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Prevalence and predictors of restless legs syndrome in non-pregnant Saudi women of childbearing age

  • Neurology • Original Article
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Abstract

Purpose

This study assessed the prevalence of restless legs syndrome (RLS) and its correlates and severity among non-pregnant Saudi women of childbearing age.

Methods

Consecutive non-pregnant female visitors (age 15–44 years) of the primary care centers of the female University campus at King Saud University (n = 1,136) were interviewed face-to-face to determine the presence and severity of RLS using the International Restless Legs Syndrome (IRLS) Study Group criteria and IRLS severity scale.

Results

A total of 271 participants (24%) were diagnosed with RLS. Of these cases, severe/very severe RLS was diagnosed in 13% and mild/moderate in 87%. None of these participants had been diagnosed or treated for RLS before. Subjects with RLS were older, had a higher body mass index, and a higher prevalence of vitamin D deficiency and diabetes mellitus than those without RLS. Multivariate binary logistic regression analysis identified the following independent predictors of RLS: age (OR 1.03 [1.009–1.051], p = 0.004), vitamin D deficiency (OR 2.147 [1.612–2.86], p < 0.001), and diabetes mellitus (OR 4.408 [1.946–9.982], p < 0.001).

Conclusions

Our results indicate that RLS is very common and underdiagnosed among non-pregnant Saudi women of a childbearing age–attending primary care cents. RLS was linked to age, vitamin D deficiency, and diabetes mellitus.

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Data availability

Data are available upon request.

References

  1. Guo S, Huang J, Jiang H, Han C, Li J, Xu X, Zhang G, Lin Z, Xiong N, Wang T (2017) Restless legs syndrome: from pathophysiology to clinical diagnosis and management. Front Aging Neurosci 9:171. https://doi.org/10.3389/fnagi.2017.00171

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Cho SJ, Hong JP, Hahm BJ, Jeon HJ, Chang SM, Cho MJ, Lee HB (2009) Restless legs syndrome in a community sample of Korean adults: prevalence, impact on quality of life, and association with DSM-IV psychiatric disorders. Sleep 32(8):1069–1076

    PubMed  PubMed Central  Google Scholar 

  3. Picchietti D, Allen RP, Walters AS, Davidson JE, Myers A, Ferini-Strambi L (2007) Restless legs syndrome: prevalence and impact in children and adolescents--the Peds REST study. Pediatrics 120(2):253–266. https://doi.org/10.1542/peds.2006-2767

    Article  PubMed  Google Scholar 

  4. Allen RP, Walters AS, Montplaisir J, Hening W, Myers A, Bell TJ, Ferini-Strambi L (2005) Restless legs syndrome prevalence and impact: REST general population study. Arch Intern Med 165(11):1286–1292. https://doi.org/10.1001/archinte.165.11.1286

    Article  PubMed  Google Scholar 

  5. Hening W, Walters AS, Allen RP, Montplaisir J, Myers A, Ferini-Strambi L (2004) Impact, diagnosis and treatment of restless legs syndrome (RLS) in a primary care population: the REST (RLS epidemiology, symptoms, and treatment) primary care study. Sleep Med 5(3):237–246. https://doi.org/10.1016/j.sleep.2004.03.006

    Article  PubMed  Google Scholar 

  6. Gupta R, Dhyani M, Kendzerska T, Pandi-Perumal SR, BaHammam AS, Srivanitchapoom P, Pandey S, Hallett M (2016) Restless legs syndrome and pregnancy: prevalence, possible pathophysiological mechanisms and treatment. Acta Neurol Scand 133(5):320–329. https://doi.org/10.1111/ane.12520

    Article  CAS  PubMed  Google Scholar 

  7. Berger K, Luedemann J, Trenkwalder C, John U, Kessler C (2004) Sex and the risk of restless legs syndrome in the general population. Arch Intern Med 164(2):196–202. https://doi.org/10.1001/archinte.164.2.196

    Article  PubMed  Google Scholar 

  8. Montplaisir J, Boucher S, Poirier G, Lavigne G, Lapierre O, Lesperance P (1997) Clinical, polysomnographic, and genetic characteristics of restless legs syndrome: a study of 133 patients diagnosed with new standard criteria. Mov Disord 12(1):61–65. https://doi.org/10.1002/mds.870120111

    Article  CAS  PubMed  Google Scholar 

  9. Walters AS, Hickey K, Maltzman J, Verrico T, Joseph D, Hening W, Wilson V, Chokroverty S (1996) A questionnaire study of 138 patients with restless legs syndrome: the ‘Night-Walkers’ survey. Neurology 46(1):92–95. https://doi.org/10.1212/wnl.46.1.92

