Abstract
Background
As a common neurological movement disorder, restless leg syndrome (RLS) is often seen in patients with multiple sclerosis (MS). However, the relationship between RLS and MS is still unclear. This case-control study aimed to measure RLS prevalence and uncover its association with MS, as well as to identify possible associated risk factors.
Methods
Six hundred and ninety-five patients were randomly selected from a cohort of patients with MS at the Neurology Department of our hospital, and a group of age- and sex-matched healthy controls (n = 603) was enrolled from the general population. Using a face-to-face interview questionnaire, we collected data on RLS incidence in participants with or without MS. We further assessed sleep quality in all the participants.
Results
We found there to be a significantly higher prevalence of RLS among patients with MS compared to healthy controls (odds ratio [OR], 3.8; P < 0.001). Risk factors such as an older MS age at onset and a longer MS duration were significantly associated with the presence of RLS. Furthermore, patients with both MS and RLS were more likely to suffer from sleep complaints compared to patients with MS without RLS.
Conclusions
RLS was significantly associated with MS and was found to have a significant impact on sleep quality, particularly in patients with MS.
Similar content being viewed by others
References
Guerreiro TM, Nishikawa DR, Ferreira LC, Melo HA, Prado RC (2010) Restless legs syndrome in Parkinson’s disease: clinical characteristics and biochemical correlations. Arq Neuropsiquiatr 68(6):869–872
Allen RP, Earley CJ (2001) Restless legs syndrome: a review of clinical and pathophysiologic features. J Clin Neurophysiol 18:128–147
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 13:1153–1157
Li LH, Chen HB, Zhang LP, Wang ZW, Wang CP (2012) A community-based investigation on restless legs syndrome in a town in China. Sleep Med 13(4):342–5
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 4:101–119
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
Manconi M, Govoni V, De Vito A, Economou NT, Cesnik E, Casetta I et al (2004) Restless legs syndrome and pregnancy. Neurology 63:1065–9
Allen R (2004) Dopamine and iron in the pathophysiology of restless legs syndrome (RLS). Sleep Med 5:385–91
Merlino G, Piani A, Dolso P, Adorati M, Cancelli I, Valente M et al (2006) Sleep disorders in patients with end-stage renal disease undergoing dialysis therapy. Nephrol Dial Transplant 21:184–90
Walters AS, Hening W, Rubinstein M, Chokroverty S (1991) A clinical and polysomnographic comparison of neuroleptic-induced akathisia and the idiopathic restless legs syndrome. Sleep 14:339–45
Polydefkis M, Allen RP, Hauer P, Earley CJ, Griffin JW, McArthur JC (2000) Subclinical sensory neuropathy in late-onset restless legs syndrome. Neurology 55:1115–21
Ondo WG, Lai D (2006) Association between restless legs syndrome and essential tremor. Mov Disord 21:515–8
Brown LK, Heffner JE, Obbens EA (2000) Transverse myelitis associated with restless legs syndrome and periodic movements of sleep responsive to an oral dopaminergic agent but not to intrathecal baclofen. Sleep 23:591–4
Rye DB (2004) Parkinson’s disease and RLS: the dopaminergic bridge. Sleep Med 5:317–28
Italian REMS Study Group, Manconi M, Ferini-Strambi L, Filippi M, Bonanni E, Iudice A et al (2008) Multicenter case-control study on restless legs syndrome in multiple sclerosis: the REMS study. Sleep 31:944–52
Deriu M, Cossu G, Molari A, Murgia D, Mereu A, Ferrigno P et al (2009) Restless legs syndrome in multiple sclerosis: a case-control study. Mov Disord 24:697–701
Aydar G, Kurt S, Karaer Unaldi H, Erkorkmaz U (2011) Restless legs syndrome in multiple sclerosis. Eur Neurol 65:302–6
Fragoso YD, Finkelsztejn A, Gomes S, Kaimen-Maciel DR, Oliveira CLS, Lopes J et al (2011) Restless legs syndrome and multiple sclerosis: a Brazilian multicenter study and meta-analysis of the literature. Arq Neuropsiquiatr 69:180–3
Li Y, Munger KL, Batool-Anwar S, De Vito K, Ascherio A, Gao X (2012) Association of multiple sclerosis with restless legs syndrome and other sleep disorders in women. Neurology 78:1500–6
Shaygannejad V, Ardestani PE, Ghasemi M, Meamar R (2013) Restless legs syndrome in Iranian multiple sclerosis patients: a case-control study. Int J Prev Med 4:S189–93
Gomez-Choco MJ, Iranzo A, Blanco Y, Graus F, Santamaria J, Saiz A (2007) Prevalence of restless legs syndrome and REM sleep behavior disorder in multiple sclerosis. Mult Scler 13:805–8
McDonald WI, Compston A, Edan G, Goodkin D, Hartung HP, Lublin FD et al (2001) Recommended diagnostic criteria for multiple sclerosis: guidelines from the International Panel on the diagnosis of multiple sclerosis. Ann Neurol 50:121–127
Weinstock LB, Walters AS, Paueksakon P (2012) Restless legs syndrome—theoretical roles of inflammatory and immune mechanisms. Sleep Med Rev 16:341e54
Manconi M, Fabbrini M, Bonanni E, Filippi M, Rocca M, Murri L et al (2007) High prevalence of restless legs syndrome in multiple sclerosis. Eur J Neurol 14(5):534–539
Mery V, Kimoff RJ, Suarez I, Benedetti A, Kaminska M, Robinson A (2015) High false-positive rate of questionnaire-based restless legs syndrome diagnosis in multiple sclerosis. Sleep Med
Vavrova J, Kemlink D, Sonka K, Havrdova E, Horakova D et al (2012) Restless legs syndrome in Czech patients with multiple sclerosis: an epidemiological and genetic study. Sleep Med 13:848–51
Moreira NC, Damasceno RS, Medeiros CA, Bruin PF, Teixeira CA, Horta WG et al (2008) Restless leg syndrome, sleep quality and fatigue in multiple sclerosis patients. Braz J Med Biol Res 41(10):932–937
Manconi M, Rocca MA, Ferini-Strambi L, Tortorella P, Agosta F, Comi G et al (2008) Restless legs syndrome is a common finding in multiple sclerosis and correlates with cervical cord damage. Mult Scler 14(1):86–93
Acknowledgments
We thank all the participants and staff who took part in the questionnaire survey. This study was supported by the Natural Science Foundation of China (U1304804) and the Youth Innovation Fund of The First Affiliated Hospital of Zhengzhou University.
Conflicts of interest
The authors declare that they have no competing interests.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Liu, G., Feng, X., Lan, C. et al. Restless leg syndrome and multiple sclerosis: a case-control study in China. Sleep Breath 19, 1355–1360 (2015). https://doi.org/10.1007/s11325-015-1201-3
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11325-015-1201-3