Actigraphy as a marker for therapy efficacy in patients with restless legs syndrome against the background of diabetic polyneuropathy

Abstract

Objective — to determine the effectiveness of complex treatment in patients with restless leg syndrome due to diabetic polyneuropathy by means of actigraphy and diagnostic scales. Methods and subjects. 43 patients with diabetic polyneuropathy, demonstrating the absence of gabapentin treatment effectiveness, were diagnosed with restless legs syndrome using the main and auxiliary diagnostic criteria. Patients were divided into 2 groups. Patients of the I group (n = 21) received pramipexole, patients of the second group (n = 22) received pramipexole in combination with zopiclone. The patients were interviewed on the international restless legs scale and the Epworth drowsiness scale. To objectify the manifestations and the treatment effectiveness all patients underwent actigraphy on admission and 30 days after the treatment. Results of the research and their discussion. While determining the dynamics of periodic limb movement index during sleep, it was found that it decreased in both groups and was 6.87 ± 0.02 versus 16.29 ± 0.13 before treatment in I group (p < 0.05) and 4.79 ± 0.04 versus 17.34 ± 0.12 before treatment in ІІ group (p < 0.05). According to the Epworth scale, the reduction of the scale score in both groups was found. In patients of the I group after treatment it was 7.86 ± 0.12 points, that is typical for the moderate drowsiness, as opposed to the ІІ group, where the scale score reduced to the 4.43 ± 0.13 points, which is typical for normal sleep (p < 0.05). Conclusions. The findings proved that the monotherapy with pramipexole improves the condition of the patients with restless leg syndrome, reducing the motor component of the disease, but does not significantly affect sleep. Therefore, the combination of pramipexole with zopiclone is more effective, which improves the sleep, reduces daytime sleepiness and positively affects the quality of patients life.