International Restless Legs Syndrome Study Research Articles

Urges to move and struggles to breathe: restless legs syndrome/WillisEkbom disease in adult patients with obstructive sleep apnea.

Recent evidences pointed out that the prevalence of comorbidity of restless legs syndrome/Willis-Ekbom disease (RLS/WED) and obstructive sleep apnea (OSA) is around 20%. Nonetheless its association factors have not been extensively evaluated after the recent modification in diagnostic criteria. We aimed to estimate the prevalence of RLS/WED and its association factors with OSA in an adult sample. This was a prospective, cross-sectional study including 490 adult patients with OSA diagnosis (apnea-hypopnea index ≥ 5 obstructive events/hour associated to clinical picture). RLS/WED diagnosis was established by the 2014 International Restless Legs Syndrome Study Group (IRLSSG) criteria established by face-to-face interview with a neurologist. The prevalence of RLS/WED was 18.6% (n = 91) and its diagnosis was previously established in 13.2% (n = 12/91). The mean IRLSSG severity score was 17.0 (standard deviation 6.8). RLS/WED was associated with female sex, chronic insomnia symptoms, greater anxiety, and depression severity scores, and with mild obstructive sleep apnea severity. On the other hand, severe obstructive sleep apnea was negatively associated to RLS/WED. Despite being relatively prevalent among patients with OSA, RLS/WED is previously underrecognized in our sample. RLS/WED severity correlated with higher scores on anxiety and depression scales. Chronic insomnia symptoms were the main RLS/WED association factor.

Sarcopenia Seems to Be Common in Older Patients With Restless Legs Syndrome.

Restless legs syndrome (RLS) is a disorder characterized by nocturnally exacerbating pain that leads to significant sleep disturbances. The hormonal and metabolic changes caused by sleep disruption may increase the incidence of muscle-related diseases like sarcopenia in older adults, which is defined by a progressive loss of muscle strength and mass. This study aimed to investigate the relationship between RLS and sarcopenia, which may affect each other through common pathophysiological pathways in older adults. This was a cross-sectional study including 109 patients with RLS and 220 without RLS who applied to the geriatric clinic. RLS was assessed using the Turkish version of the International Restless Legs Syndrome Study Group (IRLSSG). Sarcopenia was diagnosed according to the European Working Group on Sarcopenia in Older People-2 criteria. All the demographics, comorbid conditions, medications and findings of comprehensive geriatric assessments were recorded. The association between RLS and sarcopenia was examined by logistic regression. The mean age was 75 ± 7.4 and 73.8 ± 7 years for the RLS and the control groups, respectively (p > 0.05) and the ratio of females was higher in the RLS group (69.7% vs. 57.9%) (p = 0.035). The frequencies of coronary artery disease (CAD), hypertension (HT) and peripheral artery disease (PAD) were significantly higher in RLS patients (p = 0.020, p = 0.047, p = 0.010, respectively), while the prevalence of anaemia was 41% and 25-OH Vitamin D levels (25[OH]D) were higher than in the control group (p < 0.001). The frequency of probable sarcopenia and sarcopenia was higher in patients with RLS than in controls (20% vs. 11%, p = 0.037 and 8% vs. 2.3%, p = 0.047, respectively). A significant association between RLS and an increased likelihood of probable sarcopenia, sarcopenia and slow gait speed (odds ratio [OR]: 2.621, 95% confidence interval [CI] [1.265, 5.431]; OR: 4.542, 95% CI [1.284, 16.071]; OR: 2.663, 95% CI [1.432, 4.951], respectively) was found after adjusting for factors such as gender, HT, CAD, PAD, serum 25(OH)D levels, anaemia, chronic kidney disease (CKD) and nutritional status. However, the significance of low muscle mass disappeared (p > 0.05). This study demonstrated that sarcopenia is prevalent among older patients with RLS, which seems to be associated with low muscle strength and slow gait speed. Given the negative health outcomes related to sarcopenia, interventions aimed at preventing its development could be significantly beneficial for patients with RLS in older adults as well.

Efficacy of Aerobic and Stretching Exercises in Managing Willis-Ekbom Disease (Restless Leg Syndrome) Among Hemodialysis Patients.

