Abstract
BackgroundBased on questionnaire criteria, the sensorimotor disorder restless legs syndrome (RLS) has been reported to have a higher prevalence in rheumatoid arthritis (RA) patients than in the general population. There has been some speculation that peripheral arthritic symptoms may allow false positive responses to questionnaire criteria. This study evaluates whether RA patients meeting RLS questionnaire criteria also have objective evidence of increased periodic limb movements (PLMs) characteristic of RLS.MethodsParticipants were recruited from RA clinic. Questionnaire data collected at study entry included: pain scores, rheumatoid arthritis disease activity index, Epworth sleepiness scale, Pittsburgh sleep quality index and RLS diagnostic criteria. Each participant was provided a PAM-RL actigraphic monitor, which attached to the ankle. This device was worn for two consecutive nights then returned for data download. Laboratory data including hemoglobin, iron studies, renal function and C-reactive protein levels were collected.ResultsOf the 57 participants, 23 met RLS diagnostic criteria. Those who met RLS criteria demonstrated higher mean frequency of nocturnal PLMs (19.63/hour; SD:21.13) than those who did not meet RLS criteria (11.13/hour; SD:12.10; p = 0.033). There were no significant differences between groups in terms of patient characteristics, disease activity or duration measures. Patients meeting RLS criteria did have poorer sleep quality measures (p <0.001).ConclusionsRA patients who met RLS diagnostic criteria demonstrated higher frequencies of nocturnal PLMs than RA patients who did not meet criteria for RLS. This finding supports use of the RLS diagnostic criteria in helping to differentiate between RA arthritic symptoms and RLS.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2474-15-378) contains supplementary material, which is available to authorized users.
Highlights
Based on questionnaire criteria, the sensorimotor disorder restless legs syndrome (RLS) has been reported to have a higher prevalence in rheumatoid arthritis (RA) patients than in the general population
Of the 57 RA patients who participated in this study, 9 were male (15.8%)
Of the 57 participants, 23 met the essential diagnostic criteria for restless legs syndrome and 34 did not. These two groups of participants were compared for differences in age, body mass index (BMI), various laboratory parameters, RA disease activity assessments, and in sleep health (Table 1)
Summary
The sensorimotor disorder restless legs syndrome (RLS) has been reported to have a higher prevalence in rheumatoid arthritis (RA) patients than in the general population. This study evaluates whether RA patients meeting RLS questionnaire criteria have objective evidence of increased periodic limb movements (PLMs) characteristic of RLS. Restless legs syndrome (RLS), known as Willis Ekbom disease, is a sensorimotor disorder reported at an increased prevalence in people with rheumatoid arthritis (RA). In 2003 the International Restless Legs Syndrome Study Group (IRLSSG) published diagnostic criteria for RLS [3]. Utilizing these RLS criteria in a Canadian RA outpatient cohort, 27.7% of patients were found to meet criteria [4]. RA patients with RLS have been observed to report poorer sleep quality, increased pain, depression, and poorer quality of life scores than those without RLS [5]
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