    Article  CAS  PubMed  Google Scholar 

  10. Alswailem AM, Alahmad SM, Alshehri MA (2017) The prevalence of iron deficiency anemia and its associated risk factors among a sample of females in Riyadh, Saudi Arabia. Egypt J Hosp Med 72:4625–4629

    Google Scholar 

  11. Alquaiz AM, Gad Mohamed A, Khoja TA, Alsharif A, Shaikh SA, Al Mane H, Aldiris A, Kazi A, Hammad D (2013) Prevalence of anemia and associated factors in child bearing age women in Riyadh, Saudi Arabia. J Nutr Metab 2013:636585. https://doi.org/10.1155/2013/636585

    Article  PubMed  PubMed Central  Google Scholar 

  12. Al-Alyani H, Al-Turki HA, Al-Essa ON, Alani FM, Sadat-Ali M (2018) Vitamin D deficiency in Saudi Arabians: a reality or simply hype: a meta-analysis (2008-2015). J Fam Community Med 25(1):1–4. https://doi.org/10.4103/jfcm.JFCM_73_17

    Article  Google Scholar 

  13. Alzaheb RA (2018) The prevalence of hypovitaminosis D and its associated risk factors among women of reproductive age in Saudi Arabia: a systematic review and meta-analysis. Clin Med Insights Womens Health 11:1179562X18767884. https://doi.org/10.1177/1179562X18767884

    Article  PubMed  PubMed Central  Google Scholar 

  14. Al-Daghri NM (2018) Vitamin D in Saudi Arabia: prevalence, distribution and disease associations. J Steroid Biochem Mol Biol 175:102–107. https://doi.org/10.1016/j.jsbmb.2016.12.017

    Article  CAS  PubMed  Google Scholar 

  15. Al-Mogbel ES (2012) Vitamin D status among adult Saudi females visiting primary health care clinics. Int J Health Sci (Qassim) 6(2):116–126

    Article  Google Scholar 

  16. Almeneessier AS, Alyousefi N, Alzahrani M, Alsafi AA, Alotaibi R, Olaish AH, Sabr Y, BaHammam AS (2019) Prevalence of restless legs syndrome among pregnant women: a case–control study. Ann Thoracic Med 15:9–14. https://doi.org/10.4103/atm.ATM_206_19

  17. Crocetti AF, Mushak P, Schwartz J (1990) Determination of numbers of lead-exposed women of childbearing age and pregnant women: an integrated summary of a report to the U.S. Congress on childhood lead poisoning. Environ Health Perspect 89:121–124. https://doi.org/10.1289/ehp.9089121

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Martinez GM, Daniels K, Febo-Vazquez I (2018) Fertility of men and women aged 15-44 in the United States: National Survey of Family Growth, 2011-2015. Natl Health Stat Rep 113:1–17

    Google Scholar 

  19. Goonewardene M, Shehata M, Hamad A (2012) Anaemia in pregnancy. Best Pract Res Clin Obstet Gynaecol 26(1):3–24. https://doi.org/10.1016/j.bpobgyn.2011.10.010

    Article  PubMed  Google Scholar 

  20. Kidney disease: improving global outcomes (KDIGO) (2013) Chapter 1: definition and classification of CKD. Kidney Int Suppl (2011) 3(1):19–62. https://doi.org/10.1038/kisup.2012.64

    Article  Google Scholar 

  21. BaHammam A, Al-shahrani K, Al-zahrani S, Al-shammari A, Al-amri N, Sharif M (2011) The prevalence of restless legs syndrome in adult Saudis attending primary health care. Gen Hosp Psychiatry 33(2):102–106. https://doi.org/10.1016/j.genhosppsych.2011.01.005

    Article  PubMed  Google Scholar 

  22. Allen RP, Kushida CA, Atkinson MJ, Consortium RLSQ (2003) Factor analysis of the International Restless Legs Syndrome Study Group’s scale for restless legs severity. Sleep Med 4(2):133–135

    Article  Google Scholar 

  23. Allen RP, Picchietti DL, Garcia-Borreguero D, Ondo WG, Walters AS, Winkelman JW, Zucconi M, Ferri R, Trenkwalder C, Lee HB, International Restless Legs Syndrome Study G (2014) Restless legs syndrome/Willis-Ekbom disease diagnostic criteria: updated International Restless Legs Syndrome Study Group (IRLSSG) consensus criteria--history, rationale, description, and significance. Sleep Med 15(8):860–873. https://doi.org/10.1016/j.sleep.2014.03.025