Restless legsyndrome (RLS) is a neurological disorder characterized by an irresistible urge to move the legs, particularly during rest. It significantly affects the quality of life of hemodialysis patients with high prevalence in this population. While pharmacological treatments, especially dopamine agonists (DAs), are commonly used, they often come with side effects and augmentation phenomena. This systematic review examines the effectiveness of exercise interventions in managing RLS among hemodialysis patients. Eight studies, including randomized controlled trials and quasi-experimental studies, were analyzed. The interventions primarily consisted of aerobic exercises (cycling) and stretching exercises, with durations ranging from eight weeks to six months. The primary outcome measure was RLS severity, assessed using validated scales such as the International Restless Legs Syndrome Study Group (IRLSSG) scale or the Restless Legs Syndrome Questionnaire (RLSQ). Secondary outcomes included sleep quality, depression, and physical performance. The results consistently demonstrated that both aerobic and stretching exercises significantly reduced RLS severity and improved related outcomes. The intradialytic nature of some interventions offered a practical approach to incorporating exercise into patient routines. While exercise showed comparable efficacy to DAsin reducing RLS symptoms and improving depression scores, only DAs significantly enhanced sleep quality in one comparative study. These findings suggest that exercise interventions may be a viable non-pharmacological approach to managing RLS in hemodialysis patients, potentially complementing or reducing reliance on pharmacological treatments.

A síndrome das pernas inquietas

Restless legs syndrome is a disorder of unknown cause that causes an irresistible urge to move the lower limbs, worsening at night, greatly disturbing sleep, with a consequent poor quality of life. It may begin in childhood, but diagnosis is usually late. It is also known as Willis-Ekbom Disease. It affects between 10% and 15% of the population. Iron deficiency is a frequently mentioned cause, which is why the study of iron metabolism is recommended. Clinical evaluation is normal, and it helps to identify possible secondary causes. The criteria for diagnosis were developed by the International Restless Legs Syndrome Study Group (IRLSG). In treatment, it is necessary to correct iron deficits and prescribe dopamine agonists. Many patients experience worsening of symptoms as they age.

Association between inflammatory cytokines and disease severity in restless legs syndrome.

This study aims to evaluate serum cytokine levels in individuals with primary Restless Legs Syndrome (RLS) and analyze their correlation with RLS symptom severity, sleep disturbances, anxiety, and depression. A case-control study was conducted involving 87 primary RLS patients and 100 healthy individuals undergoing health check-ups. Serum cytokine levels were assessed, and RLS severity was evaluated using the International Restless Legs Syndrome Study Group (IRLSSG) rating scale. Additionally, the Pittsburgh Sleep Quality Index (PSQI), 24-item Hamilton Depression Rating Scale (HAMD24), and 14-item Hamilton Anxiety Rating Scale (HAMA14) were utilized to assess symptom severity, sleep disturbances, and emotional states in RLS patients. Serum cytokine levels, including IL-6 and TNF-α, were significantly higher in RLS patients compared to controls (P < 0.05). Adjustment for disease duration, sex, age, BMI, SBP, and DBP revealed an independent association between serum IL-6 and RLS (OR = 1.46; 95% CI = 1.02-1.93; P = 0.003). Linear regression analysis demonstrated a significant correlation between IL-6 levels and IRLS scores (β = 0.123, P = 0.008). Elevated circulating levels of inflammatory cytokines in RLS patients suggest a potential role of inflammation in the pathogenesis of primary RLS. Additionally, serum cytokine levels correlate closely with disease severity.

