Sleep and Breathing

, Volume 19, Issue 2, pp 579–583 | Cite as

The effect of vitamin D supplements on the severity of restless legs syndrome

  • Siraj WaliEmail author
  • Afnan Shukr
  • Ayah Boudal
  • Ahmad Alsaiari
  • Ayman Krayem
Original Article



Clinical observation hinted improved symptoms of restless legs syndrome (RLS) after vitamin D supplements. Hence, the aim of this study is to evaluate the effect of vitamin D supplementation on the severity of RLS symptoms.


Twelve adult subjects diagnosed with primary RLS and vitamin D deficiency were recruited. Patients with secondary RLS were excluded from this study. The complete cell count; serum levels of ferritin, iron, glycated hemoglobin, and vitamin D3 (25 (OH) vitamin D); and renal and bone profiles of the patients were assayed. Patients with vitamin D deficiency (<50 nmol/l) were treated with vitamin D3 supplements (high oral dose or intramuscular injection). The severity scores of RLS were reassessed after the vitamin D3 level was corrected to >50 nmol/l and compared with those before the administration of the supplements.


The median pretreatment vitamin D level was 21.7 nmol/l (13.45–57.4), which improved to 61.8 nmol/l (42.58–95.9) (P = 0.002) with the treatment. The median RLS severity score improved significantly from 26 (15–35) at baseline to 10 (0–27) after correction of the vitamin D levels (P = 0.002).


This study indicates that vitamin D supplementation improves the severity of RLS symptoms and advocates that vitamin D deficiency is conceivably associated with RLS.


Restless legs syndrome Vitamin D deficiency Rating score Diagnosis 


Conflict of interest

The authors have reported no significant conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Funding support


Author contributorship

Siraj Wali and Ayman Krayem wrote the proposal, recruited the patients, interpreted the results, and wrote the manuscript. Afnan Shukr, Ayah Boudal, and Ahmad Alsaiari recruited the patients, conducted the statistical analysis, and wrote the manuscript.