    Article  Google Scholar 

  24. Chen PH, Liou KC, Chen CP, Cheng SJ (2012) Risk factors and prevalence rate of restless legs syndrome among pregnant women in Taiwan. Sleep Med 13(9):1153–1157. https://doi.org/10.1016/j.sleep.2012.06.008

    Article  PubMed  Google Scholar 

  25. Manconi M, Govoni V, De Vito A, Economou NT, Cesnik E, Casetta I, Mollica G, Ferini-Strambi L, Granieri E (2004) Restless legs syndrome and pregnancy. Neurology 63(6):1065–1069

    Article  CAS  Google Scholar 

  26. Sikandar R, Khealani BA, Wasay M (2009) Predictors of restless legs syndrome in pregnancy: a hospital based cross sectional survey from Pakistan. Sleep Med 10(6):676–678. https://doi.org/10.1016/j.sleep.2008.06.011

    Article  PubMed  Google Scholar 

  27. Tunc T, Karadag YS, Dogulu F, Inan LE (2007) Predisposing factors of restless legs syndrome in pregnancy. Mov Disord 22(5):627–631. https://doi.org/10.1002/mds.21291

    Article  PubMed  Google Scholar 

  28. Al Hassan NN (2015) The prevalence of iron deficiency anemia in a Saudi University female students. J Microsc Ultrastruct 3(1):25–28. https://doi.org/10.1016/j.jmau.2014.11.003

    Article  PubMed  Google Scholar 

  29. Trenkwalder C, Allen R, Hogl B, Paulus W, Winkelmann J (2016) Restless legs syndrome associated with major diseases: a systematic review and new concept. Neurology 86(14):1336–1343. https://doi.org/10.1212/WNL.0000000000002542

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Connor JR, Patton SM, Oexle K, Allen RP (2017) Iron and restless legs syndrome: treatment, genetics and pathophysiology. Sleep Med 31:61–70. https://doi.org/10.1016/j.sleep.2016.07.028

    Article  PubMed  Google Scholar 

  31. Lin S, Zhang H, Gao T, Zhong F, Sun Y, Cai J, Ma A (2018) The association between obesity and restless legs syndrome: a systemic review and meta-analysis of observational studies. J Affect Disord 235:384–391. https://doi.org/10.1016/j.jad.2018.04.042

    Article  PubMed  Google Scholar 

  32. Gao Q, Kou T, Zhuang B, Ren Y, Dong X, Wang Q (2018) The association between vitamin D deficiency and sleep disorders: a systematic review and meta-analysis. Nutrients 10(10). https://doi.org/10.3390/nu10101395

  33. Archontogeorgis K, Nena E, Papanas N, Steiropoulos P (2018) The role of vitamin D in obstructive sleep apnoea syndrome. Breathe (Sheff) 14(3):206–215. https://doi.org/10.1183/20734735.000618

    Article  Google Scholar 

  34. Balaban H, Yildiz OK, Cil G, Senturk IA, Erselcan T, Bolayir E, Topaktas S (2012) Serum 25-hydroxyvitamin D levels in restless legs syndrome patients. Sleep Med 13(7):953–957. https://doi.org/10.1016/j.sleep.2012.04.009

    Article  PubMed  Google Scholar 

  35. Wali S, Shukr A, Boudal A, Alsaiari A, Krayem A (2014) The effect of vitamin D supplements on the severity of restless legs syndrome. Sleep Breath 19:579–583. https://doi.org/10.1007/s11325-014-1049-y

    Article  PubMed  Google Scholar 

  36. Cui X, Pelekanos M, Liu PY, Burne TH, McGrath JJ, Eyles DW (2013) The vitamin D receptor in dopamine neurons; its presence in human substantia nigra and its ontogenesis in rat midbrain. Neuroscience 236:77–87. https://doi.org/10.1016/j.neuroscience.2013.01.035

    Article  CAS  PubMed  Google Scholar 

  37. Patton SM, Cho YW, Clardy TW, Allen RP, Earley CJ, Connor JR (2013) Proteomic analysis of the cerebrospinal fluid of patients with restless legs syndrome/Willis-Ekbom disease. Fluids Barriers CNS 10(1):20. https://doi.org/10.1186/2045-8118-10-20

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  38. Wali SO, Abaalkhail B, Alhejaili F, Pandi-Perumal SR (2019) Efficacy of vitamin D replacement therapy in restless legs syndrome: a randomized control trial. Sleep Breath 23(2):595–601. https://doi.org/10.1007/s11325-018-1751-2