Effect of Restless leg syndrome on the sleep quality of medical students of university in rural Sindh

Background: Restless legs syndrome a neurological condition its symptoms appear with gnawing sensation, cramps and feels like unpleasant sensations during period of rest and mid of sleep. A set of criteria for a more consistent diagnosis of this condition, which frequently causes severe sleep problems, it was devised and published by the recently established International RLS Study Group (IRLSSG) fifty years later the research has shown that, although its symptoms are preventable and manageable, but RLS is still under diagnosed since the IRLSSG criteria were published. Materials and methods: All medical students were considered as the population of the study. Convenient specific young adults selected a sample of 200 students. Besides that, students with a history of trauma and infection had exaggerated routines and recent viral infections also having pain with cramps in calf muscles, which increased during inactivity and rest at night. The questionnaires were administered from the students, with the permission of the ethical review committee of Bhitai dental &amp; medical College Mirpurkhas. Informed consent-form taken. Data collection procedures were applied standard questionnaire used International Restless Legs Syndrome Study Group (IRLLSG). The data were analyzed by SPSS-25. Percentage, mean, standard deviation, and chi-square were applied to measure the severity and overall score of RlS. Result: The medical students 119 were male and 81 female. Participants had demographic data mean of age 1.26, (SD=.544). 57.5% male, 42.5% female in the age group of 18–28. Sleep problem were found in male had moderate 25 (21.0%) and severe in 15 (12.6%) students, in very severe of RLS symptoms were less in count 13 (10.9%), A female participant was affected with RLS moderate 54 (27.0%), mild in 43 (21.5%), moderate RLS in 26 (32.1%) some participants in severe had low 30 (15.0%) RLS found, moreover participants had none 20 (24.5%) RLS symptoms. The significant valued (p=.296). Conclusion: It was concluded that RLS is a sleep disorder it mostly in male than female students. Severity of RLS symptoms mild to moderate among participants.

Aerobic Exercise in Individuals with Restless Legs Syndrome: A Case Series Study

Purpose: Exercise has been demonstrated to alleviate restless legs syndrome (RLS) symptoms in individuals with RLS, but little studies are available on the physical health of primary RLS. This case series aim to describe outcome after the training of supervised aerobic exercise training in individuals with RLS. Case Report: Five individuals with RLS were received with a supervised aerobic exercise training 2 days per week for 12 weeks. The International Restless Legs Syndrome Study Group Rating Scale (IRLS) was used to detect the severity of RLS. The Turkish version of the Pittsburgh Sleep Quality Index (PSQI) was used to measure sleep quality. The functional effect of fatigue was evaluated with Fatigue Impact Scale (FIS). The Six-Minute Walk test (6MWT) were used to determine the functional exercise capacity. All assessments took place at baseline and post-intervention. Conclusion: Following aerobic exercise, clinically meaningful changes in the severity of RLS, PSQI, and 6MWT were reported in all individuals with severe RLS. Four of 5 patients improved their FIS at post-intervention. These results suggest that 24-session supervised aerobic exercise training might help to improve RLS severity, sleep quality, fatigue, and exercise capacity in an individual with RLS.

#1839 Evaluating the severity of restless legs syndrome in chronic kidney disease patients across different renal replacement therapies

Abstract Background and Aims Restless Legs Syndrome (RLS) is increasingly recognized as a significant comorbidity in chronic kidney disease (CKD) patients. This cross-sectional study evaluates the risk and severity of RLS in CKD patients across various renal replacement therapies (RRT). Method A total of 167 CKD patients were assessed, including those on hemodialysis (HD) (39%), peritoneal dialysis (PD) (22%), with kidney transplants (19%), and those with non-dialyzed CKD stages IV-V (20%)—the International Restless Legs Syndrome Study Group (IRLS) questionnaire measured RLS severity. Severity scales were categorized into mild (0-10), moderate (11-20), severe (21-30), and very severe (31-40). PTH, P, Ca, ALP, and Mg serum concentrations, as well as vascular calcification, were measured as MBD biomarkers. The Adragaos score was applied to graphs of the hands and pelvis to evaluate vascular calcification. Statistical analyses focused on differences in RLS severity across RRT modalities and associated risk factors. Results The cohort comprised 82 males and 85 females, averaging 58 years. Primary disease etiologies included nephroangiosclerosis (24%), diabetic nephropathy (12%), chronic pyelonephritis (24%), chronic glomerulonephritis (24%), and ADPKD (7%). RLS prevalence was 53.8%, with significant differences in IRLS scores across groups (p ≤ 0.001). HD patients showed a mean IRLS score of 21.8 ± 12.3, with 55% reporting severe or severe symptoms. PD patients scored 16.06 ± 13.02; non-dialyzed CKD patients scored 6.41 ± 6.04; and transplant recipients scored 3.1 ± 4.7. No correlation was found between RLS severity and age or time on RRT. However, significant correlations were observed between RLS severity with HD modality, and the high Adragaos score. Multivariate analysis showed high serum phosphorus p=0.018 and markers of inflammation as a risk factor for RLS severity (CRP levels p=0.034; ferritin (p=0.048). Conclusion This study underscores the disproportionately higher severity of RLS in HD patients, necessitating tailored management strategies for this subgroup. The significant association between RLS severity and calcification and inflammation markers in CKD patients, particularly those on HD, suggests that RLS severity should be a key consideration in the clinical management of CKD. Addressing RLS in these patients may improve their quality of life and influence the outcomes of their renal replacement therapy.

