Effects of short- and long-term variations in RLS severity on perceived health status - the COR-study.

Andrea Fuhs,Johannes Mathis,Claudia Trenkwalder,Klaus Berger,Rafael Antkowiak,Dunya Bentama,Jan Kassubek

doi:10.1371/journal.pone.0094821

Andrea Fuhs, Johannes Mathis + Show 5 more

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https://doi.org/10.1371/journal.pone.0094821

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Abstract

In a cohort study among 2751 members (71.5% females) of the German and Swiss RLS patient organizations changes in restless legs syndrome (RLS) severity over time was assessed and the impact on quality of life, sleep quality and depressive symptoms was analysed. A standard set of scales (RLS severity scale IRLS, SF-36, Pittsburgh Sleep Quality Index and the Centre for Epidemiologic Studies Depression Scale) in mailed questionnaires was repeatedly used to assess RLS severity and health status over time and a 7-day diary once to assess short-term variations. A clinically relevant change of the RLS severity was defined by a change of at least 5 points on the IRLS scale. During 36 months follow-up minimal improvement of RLS severity between assessments was observed. Men consistently reported higher severity scores. RLS severity increased with age reaching a plateau in the age group 45–54 years. During 3 years 60.2% of the participants had no relevant (±5 points) change in RLS severity. RLS worsening was significantly related to an increase in depressive symptoms and a decrease in sleep quality and quality of life. The short-term variation showed distinctive circadian patterns with rhythm magnitudes strongly related to RLS severity. The majority of participants had a stable course of severe RLS over three years. An increase in RLS severity was accompanied by a small to moderate negative, a decrease by a small positive influence on quality of life, depressive symptoms and sleep quality.

Highlights

Restless legs syndrome is a common sleep disorder with prevalences between 5 and 10% in population based studies in Europe and North America [1,2,3,4].The prevalence of restless legs syndrome (RLS) increases with age, while the course of the disease, i.e. the pattern of symptom severity over time, is unclear
The prevalence of RLS increases with age, while the course of the disease, i.e. the pattern of symptom severity over time, is unclear. Assessing the latter has been predominantly done in clinical trials testing specific single medication over follow-up periods between one week and 35 months [5]. It is unknown if RLS is a chronic condition progressing slowly after onset over the life span or expresses other patterns over long time periods in individual patients depending on life events or associated diseases
An increase of the IRLS score by one point yielded a significant increase of the Center for Epidemiological Studies Depression Scale (CES-D) score by 0.21 points

Summary

Introduction

Restless legs syndrome is a common sleep disorder with prevalences between 5 and 10% in population based studies in Europe and North America [1,2,3,4]. The prevalence of RLS increases with age, while the course of the disease, i.e. the pattern of symptom severity over time, is unclear Assessing the latter has been predominantly done in clinical trials testing specific single medication over follow-up periods between one week and 35 months [5]. Better knowledge of short-term fluctuations and long-term severity patterns might enable an individual to better cope with the consequences of the disease Aim of this analysis was to evaluate individual variations of RLS severity over a short, i.e. 7-day, and a long, i.e. 36-month timeperiod and to analyse the impact of these variations on self. Doi:10.1371/journal.pone.0094821.t001 perceived quality of life, sleep quality and depressive symptoms in a cohort of German and Swiss RLS patients

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