Restless Legs Syndrome Symptoms Research Articles

Adjunctive tonic motor activation enables opioid reduction for refractory restless legs syndrome: a prospective, open-label, single-arm clinical trial

BackgroundThere is a large population of restless legs syndrome (RLS) patients who are refractory to medication. Whereas experts recommend off-label opioids as an effective long-term treatment for refractory RLS, reducing opioid dose could substantially reduce side effects and risks. Tonic motor activation (TOMAC) is a nonpharmacological therapeutic device indicated for refractory RLS. Here, we investigated if TOMAC could enable opioid dose reduction for refractory RLS.MethodsThis prospective, open-label, single-arm clinical trial [NCT04698343] enrolled 20 adults taking ≤ 60 morphine milligram equivalents (MMEs) per day for refractory RLS. Participants self-administered 30-min TOMAC sessions bilaterally over the peroneal nerve when RLS symptoms presented. During TOMAC treatment, opioid dose was reduced iteratively every 2–3 weeks until Clinician Global Impression of Improvement (CGI-I) score relative to baseline exceeded 5. Primary endpoint was percent of participants who successfully reduced opioid dose ≥ 20% with CGI-I ≤ 5. Secondary endpoints included mean successful percent opioid dose reduction with CGI-I ≤ 5.ResultsOn average, participants were refractory to 3.2 medications (SD 1.6) and were taking a stable dose of opioids for 5.3 years (SD 3.9). Seventy percent of participants (70%, 14 of 20) successfully reduced opioid dose ≥ 20% with CGI-I ≤ 5. Mean percent opioid dose reduction with CGI-I ≤ 5 was 29.9% (SD 23.7%, n = 20) from 39.0 to 26.8 MME per day. Mean CGI-I score at the reduced dose was 4.0 (SD 1.4), indicating no change to RLS severity.ConclusionsFor refractory RLS, TOMAC enabled substantial opioid dose reduction without increased RLS symptoms. These results suggest that TOMAC has the potential to reduce the risk profile associated with opioid therapy for refractory RLS.Trial registrationClinicalTrials.gov trial number NCT04698343 registered on January 6, 2021.

Long-term dopamine agonist treatment fails to restore altered central sensory processing in restless legs syndrome: Evidence from current perception threshold measurements

ObjectivesAlthough some studies have examined the impact of short-term dopamine agonist treatment on altered central sensory processing in patients with restless legs syndrome (RLS), there is a scarcity of research investigating the effect of long-term treatment with these drugs. The aim of this study is to investigate the long-term impact of dopamine agonist treatment on altered central sensory processing in RLS patients using current perception threshold (CPT) testing. MethodsWe conducted a study of 24 RLS patients, measuring their CPT values before and after dopamine agonist treatment for at least 2 months. Patients were classified as responders or non-responders based on their decrease in International Restless Legs Syndrome (IRLS) score. Clinical parameters were collected and compared pre- and post-treatment. ResultsThe mean duration of treatment with dopamine agonist was 13.6 ± 11.0 months. Our results showed that dopamine agonist treatment significantly improved clinical parameters, including the IRLS score, Visual Analogue Scale, and RLS Quality of Life questionnaire. However, CPT values did not show significant changes for all stimulus frequencies after treatment. Furthermore, we did not find any difference in CPT values before and after treatment in both responders and non-responders. ConclusionsOur study demonstrated that long-term treatment with dopamine agonists effectively reduces RLS symptoms, but does not reverse the altered central sensory processing observed on CPT testing in RLS patients. These results support the notion that the pathophysiology of RLS is multifactorial and not solely driven by dopaminergic dysfunction.

Correlation of Diffusion Tensor Tractography with Restless Legs Syndrome Severity.

This prospective study investigated white matter tracts associated with restless legs syndrome (RLS) severity in 69 patients with primary RLS using correlational tractography based on diffusion tensor imaging. Fractional anisotropy (FA) and quantitative anisotropy (QA) were analyzed separately to understand white matter abnormalities in RLS patients. Connectometry analysis revealed positive correlations between RLS severity and FA values in various white matter tracts, including the left and right cerebellum, corpus callosum forceps minor and major, corpus callosum body, right cingulum, and frontoparietal tract. In addition, connectometry analysis revealed that the FA of the middle cerebellar peduncle, left inferior longitudinal fasciculus, left corticospinal tract, corpus callosum forceps minor, right cerebellum, left frontal aslant tract, left dentatorubrothalamic tract, right inferior longitudinal fasciculus, left corticostriatal tract superior, and left cingulum parahippocampoparietal tract was negatively correlated with RLS severity in patients with RLS. However, there were no significant correlations between QA values and RLS severity. It is implied that RLS symptoms may be potentially reversible with appropriate treatment. This study highlights the importance of considering white matter alterations in understanding the pathophysiology of RLS and in developing effective treatment strategies.