The Frequency and Associated Factors of Restless Leg Syndrome among Pregnant Women in 3rd Trimester

Background: Restless leg syndrome (RLS), also known as Willis-Ekbom disease, is characterized by an uncomfortable sensation in the legs, often occurring at the onset of sleep, which triggers an irrepressible urge to move the legs. This condition is particularly prevalent among pregnant women, with symptoms typically worsening during the third trimester. Despite its impact, many pregnant women are unaware of RLS, attributing their discomfort to normal pregnancy symptoms. Objective: To assess the frequency and associated factors of RLS in pregnant females during the third trimester and to evaluate its impact on their quality of life. Methods: A cross-sectional study was conducted involving 250 pregnant females in their third trimester, recruited from Shalimar Hospital, Nawaz Sharif Hospital, Zahida Welfare Trust, Alshad Clinic, Ali Hospital, Ahsan Hospital, Nargis Clinic, Manawa Government Hospital, and Sultan Medical Center. Participants aged 15-45 years were included, while those with rheumatoid arthritis, diabetes mellitus, neurological disorders, preeclampsia, and gestational diabetes mellitus were excluded. Data were collected using structured questionnaires incorporating the International Restless Legs Syndrome Study Group (IRLSSG) criteria and the Pittsburgh Sleep Quality Index (PSQI). Ethical approval was obtained, and the study adhered to the Declaration of Helsinki principles. Statistical analysis was performed using SPSS version 25, with descriptive statistics, frequencies, and graphical representations employed to summarize and analyze the data. Results: The mean age of participants was 26.32 years (SD = 5.08). The prevalence of RLS in the third trimester was found to be 89.2%. The age group most affected was 18-23 years. Factors associated with RLS included inadequate calcium intake (40.4%), insufficient daily water intake (40.4%), poor food intake (48%), mood disturbances (89.2%), lack of movement or light exercise (78%), caffeine consumption (16%), disturbances in sexual activities (48%), and disruption in daily activities (45.2%). Conclusion: RLS is highly prevalent among pregnant women, particularly in the third trimester, significantly impacting their quality of life. Despite its prevalence, many women remain unaware of RLS, mistaking it for typical pregnancy discomfort. Raising awareness and implementing screening and management strategies during prenatal care could improve the quality of life for affected women.

Successful treatment of restless legs syndrome accompanied by headaches for 30 years with herbal prescriptions containing Paeoniae Radix: A case report

BackgroundRestless legs syndrome (RLS) is a neurological disorder that causes unpleasant symptoms in the legs when resting, which are relieved by movement. Pharmacotherapy is the standard treatment. However, current treatment provides only symptomatic relief and may result in adverse effects with long-term use. Treatment protocols using herbal medicines have emerged to compensate for this limitation. Case presentationA 70-year-old Asian woman visited our hospital with worsening headaches that had persisted for 30 years. Her headaches were aggravated by night-time lower-extremity discomfort. The patient was diagnosed with RLS based on the 2012 Revised International Restless Leg Syndrome Study Group Diagnostic Criteria (IRIS). The patient was prescribed herbal medicines, Shihogyeji-tang, Gyejibokryeong-hwan, and Jakyakgamcho-tang, all of which contain Paeoniae Radix. Fourteen days after starting herbal medicine treatment, the IRIS score decreased from 30 to 18. The patient experienced less leg discomfort. Moreover, her sleep time increased, and her headaches resolved. After 28 days of herbal treatment, the IRIS score decreased to 9. Importantly, the patient reported no sleep disturbance or headaches. Subsequently, conventional medications were discontinued. The patient remained stable (IRIS score: 9–10). Herbal treatment was discontinued on day 163. At the last follow-up, (day 364), the patient has not reported any symptom recurrence. ConclusionsWe described a female patient with a 30-year history of RLS symptoms and related sleep disturbances that induced chronic uncontrolled headaches, who experienced improvements shortly after using herbal medicines containing Paeoniae Radix. Conventional medications were discontinued and the patient had no recurrence of symptoms. Considering these, herbal medicines containing Paeoniae Radix may be a suitable alternative treatment for RLS and its related symptoms.

