Advertisement

Acta Neurologica Belgica

, Volume 115, Issue 4, pp 623–627 | Cite as

An evaluation of sleep quality and the prevalence of restless leg syndrome in vitamin D deficiency

  • Tuncay ÇakırEmail author
  • Gülsüm Doğan
  • Volkan Subaşı
  • Meral Bilgilisoy Filiz
  • Nur Ülker
  • Şebnem Koldaş Doğan
  • Naciye Füsun Toraman
Original Article

Abstract

Vitamin D is known to increase levels of dopamine and its metabolites in the brain and also protects dopaminergic neurons against dopaminergic toxins. The aims of the study were to assess the frequency and symptom severity of restless leg syndrome (RLS) and sleep quality in vitamin D deficiency. A total of 102 patients were enrolled in this cross-sectional study, comprising 57 vitamin D deficient patients as Group 1 and 45 patients with normal levels of vitamin D as Group 2. RLS was diagnosed according to the International RLS Study Group (IRLSSG) diagnostic criteria. Symptom severity was assessed using the IRLSSG rating scale and sleep quality was measured with the Pittsburgh sleep quality index (PSQI). RLS incidence was higher in Group 1 (p = 0.034). The PSQI scores were higher in Group 1 and the difference between the groups was determined as statistically significant (p < 0.05). No statistically significant difference was determined in respect of the clinical evaluation and the IRLSSG Symptom Severity Scale between the patients in Group 1 diagnosed with RLS and the patients in Group 2 diagnosed with RLS (p > 0.05). The findings of this study support the hypothesis that RLS is more frequent and more severe in vitamin D deficiency and indicate a negative effect of vitamin deficiency on sleep parameters.

Keywords

Vitamin D Sleep quality Restless leg syndrome Leg pain 

Notes

Conflict of interest

All the authors declare that they have no conflict of interest, and the study has no financial support.

Ethical Standard

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.

Informed consent

Additional informed consent was obtained from all individual participants for whom identifying information is included in this article.

