Abstract
<strong>Background:</strong> Restless legs syndrome (RLS) is a common sleep disorder,. although controversial, growing evidence relates the presence of RLS to an increased risk of mortality, mainly due to cardiovascular events. The aim of this article was to review the role of RLS as a risk factor of mortality according to independent cohort studies. <strong>Methods:</strong> We performed a literature review via PubMed database for articles relating RLS and mortality. We used the random-effects model to calculate the pooled effect estimates on mortality. Heterogeneity between studies was assessed using quantitative and qualitative analysis. <strong>Results:</strong> Out of 100 articles identified, 13 were finally included. Although studies were heterogeneous (p = 0.001), no significant publication bias was found. When all cohort studies were considered, the random-effects model yielded a significantly increased risk of mortality in RLS versus non-RLS patients (13 studies, hazard ratio [HR] = 1.52, 95% confidence interval [CI] 1.28–1.80). However, this association was not statistically significant when only cohort studies using the international RLS diagnostic criteria were considered (5 studies, HR = 1.63, 95% CI 0.94–2.81). <strong>Discussion:</strong> The results of this meta-analysis suggest that RLS seems to be a risk factor of mortality, although this association is conditioned by the diagnostic criteria used in the studies. Future long-term follow-up standardized mortality studies are needed to address this important question that carries potential impact on population global health.
Highlights
Restless legs syndrome (RLS) is defined as an urge to move the legs when resting or lying down, especially at night, that is relieved by activity.[1]
According to the random-effects model including the 13 selected cohort studies, the pooled hazard ratios (HR) for mortality in patients with RLS compared to non-RLS was HR = 1.52 (Figure 2A)
In this meta-analysis including 13 cohort studies, using different RLS diagnostic criteria, we observed a higher risk of mortality among patients presenting RLS, likely associated with cardiovascular diseases and especially in women, compared to non-RLS population
Summary
Restless legs syndrome (RLS) is a common sleep disorder, with an estimated prevalence of 5 to 10% of the adult population.[1,2,3] RLS is defined as an urge to move the legs when resting or lying down, especially at night, that is relieved by activity.[1]. When all cohort studies were considered, the random-effects model yielded a significantly increased risk of mortality in RLS versus non-RLS patients (13 studies, hazard ratio [HR] = 1.52, 95% confidence interval [CI] 1.28–1.80). This association was not statistically significant when only cohort studies using the international RLS diagnostic criteria were considered (5 studies, HR = 1.63, 95% CI 0.94–2.81). Discussion: The results of this meta-analysis suggest that RLS seems to be a risk factor of mortality, this association is conditioned by the diagnostic criteria used in the studies.
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