A comprehensive look at inflammation in RLS: assessing NLR, MLR, PLR, SII, SIRI, and microR

Aims: Restless legs syndrome (RLS) has been linked to systemic inflammation. The number of studies investigating inflammation in RLS patients is extremely limited. The purpose of this study is to examine the possible role of proinflammatory parameters in RLS, specifically neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), systemic inflammatory response index (SIRI), and microR.&#x0D; Methods: The study included 100 patients admitted to the neurology outpatient clinic diagnosed with RLS using the International Restless Legs Syndrome Study Group ((IRLSSG) scale and 100 healthy controls. Hemogram results were obtained from both RLS patients and healthy controls, while ferritin, folate, vitamin D and B12, and C-reactive protein (CRP) levels were obtained only from RLS patients.&#x0D; Results: The median age of the patient group was 52.50 (43-60.75), while the median age of the healthy group was 51.00 (50-53). The patient group is 37% male, while the healthy group is 34% male. It doesn't vary by age or gender (p=0.658). The two groups showed significant differences in PLR (

A randomized double-blind pilot study to evaluate the efficacy, safety, and tolerability of intravenous iron versus oral iron for the treatment of restless legs syndrome in patients with iron deficiency anemia.

Restless legs syndrome (RLS) is a neurological disorder that can have a profound effect on sleep and quality of life. Idiopathic RLS is associated with brain iron insufficiency despite normal peripheral iron stores. There is, however, a five- to six-fold increase in prevalence of RLS in patients with iron deficiency anemia (IDA). Several open-label trials have demonstrated symptomatic improvement in RLS following treatment of IDA using oral or intravenous iron supplementation. To date, there have been no randomized double-blind controlled trials of intravenous iron compared with oral iron for the treatment of RLS patients with IDA. In the current study, oral ferrous sulfate and ferumoxytol were compared for efficacy and speed of response for treatment of RLS occurring in patients with IDA. The planned recruitment for this study was 70 patients with RLS and IDA, to be randomly assigned 1:1 to oral or intravenous iron, using double-blind, double-dummy procedures. At Week 6, the primary outcomes of Clinical Global Impression-Improvement score and change from baseline in the International Restless Legs Syndrome Study Group rating scale score were assessed. Due to challenges, performing the clinical trial during the COVID-19 pandemic, final-week data were found missing for 30 patients. As a result, in order to maintain the prespecified statistical analysis, an additional 30 patients were recruited. Both IV and oral iron were associated with a marked improvement in RLS symptoms, with no statistically significant difference between treatment groups. No serious adverse events were observed in either treatment group.

Sleep disorders among elderly in Saudi Arabia: A cross-sectional study.

Aging has been shown to have an impact on sleep patterns, necessitating a deep dive into understanding the complex relationship between aging and sleep disorders. This study aimed to assess the prevalence of sleep disorders among elderly people and identify the associations between different factors and sleep disorders in this age group. This study was conducted at nursing homes in Jeddah. The target populations were those aged 65 years and older (geriatric group) and those aged younger than 65 years (nongeriatric group). Validated questionnaires, including the Athens Insomnia Scale, Berlin Questionnaire, Epworth Sleepiness Scale, International restless legs syndrome (RLS) Study Group, and Pittsburgh Sleep Quality Index, were used to assess different sleep disorders. A total of 313 participants were recruited in the geriatric (n = 153) and nongeriatric (n = 160) groups. Compared with the nongeriatric group, the geriatric group had greater risks of obstructive sleep apnea (OSA) (70.6%) and RLS (40.5%) (P < 0.001). Both groups had a notable prevalence of poor sleep quality (86.6%). Although insomnia was found to be common, there was no significant difference in the prevalence of insomnia between the two groups. In addition, insomnia (odds ratio [OR] = 3.04, confidence interval [CI]: 1.06-8.86, P = 0.037), OSA (OR = 3.17, CI: 1.06-9.41, P = 0.038), and high body mass index (OR = 1.76, CI: 1.63-2.9, P = 0.003) were significantly associated with poor sleep quality. This study revealed that sleep disorders, particularly OSA and RLS, are common in the elderly population in Saudi Arabia.