Prevalence of Restless Legs Syndrome in Rheumatoid Arthritis: A Systematic Review and Meta-Analysis

Introduction: Restless legs syndrome (RLS) is a common sensorimotor sleep disorder, and rheumatoid arthritis (RA) is an inflammatory autoimmune disease that causes disability. Previous studies showed that the prevalence of RLS varies in different populations of RA (13.2 – 68.4%). It raises the need for a pooled metaanalysis to determine a more reliable estimate. Therefore, we aimed to perform a meta-analysis to assess the pooled prevalence of RLS in RA patients.
 Methods: Meta-analysis was performed according to the PRISMA checklist. Embase, MEDLINE, Ovid, Web-of-Science, and Scopus databases were used for the systematic search, and eligible studies were analyzed using R version 4.0.3. For further review, we performed sensitivity analyzes to identify influential studies.
 Results: Of a total of 763 studies, 11 studies (3 were from Europe, 4 from North America, and 4 from Asia) were suitable for synthesis. A total of 931 RA patients were identified, 300 of whom had symptoms of RLS. The pooled prevalence of RLS among people with RA from 11 studies was 34% (95% CI: 26-43%). The pooled prevalence of RLS in Europe, Asia, and North America was 48% (95% CI: 32-65%), 32% (95% CI: 18-45%), and 28% (95% CI: 15-42%), respectively. RLS prevalence was dramatically high in RA women patients (32% CI: 23-41%) than RA men patients (3%; 95% CI: 2-5%).
 Conclusion: This systematic review and meta-analysis indicates that the risk of RLS in RA patients was 34% and female patients with RA were more prone to having RLS than male patients.

Difference in functional connectivity between end-stage renal disease patients with and without restless legs syndrome: A prospective study.

The purpose of this study was to examine differences in functional connectivity between patients with end-stage renal disease (ESRD) with and without restless legs syndrome (RLS). In addition, the study aimed to identify any potential associations between RLS severity and functional connectivity. We enrolled patients with ESRD who had been undergoing hemodialysis. Patients with and without RLS were separated into two groups. Using functional near-infrared spectroscopy (fNIRS) and a graph theory approach, we determined the functional connectivity of patients with ESRD. The data were collected during a 300-s resting state evaluation performed in the dialysis room prior to dialysis. Eighteen of 48 patients with ESRD were diagnosed with RLS, whereas 30 patients did not exhibit RLS symptoms. Notably, functional connectivity metrics differed significantly between patients with and without RLS. Specifically, patients withESRD and RLS displayed higher values for mean clustering coefficient (0.474 vs. 0.352, p = 0.001), global efficiency (0.520 vs. 0.414, p = 0.001), strength (6.538 vs. 4.783, p = 0.001), and transitivity (0.714 vs. 0.521, p = 0.001), while values for diameter (5.451 vs. 7.338, p = 0.002), eccentricity (4.598 vs. 5.985, p = 0.004), and characteristic path length (2.520 vs. 3.271, p = 0.002) were lower in patientswithESRD and RLS compared to those without RLS. In addition, there were correlations between the RLS severity score and the assortative coefficient (r = 0.479, p = 0.044), the small-worldness index (r = -0.475, p = 0.046), and transitivity (r = 0.500, p = 0.034). We demonstrated differences in functional connectivity between patients withESRD with and without RLS, which may shed light on the pathophysiology of RLS. Notably, a number of functional connectivity metrics demonstrated strong associations with RLS severity. Our study also confirmed the applicability of fNIRS as a tool for investigating functional connectivity in patients with RLS.

