Abstract
We aimed to investigate the prevalence of restless legs syndrome (RLS) and sleep disorders in patients with rheumatoid arthritis (RA), and the association of iron deficiency with them. The study included 72 patients with RA (59 females, 13 males), and 50 healthy control subjects (57 females, 15 males). Assessments were made using the International RLS Rating Scale, Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale, Fatigue Severity Scale (FSS), Beck anxiety and depression index and the SF-36 quality of life scores. We found that the frequency of RLS in RA patients was 29.1% and 13.8% in healthy control (p = 0.021). RA patients had 44.4% iron deficiency and 5.5% anemia of chronic disease. We found that 52.3% of patients with iron deficiency had RLS. There was an independent relationship between present of RLS and FSS (Beta [β] = 0.317, p = 0.005) and total iron binding capacity (TIBC) (β = 0.244, p = 0.031). There was an independent relationship between RLS severity score and PSQI (β = 0.264, p = 0.025) and social functionality (β = 0.302, p = 0.009). The prevalence of iron deficiency is high in RA in the developing countries. Analysis obtained in patients with RA is suggestive of an association between iron deficiency and increased frequency of RLS. The presence of RLS in patients with RA negatively affects sleep quality, psychiatric status, and quality of life of patients with RA. TIBC value may be a predictive marker for early detection of RLS in patients with RA.
Highlights
Rheumatoid arthritis (RA) affects approximately 0.5% to 1% of the population worldwide [1]
Erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) values of RA patients were higher than the control group
When correlation analysis was performed in the patient group, we found that the restless legs syndrome (RLS) severity score was positively associated with Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index, Fatigue Severity Scale, BECK ANXIETY INVENTORY (BAI), BECK DEPRESSION INVENTORY (BDI), pain, and total iron binding capacity (TIBC) values
Summary
Rheumatoid arthritis (RA) affects approximately 0.5% to 1% of the population worldwide [1]. RA is a systemic, chronic autoimmune disease that symmetrically leads to arthritis in the joints. It is three to four times more common in women than in men. RA can affect the central and peripheral nervous system and many organs. Anemia is common in patients with RA and has multifactorial pathogenesis [3]. Most types of anemia can be seen in RA patients, iron deficiency anemia (IDA) and anemia of chronic disease (ACD) are common [3]. In patients with RA, IDA is mostly caused by chronic blood loss from the gastrointestinal tract due to gastritis (due to the use of non-steroidal anti-inflammatory drugs), peptic ulcer, or diaphragmatic hernia. Most patients with IDA are asymptomatic [4]
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