Evaluation of Restless Leg Syndrome in Patients with Non-Dialysis Dependent Chronic Kidney Disease at Fatima Memorial Hospital Lahore: A Cross-sectional Study

Objective: To determine the occurrence of restless leg syndrome in individuals with non-dialysis-dependent chronic kidney disease.Study Design: A descriptive cross-sectional study.Place and Duration of Study: The study was carried out at the Outpatient Department (OPD) of Fatima Memorial Hospital, Lahore, Pakistan, from March 2020 to August 2020.Methods: A total of 280 CKD patients not dependent on dialysis were included in the study. The data were collected through interviews containing questions from international restless leg syndrome study group (IRLSSG). Patients were stratified into different stages according to the estimated glomerular filtration rate (eGFR). Restless leg syndrome was diagnosed by analyzing the responses of the interview marked by the examiner. Results: Among 280 patients, 15.7% (n=44) of chronic kidney disease patients were noted to have restless leg syndrome. The syndrome was significantly more frequent in females and was associated with higher CKD stages (Stage V &gt; Stage III and IV). There was no association with either age or BMI.Conclusion: Restless leg syndrome is more common in chronic kidney disease stage V as compared to lower chronic kidney disease stages (III &amp; IV). If untreated, it can affect patients' quality of life and increase the risk of cardiovascular activities.&#x0D; How to cite this: Basit MB, Sabir O, Shahid AH, Kanwal A, Qadri GA, Rizvi N. Evaluation of Restless Leg Syndrome in Patients with NonDialysis Dependent Chronic Kidney Disease at Fatima Memorial Hospital Lahore: A Cross-sectional study. Life and Science. 2024; 5(1): 95-100.doi: http://doi.org/10.37185/LnS.1.1.516

Prevalence and clinical correlates of restless legs syndrome in psychiatric patients: A cross-sectional study from North India.

Restless legs syndrome (RLS) is a neuro-sensorimotor disorder which is scarcely researched and is commonly missed in routine psychiatry practice. To evaluate the prevalence of RLS and its correlates in patients with anxiety, depression, and somatoform disorders. A cross-sectional single-center study was undertaken in patients aged 18-65 years suffering from ICD-10 (International Statistical Classification of Diseases-10th edition) diagnosis of anxiety, depressive, and somatoform disorders. RLS was evaluated by using diagnostic criteria of International Restless Legs Syndrome Study Group (IRLSSG) and severity measured on IRLSSG scale. Depression and anxiety were rated on Hamilton Depression and Anxiety Rating Scales respectively, insomnia severity measured by Insomnia Severity Index (ISI), and quality of life measured by WHO Quality of Life-Brief version (WHO-QOL BREF) scale. Serum ferritin levels were measured for evaluating iron deficiency. The rate of RLS was 66.7%, 50%, and 48% in patients with depressive, anxiety, and somatoform disorders, respectively, with no significant inter-group difference. Nearly one-third of patients suffered from severe to very severe symptoms of RLS, and quality of life was poorest in those with depressive disorders. RLS was significantly higher in females (P = 0.019), who were married (P = 0.040), diagnosed with severe depression (P = 0.029), and abused benzodiazepines (P = 0.045). On binary logistic regression, female gender and presence of clinical insomnia predicted occurrence of RLS. The prevalence of RLS is very high in patients with common psychiatric disorders which is often missed. Clinical enquiry and examination for reversible causes such as iron deficiency may assist in its diagnosis and improve clinical outcome.