    Article  PubMed  Google Scholar 

  39. Moradi-Lakeh M, El Bcheraoui C, Afshin A, Daoud F, AlMazroa MA, Al Saeedi M, Basulaiman M, Memish ZA, Al Rabeeah AA, Mokdad AH (2017) Diet in Saudi Arabia: findings from a nationally representative survey. Public Health Nutr 20(6):1075–1081. https://doi.org/10.1017/S1368980016003141

    Article  PubMed  Google Scholar 

  40. Alsuwadia AO, Farag YM, Al Sayyari AA, Mousa DH, Alhejaili FF, Al-Harbi AS, Housawi AA, Mittal BV, Singh AK (2013) Prevalence of vitamin D deficiency in Saudi adults. Saudi Med J 34(8):814–818

    PubMed  Google Scholar 

  41. Innes KE, Selfe TK, Agarwal P (2012) Restless legs syndrome and conditions associated with metabolic dysregulation, sympathoadrenal dysfunction, and cardiovascular disease risk: a systematic review. Sleep Med Rev 16(4):309–339. https://doi.org/10.1016/j.smrv.2011.04.001

    Article  PubMed  Google Scholar 

  42. Keckeis M, Lattova Z, Maurovich-Horvat E, Beitinger PA, Birkmann S, Lauer CJ, Wetter TC, Wilde-Frenz J, Pollmacher T (2010) Impaired glucose tolerance in sleep disorders. PLoS One 5(3):e9444. https://doi.org/10.1371/journal.pone.0009444

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  43. Bosco D, Plastino M, Fava A, Ettore M, Bosco F, Ermio C, Tallarigo F, Pirritano D, Consoli D (2009) Role of the Oral Glucose Tolerance Test (OGTT) in the idiopathic restless legs syndrome. J Neurol Sci 287(1–2):60–63. https://doi.org/10.1016/j.jns.2009.09.008

    Article  PubMed  Google Scholar 

  44. Mirghani OH, Amirthalingam P, Mohammed OS (2016) The effect of restless leg syndrome on diabetes control among type-2 diabetic patients in the Northwest region of Saudi Arabia. J Diabetol 7(3):1–5

    Google Scholar 

  45. Phillips B, Young T, Finn L, Asher K, Hening WA, Purvis C (2000) Epidemiology of restless legs symptoms in adults. Arch Intern Med 160(14):2137–2141. https://doi.org/10.1001/archinte.160.14.2137

    Article  CAS  PubMed  Google Scholar 

  46. Ohayon MM, Roth T (2002) Prevalence of restless legs syndrome and periodic limb movement disorder in the general population. J Psychosom Res 53(1):547–554. https://doi.org/10.1016/s0022-3999(02)00443-9

    Article  PubMed  Google Scholar 

  47. Tison F, Crochard A, Leger D, Bouee S, Lainey E, El Hasnaoui A (2005) Epidemiology of restless legs syndrome in French adults: a nationwide survey: the INSTANT Study. Neurology 65(2):239–246. https://doi.org/10.1212/01.wnl.0000168910.48309.4a

    Article  CAS  PubMed  Google Scholar 

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Funding

This study was funded by a grant from the Strategic Technologies Program of the National Plan for Sciences and Technology and Innovation in the Kingdom of Saudi Arabia (08-MED511-02).

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Authors and Affiliations

  1. Department of Medicine, College of Medicine, The University Sleep Disorders Center, King Saud University, P. O. Box 225503, Riyadh, 11324, Saudi Arabia

    Aljohara S. Almeneessier, Maha Alzahrani, Aisha Alsafi, Raneem Alotaibi, Awad H. Olaish & Ahmed S. BaHammam

  2. Family and Community Medicine Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia

    Aljohara S. Almeneessier

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  1. Aljohara S. Almeneessier
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  2. Maha Alzahrani
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  3. Aisha Alsafi
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  5. Awad H. Olaish
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  6. Ahmed S. BaHammam
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Correspondence to Ahmed S. BaHammam.

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Research involving human subjects

This study was approved by the Ethics Committee of the College of Medicine, King Saud University. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Written informed consent was obtained from all individual participants included in the study.

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Almeneessier, A.S., Alzahrani, M., Alsafi, A. et al. Prevalence and predictors of restless legs syndrome in non-pregnant Saudi women of childbearing age. Sleep Breath 24, 1107–1113 (2020). https://doi.org/10.1007/s11325-020-02054-9

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  • DOI: https://doi.org/10.1007/s11325-020-02054-9

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