  1. 1.
    Ohayon MM, O'Hara R, Vitiello MV (2012) Epidemiology of restless legs syndrome: a synthesis of the literature. Sleep Med Rev 16:283–295PubMedCentralCrossRefPubMedGoogle Scholar
  2. 2.
    Phillips B, Young T, Finn L, Asher K, Hening WA, Purvis C (2000) Epidemiology of restless legs symptoms in adults. Arch Intern Med 160:2137–2141CrossRefPubMedGoogle Scholar
  3. 3.
    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 164:196CrossRefPubMedGoogle Scholar
  4. 4.
    Ibia M, Sawadab H, Nakanishia M, Kumea T, Katsukia H, Kanekoc S, Shimohamab S, Akaikea A (2001) Protective effects of 1,25-(OH)2D3 against the neurotoxicity of glutamate and reactive oxygen species in mesencephalic culture. Neuropharmacology 40:761–771CrossRefGoogle Scholar
  5. 5.
    Prakash S, Bhanvadia RJ, Shah ND (2010) Restless legs syndrome with carbamazepine-induced osteomalacia: causal or casual association. Gen Hosp Psychiatry 32(2):228CrossRefPubMedGoogle Scholar
  6. 6.
    Allen RP, Picchietti D, Hening WA, Trenkwalder C, Walters AS, Montplaisi J (2003) Restless legs syndrome: diagnostic criteria, special considerations, and epidemiology. A report from the restless legs syndrome diagnosis and epidemiology workshop at the National Institutes of Health. Sleep Med 4(2):101–119CrossRefPubMedGoogle Scholar
  7. 7.
    Walters AS, LeBrocq C, Dhar A, Hening W, Rosen R, Allen RP, Trenkwalder C, International Restless Legs Syndrome Study Group (2003) Validation of the International Restless Legs Syndrome Study Group rating scale for restless legs syndrome. Sleep Med 4:121–132CrossRefPubMedGoogle Scholar
  8. 8.
    Abetz L, Arbuckle R, Allen RP, Garcia-Borreguero D, Hening W, Walters AS, Mavraki E, Kirsch JM (2006) The reliability, validity and responsiveness of the International Restless Legs Syndrome Study Group rating scale and subscales in a clinical-trial setting. Sleep Med 7(4):340–349CrossRefPubMedGoogle Scholar
  9. 9.
    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):814–818PubMedGoogle Scholar
  10. 10.
    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):102–106CrossRefPubMedGoogle Scholar
  11. 11.
    Balaban H, Yıldız ÖK, Çil G, Şentürk İA, Erselcan T, Bolayır E, Topaktaş S (2012) Serum 25- hydroxyvitamin D levels in restless legs syndrome patients. Sleep Med 13(7):953–957CrossRefPubMedGoogle Scholar
  12. 12.
    Allen RP, Earley CJ (2007) The role of iron in restless legs syndrome. MovDisord 22(18):440–448Google Scholar
  13. 13.
    Zucconi M, Manconi M (2008) Sleep and quality of life in restless legs syndrome. In: Verster JC, Pandi-Perumal SR, Streiner D (eds) Sleep and quality of life in clinical medicine. Humana Press, Totowa, NJGoogle Scholar
  14. 14.
    Manconi M, Ferri R, Zucconi M, Clemens S, Giarolli L, Bottasini V, Ferini-Strambi L (2011) Preferential D2 or preferential D3 dopamine agonists in restless legs syndrome. Neurology 77(2):110–117CrossRefPubMedGoogle Scholar
  15. 15.
    Walters AS, Rye DB (2009) Review of the relationship of restless legs syndrome and periodic limb movements in sleep to hypertension, heart disease, and stroke. Sleep 32(5):589–597PubMedCentralPubMedGoogle Scholar
  16. 16.
    Meguro S, Tomita M, Katsuki T, Kato K, Oh H, Ainai A, Ito R, Takeda S, Kawai T, Atsumi Y, Itoh H, Hasegawa H (2011) Plasma 25- hydroxyvitamin D is independently associated with hemoglobin concentration in male subjects with type 2 diabetes mellitus. Int J Endocrinol 362981:5. doi: 10.1155/2011 Google Scholar
  17. 17.
    Abou-Raya S, Helmii M, Abou-Raya A (2009) Bone and mineral metabolism in older adults with Parkinson’s disease. Age Ageing 38(6):675–680CrossRefPubMedGoogle Scholar
  18. 18.
    Evatt ML, Delong MR, Khazai N, Rosen A, Triche S, Tangpricha V (2008) Prevalence of vitamin d insufficiency in patients with Parkinson disease and Alzheimer disease. Arch Neurol 65(10):1348–1352PubMedCentralCrossRefPubMedGoogle Scholar
  19. 19.
    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 236:77–87CrossRefPubMedGoogle Scholar
  20. 20.
    Newmark HL, Newmark J (2007) Vitamin D and Parkinson’s disease—a hypothesis. Mov Disord 22(4):461–468CrossRefPubMedGoogle Scholar
  21. 21.
    Danielle ED, Lydia MM, Natalie LC, Jeanne EM, Mahlon RD, Kurt DP, Jonathan AD, Tangpricha V, Gary WM, Marian LE (2012) 25-Hydroxyvitamin D depletion does not exacerbate MPTP-induced dopamine neuron damage in mice. PLoS ONE 7(7):e39227CrossRefGoogle Scholar
  22. 22.
    Garcia-Borreguero D, Kohnen R, Boothby L, Tzonova D, Larrosa O, Dunkl E (2013) Validation of the multiple suggested immobilization test: a test for the assessment of severity of restless legs syndrome (Willis-Ekbom disease). Sleep 36(7):1101–1109PubMedCentralPubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Siraj Wali
    • 1
    • 3
    Email author
  • Afnan Shukr
    • 1
  • Ayah Boudal
    • 1
  • Ahmad Alsaiari
    • 1
  • Ayman Krayem
    • 2
  1. 1.Sleep Medicine and Research CenterKing Abdulaziz UniversityJeddahSaudi Arabia
  2. 2.Sleep Disorders CenterKing Abdulaziz Medical CityJeddahSaudi Arabia
  3. 3.Associate Professor of Medicine College of MedicineKing Abdulaziz University Sleep Medicine and Research Center King Abdulaziz University HospitalJeddahSaudi Arabia

Personalised recommendations