Alerjik rinit tanılı çocuklarda huzursuz bacak sendromunun değerlendirilmesi

Aim: It was aimed to evaluate the frequency of restless legs syndrome (RLS) in children with a diagnosis of allergic rhinitis (AR).&#x0D; Material and Method: The study is case-control type. Age, gender, height, weight, Body Mass Index (BMI), allergic rhinitis symptom score, allergic rhinitis severity, allergy tests, total IgE, eosinophil values of the case group were examined. Gender, age, height, weight and BMI were also calculated in the control group. Patients in both groups were questioned using the International Restless Legs Syndrome Study Group's (IRLSSG) questionnaire containing the latest diagnostic criteria and severity scoring revised for the pediatric age group. Neurological examination, questionnaire and RLS severity scoring results of the patients were performed by a pediatric neurologist.&#x0D; Results: In the study, the data of a total of 230 children, 115 AR cases and 115 control groups, were evaluated. The frequency of restless legs syndrome in children with allergic rhinitis was significantly higher than in the control group (15.7% and 5.2%, respectively; p=0.010). The clinical severity of RLS patients was mostly moderate in both the case and control groups [44.4% (n=8) and 50% (n=3), respectively].&#x0D; Conclusion: According to the results of our study; restless legs syndrome was observed more frequently in patients with allergic rhinitis compared to the control group.

A cross-sectional study on restless legs syndrome (RLS) in polycythemia vera (PV): is iron deficiency the only culprit?

ABSTRACT Introduction In polycythemia vera (PV) patients undergoing phlebotomy, iron deficiency (ID) may develop. ID has been linked to restless legs syndrome (RLS), and in one study, 29.6% of PV patients had RLS. We aimed to evaluate the frequency of RLS in PV and to evaluate factors that might play a role in RLS development among PV and essential thrombocythemia (ET) patients. Methods We consecutively included PV cases as the patient group, and ET and ID patients and healthy subjects (HSs) were included as controls. Those with conditions that could lead to RLS were excluded. All subjects were questioned according to the diagnostic criteria of the International Restless Legs Syndrome Study Group. Results Twenty-seven PV, 23 ET, and 22 ID patients and 23 HSs were included. RLS was detected in 25.9%, 34.8%, and 45.5% of PV, ET, and ID patients, respectively. None of the HSs had RLS. In univariate analysis, interferon-α and anagrelide use, magnesium levels, and the Leeds assessment of neuropathic symptoms and signs (LANSS) scores had a significant impact on RLS in PV and ET patients (p = 0.014, p = 0.032, p = 0.036, and p = 0.003, respectively). Conclusion RLS was more common among PV and ET patients than HSs, which was irrespective to the iron status. RLS was more frequent in ET patients than that observed in PV cases, indicating that ID may not be the only causative factor for RLS development in PV. Further prospective studies are needed to determine the prevalence and risk factors of RLS developing in PV and ET.

Evaluation of the relationship between idiopathic restless legs syndrome and serum hepcidin levels.

The relationship between restless legs syndrome (RLS) and iron deficiency is a well-known topic. However, the etiology of the disease has not been determined. As the central iron deficiency is the most critical biological abnormality for RLS, we planned a study examining the relationship between RLS and hepcidin, which is the only regulatory hormone of iron metabolism known so far. International Restless Legs Syndrome Study Group diagnostic criteria (2014) were taken as a basis. A total of 40 RLS patients and 40 healthy controls were included in the study. To avoid the potential variables that might cause secondary RLS, all the participants were asked to provide hemogram, ferritin, iron, thyroid function tests, and sedimentation analysis. The hepcidin levels were measured with a Human Hepcidin (Hepc 25) ELISA kit (MyBioSource). The statistically significant results of our analysis show that the red blood cell count, the neutrophil count, the percentage of lymphocytes and neutrophils, and, more distinctively, hepcidin levels were higher in RLS patients in comparison with the control group. In this study, no differences were found in iron and ferritin values. High levels of hepcidin, the main regulator of iron metabolism, in those with primary RLS support the possibility that hepcidin may play a role in the pathogenesis of RLS. We think that larger studies on this subject can give clearer ideas.

