factors: advanced age, depression, anxiety, smoking, and hypertension. "
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    ABSTRACT: Sleep disorders are frequently reported in Alzheimer's disease (AD), with a significant impact on patients and caregivers and a major risk factor for early institutionalization. Although changes in sleep organization are a hallmark of the normal aging processes, sleep macro- and micro-architectural alterations are more evident in patients affected by AD. Degeneration of neural pathways regulating sleep-wake patterns and sleep architecture may contribute to sleep alterations. In return, several recent studies suggested that common sleep disorders may precede clinical symptoms of dementia and represent risk factors for cognitive decline, through impairment of sleep-dependent memory consolidation processes. Thus, a close relationship between sleep disorders and AD has been largely hypothesized. Here, sleep alterations in AD and its pre-dementia stage, mild cognitive impairment, and their complex interactions are reviewed.
    Journal of Alzheimer's disease: JAD 04/2015; 46(3). DOI:10.3233/JAD-150138 · 4.15 Impact Factor
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