References

  1. 1.
    Holick MF (2009) MrOs is D-ficient. J Clin Endocrinol Metab 94(4):1092–1093CrossRefPubMedGoogle Scholar
  2. 2.
    Bordelon P, Ghetu MV, Langan R (2009) Recognition and management of vitamin D deficiency. Am FamPhysician 80(8):841–846Google Scholar
  3. 3.
    Mosekilde L (2005) Vitamin D and the elderly. Clin Endocrinol (Oxf) 62(3):265–281CrossRefGoogle Scholar
  4. 4.
    Holick MF, Chen TC (2008) Vitamin D deficiency: a worldwide problem with health consequences. Am J Clin Nutr 87(4):1080–1086Google Scholar
  5. 5.
    Parisi AV, Wilson CA (2005) Pre-vitamin D3 effective ultraviolet transmission through clothing duringsimulated wear. Photodermatol Photoimmunol Photomed 21:303–310CrossRefPubMedGoogle Scholar
  6. 6.
    Zittermann A (2006) Vitamin D and disease preventionwith special reference to cardiovascular disease. Prog Biophys Mol Biol 92:39–48CrossRefPubMedGoogle Scholar
  7. 7.
    Eyles DW, Feron F, Cui X, Kesby JP, HarmsLH Ko P et al (2009) Developmental vitamin D deficiency causes abnormal brain development. Psychoneuroendocrinology 34(Suppl 1):S247–S257CrossRefPubMedGoogle Scholar
  8. 8.
    Fernandes de Abreu DA, Eyles D, Féron F (2009) Vitamin D, a neuro-immunomodulator: implications forneurodegenerative and autoimmune diseases. Psychoneuroendocrinology 34(1):265–277CrossRefGoogle Scholar
  9. 9.
    Michaud M, Paquet J, Lavigne G, Desautels A, Montplaisir J (2002) Sleep laboratory diagnosis of restless legs syndrome. Eur Neurol 48:108–113CrossRefPubMedGoogle Scholar
  10. 10.
    O’Keeffe ST (1996) Restless legs syndrome. Arch Intern Med 156:243–248CrossRefPubMedGoogle Scholar
  11. 11.
    O’Keeffe ST (2005) Iron deficiency with normal ferritin levels in restless legs syndrome. Sleep Med 6:281–282CrossRefPubMedGoogle Scholar
  12. 12.
    Krishnan PR, Bhatia M, Behari M (2003) Restless legs syndrome in Parkinson’s disease: a case-controlled study. Mov Disord 18:181–185CrossRefPubMedGoogle Scholar
  13. 13.
    Rye DB (2004) Parkinson’s disease and RLS: the dopaminergic bridge. Sleep Med 5:317–328CrossRefPubMedGoogle Scholar
  14. 14.
    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
  15. 15.
    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. doi: 10.1007/s11325-014-1049-y
  16. 16.
    Allen RP, Picchietti D, Hening WA, Trenkwalder C, Walters AS, Montplaisi J (2003) Restless legs syndrome diagnosis and epidemiology workshop at the National Institutes of Health International Restless Legs Syndrome Study Group. 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
  17. 17.
    Ozder A, Eker HH (2014) Anxiety levels among Turkish public transportation drivers: a relation to restless legs syndrome. Int J Clin Exp Med. 7(6):1577–1584PubMedCentralPubMedGoogle Scholar
  18. 18.
    Sevim S, Dogu O, Camdeviren H (2003) Unexpectedly low prevalence and unusual characteristics of RLS in Mersin, Turkey. Neurology 61:1562–1569CrossRefPubMedGoogle Scholar
  19. 19.
    Buysse DJ, Reynolds CF 3rd, Monk TH (1989) The Pittsburgh sleep quality index: a new instrument for psychiatric practice and research. Psychiatry Res 28:193–213CrossRefPubMedGoogle Scholar
  20. 20.
    Buysse DJ, Reynolds CF 3rd, Monk TH (1991) Quantification of subjective sleep quality in healthy elderly men and women using the Pittsburgh sleep quality index (PSQI). Sleep 14:331–338PubMedGoogle Scholar
  21. 21.
    Ağargün MY, Kara H, Anlar O (1996) Pittsburgh Uyku Kalitesi İndeksinin geçerliği ve güvenirliği. Türk Psikiyatri Derg 7:107–115Google Scholar
  22. 22.
    Mathis J (2005) Update on restless legs. Swiss Med Wkly 135:687–696PubMedGoogle Scholar
  23. 23.
    Shuler FD, Wingate MK, Moore GH, Giangarra C (2012) Sports health benefits of vitamin d. Sports Health 4(6):496–501PubMedCentralCrossRefPubMedGoogle Scholar
  24. 24.
    Çidem M, Kara S, Sarı H, Özkaya M, Karacan İ (2013) Yaygın kas-iskelet ağrısı olan hastalarda D vitamini eksikliği prevalansı ve risk faktörleri. J Clin Exp Investig 4(4):488–491CrossRefGoogle Scholar