Restless legs syndrome in multiple sclerosis patients: Prevalence, impact, and association with disease-modifying therapies in a Saudi Arabian pilot study

BackgroundRestless legs syndrome (RLS) emerges as a notable sleep disorder characterized by distressing sensations within the lower extremities. Its prevalence appears to be higher among patients afflicted with multiple sclerosis (MS) compared to the general population. Despite this observation, the understanding of the intricacies of RLS and its repercussions within the context of MS patients in Saudi Arabia remains limited. MethodsEmploying a cross-sectional design, a comprehensive investigation was undertaken at King Fahad Armed Forces Hospital in Jeddah, Saudi Arabia, spanning from November 2021 to March 2022. A cohort of 66 individuals diagnosed with MS was recruited and subjected to an assessment for RLS employing the revised diagnostic criteria outlined by the International Restless Legs Syndrome Study Group (IRLSSG). Furthermore, the Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, and Sleepiness Scale were employed to gage the extent of RLS's impact on sleep quality and daily functioning. ResultsThe prevalence of RLS amidst the MS cohort was determined to be 30.4%. An observable association was discerned between RLS presence and higher scores on the Expanded Disability Status Scale (p < 0.001), along with diminished sleep quality scores (p < 0.001) and elevated fatigue scores based on IRLSSG criteria (p < 0.001). Within the studied MS cases, 98.5 % exhibited the relapsing-remitting subtype. Further investigation demonstrated that patients treated with Fingolimod or Ocrevus presented normal IRLSSG scores, whereas those undergoing Rituximab treatment manifested an even distribution between normal and moderate scores. Correspondingly, patients receiving interferons showcased 72.2 % with normal scores and 27.8 % with mild scores. Notably, a statistically significant variance in IRLSSG scores was observed when contrasting Fingolimod and Aubagio treatments (P < 0.001). ConclusionThe presence of RLS as a comorbidity in MS patients within the Saudi Arabian context emerges as a significant finding, exerting a discernible detrimental influence on both disability status and sleep quality. This study underscores the need for further investigations aimed at unraveling the intricate pathophysiological underpinnings, identification of risk factors, and exploration of therapeutic modalities for RLS in this population. Furthermore, additional research endeavors are warranted to elucidate the diverse impact of various disease-modifying therapies on clinical outcomes.

Treatment of primary restless legs syndrome with Fu's subcutaneous needling: A case report

RationaleFu's subcutaneous needling (FSN) is a novel acupuncture technique developed based on traditional needling principles that aims to alleviate diseases by improving local muscle conditions and blood supply. FSN have been widely used for the treatment of various diseases. Restless legs syndrome (RLS) is a common central nervous system disorder characterized by intense discomfort in the legs, particularly at night, leading to an urge to move the legs for relief. In this study, we report a case in which FSN was used to treat primary RLS. Patient concernsA 67-year-old patient complained of nocturnal discomfort in the right leg for over 4 months, the symptoms occurred 2–3 times, with uncontrollable movement impulses in the right leg during the onset, accompanied by a burning sensation, lasting about 2 h, accompanied by anxiety and insomnia. Imaging examinations revealed no spinal stenosis or history of kidney disease, rheumatic disease, diabetes, or Parkinson's disease. DiagnosesThe patient was diagnosed with primary RLS, and the International Restless Legs Syndrome Study Group rating scale (IRLS) score was 26. InterventionsFSN was successfully performed three times per week on different days. No adverse and unanticipated events while the treatment. The total treatment course lasted for six weeks. OutcomesAfter the treatment, the patient reported that the recent onset interval was approximately 10 days, each time lasting approximately 15 min. The patient's IRLS score was 5, After a follow-up of 2 months following the end of treatment, the patient reported that the incidence of RLS was approximately one episode within two weeks,each lasting approximately 10 min. LessonsFSN significantly improved leg discomfort and desire for leg movement in patients with RLS. FSN may exert its therapeutic effects by influencing connective and muscular tissues, thereby improving the condition of the central nervous system and the local blood supply in the legs. However, due to the limitation of a single clinical observation case, a randomized clinical trial with a sufficient follow-up time is needed.