  25. 25.
    Wang JY, Wu JN, Cherng TL, Hoffer BJ, Chen HH, Borlongan CV et al (2001) Vitamin D(3) attenuates 6-hydroxydopamine-induced neurotoxicity in rats. Brain Res 904:67–75CrossRefPubMedGoogle Scholar
  26. 26.
    Sapolsky RM (1996) Stress, glucocorticoids and damage to the nervous system: the current state of confusion. Stress 1:1–19CrossRefPubMedGoogle Scholar
  27. 27.
    Tekes K, Gyenge M, Folyovich A, Csaba G (2009) Influence of neonatal vitamin A or vitamin D treatment on the concentration of biogenic amines and their metabolites in the adult rat brain. Horm Metab Res 41(4):277–280CrossRefPubMedGoogle Scholar
  28. 28.
    Heldenberg D, Tenenbaum G, Weisman Y (1992) Effect of iron on serum 25-hydroxyvitamin D and 24,25-dihydroxyvitamin D concentrations. Am J Clin Nutr 56(3):533–536PubMedGoogle Scholar
  29. 29.
    Masuhara T, Migicovsky BB (1963) Vitamin D and the intestinal absorption of iron and cobalt. J Nutr 80:332–336PubMedGoogle Scholar
  30. 30.
    Dosman C, Witmans M, Zwaigenbaum L (2012) Iron’s role in paediatric restless legs syndrome—a review. Paediatr Child Health 17(4):193–197PubMedCentralPubMedGoogle Scholar
  31. 31.
    Oner P, Dirik EB, Taner Y, Caykoylu A, Anlar O (2007) Association between low serum ferritin and restless legs syndrome in patients with attention deficit hyperactivity disorder. Tohoku J Exp Med 213(3):269–276CrossRefPubMedGoogle Scholar
  32. 32.
    Patrick LR (2007) Restless legs syndrome: pathophysiology and the role of iron and folate. Altern Med Rev 12(2):101–112PubMedGoogle Scholar
  33. 33.
    Peeraully T, Tan EK (2012) Linking restless legs syndrome with Parkinson’s disease: clinical, imaging and genetic evidence. Transl Neurodegener 1(1):1–6CrossRefGoogle Scholar
  34. 34.
    Garcia-Borreguero D, Odin P, Schwarz C (2004) Restless legs syndrome: an overview of the current understanding and management. Acta Neurol Scand 109(5):303–317CrossRefPubMedGoogle Scholar
  35. 35.
    Cervenka S, Pålhagen SE, Comley RA, Panagiotidis G, Cselényi Z, Matthews JC, Lai RY, Halldin C, Farde L (2006) Support for dopaminergic hypoactivity in restless legs syndrome: a PET study on D2-receptor binding. Brain 129:2017–2028CrossRefPubMedGoogle Scholar
  36. 36.
    Garcia-Borreguero D, Odin P, Serrano C (2003) Restless legs syndrome and PD: a review of the evidence for a possible association. Neurology 61:49–55CrossRefGoogle Scholar
  37. 37.
    Burke RA, Faulkner MA (2012) Review of the treatment of restless legs syndrome: focus on gabapentin enacarbil. J Cent Nerv Syst Dis. 17(4):147–156CrossRefGoogle Scholar
  38. 38.
    Zobeiri M, Shokoohi A (2014) Restless leg syndrome in diabetics compared with normal controls. Sleep Disord. 2014:1–4. doi: 10.1155/2014/871751 CrossRefGoogle Scholar
  39. 39.
    Oran M, Unsal C, Albayrak Y, Tulubas F, Oguz K, Avci O, Turgut N, Alp R, Gurel A (2014) Possible association between vitamin D deficiency and restless legs syndrome. Neuropsychiatr Dis Treat 21(10):953–958CrossRefGoogle Scholar
  40. 40.
    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
  41. 41.
    Huang W, Shah S, Long Q, Crankshaw AK, Tangpricha V (2013) Improvement of pain, sleep and quality of life in chronic pain patients with vitamin D supplementation. Clin J Pain 29(4):341–347CrossRefPubMedGoogle Scholar

Copyright information

© Belgian Neurological Society 2015

Authors and Affiliations

  • Tuncay Çakır
    • 1
    Email author
  • Gülsüm Doğan
    • 1
  • Volkan Subaşı
    • 2
  • Meral Bilgilisoy Filiz
    • 1
  • Nur Ülker
    • 3
  • Şebnem Koldaş Doğan
    • 1
  • Naciye Füsun Toraman
    • 1
  1. 1.Department of Physical Medicine and RehabilitationAntalya Training and Research HospitalAntalyaTurkey
  2. 2.Private Dermancan Medical CenterAdanaTurkey
  3. 3.Physical Medicine and Rehabilitation ClinicsKaş State HospitalKaşTurkey

Personalised recommendations