P074 Sleep-Related Predictors of Road and Workplace Safety in Young Adults: Results from a Community Representative Sample

Abstract Young adults are at increased risk of road and workplace incidents. Sleep-related predictors of increased risk include short sleep duration, sleep disorders and shift work. It is unknown which predictors are the most impactful, or whether they are interrelated. To address this, sleep-related predictors were concurrently examined in young adults. Participants were young adults (22 years) from the Raine Study, who were employed, assessed for common sleep disorders (obstructive sleep apnoea by polysomnography, insomnia and restless legs syndrome symptoms by validated questionnaires), provided information on shift work status and habitual sleep duration. Two sub-groups were analysed: participants with a driver’s licence and self-reported information on road incidents (n=519) and those with information on workplace incidents, regardless of driver’s license status (n=575). Poisson regression models adjusted for sex and comorbidities were used to examine sleep-related predictors of road and workplace incidents. A total of 15% reported ever falling asleep behind the wheel and 23% reported ever having at least one near-miss road accident due to sleepiness. Diagnosis of a sleep disorder predicted near-miss road accidents (risk ratio, 3.0; 95%CI 1.7–5.3), independent of sleep duration and shift work. A total of 11% reported ever falling asleep on the job and 12% reported ever having an accident at work that required seeing a doctor or nurse, neither of these were associated with sleep duration, sleep disorders or shift work status. Sleep disorder diagnosis may be important in young adults given road incidents are strongly associated with the presence of a sleep disorder.

O074 Does Sleep Duration, Shift work or Sleep Disorder Status Predict Perceived work Performance and Quality of Life in Young Adults?

Abstract Young adults are vulnerable to the consequences of disturbed sleep from insufficient sleep, shift work and sleep disorders. The impact of these causes of disturbed sleep on perceived work performance and quality of life (QOL) in young adults is unclear. This study sought to investigate these associations in a community sample of 22-year-old adults. Participants studied (n=565, 53% female) were a subset of the Raine Study. All were employed and provided information on sleep disorders (obstructive sleep apnoea by polysomnography and insomnia and restless legs syndrome symptoms by validated questionnaires), shift work status, habitual sleep duration, QOL (Short Form (SF) 12) and perceived work performance (categorical response: perform better, same or worse than most workers). Multinomial and linear regression models adjusted for sex, comorbidities and work hours were used to examine the associations between disturbed sleep with work performance and QOL, respectively. In total 25% of participants had a sleep disorder, 29% were shift workers, and 31% had insufficient sleep (<6 hours). Presence of a sleep disorder was associated with poorer perceived work performance (OR, 2.27; 95%CI, 1.3 – 4.1). Sleep disorders were also associated with significantly lower SF-12 mental (β, -4.19; 95%CI, -5.92 to -2.45, p<0.001) and physical (β, -1.56; 95%CI, -2.70 to -0.42, p<0.008) component scores. Shift work and insufficient sleep were not associated with either perceived work performance or QOL. Identifying and treating sleep disorders in young adults may be important given its negative association with perceived work performance and QOL.

A Comparative Investigation of Functional Connectivity Utilizing Electroencephalography in Insomnia Patients with and without Restless Leg Syndrome

The current study aimed to identify distinctive functional brain connectivity characteristics that differentiate patients with restless legs syndrome (RLS) from those with primary insomnia. Quantitative electroencephalography (QEEG) was employed to analyze connectivity matrices using the phaselocking value technique. A total of 107 patients with RLS (RLS group) and 17 patients with insomnia without RLS (primary insomnia group) were included in the study. Demographic variables were compared using t tests and chi-square tests, while differences in connectivity were examined through multiple analyses of covariance. Correlation analysis was conducted to explore the relationship between connectivity and the severity of RLS. The results indicated significant differences in the primary somatosensory cortex (F = 4.377, r = 0.039), primary visual cortex (F = 4.215, r = 0.042), and anterior prefrontal cortex (F = 5.439, r = 0.021) between the RLS and primary insomnia groups. Furthermore, the connectivity of the sensory cortex, including the primary somatosensory cortex (r = -0.247, p = 0.014), sensory association cortex (r = -0.238, p = 0.028), retrosplenial region (r = -0.302, p = 0.002), angular gyrus (r = -0.258, p = 0.008), supramarginal gyrus (r = -0.230, p = 0.020), primary visual cortex (r = -0.275, p = 0.005) and secondary visual cortex (r = -0.226, p = 0.025) exhibited an inverse association with RLS symptom severity. The prefrontal cortex, primary somatosensory cortex, and visual cortex showed potential as diagnostic biomarkers for distinguishing RLS from primary insomnia. These findings indicate that QEEG-based functional connectivity analysis shows promise as a valuable diagnostic tool for RLS and provides insights into its underlying mechanisms. Further research is needed to explore this aspect further.

Effectiveness Of Buerger Allen Exercise Among Pregnant Women With Restless Leg Syndrome In A Selected Hospital Banke, Nepal

Restless Leg Syndrome is a neuromuscular sensorimotor disorder characterized by uncontrolled urge to move the affected legs which is accompanied by distressing parathesia of the leg, described as” creeping, tugging and pulling feeling.”. The aim of the study was to evaluate the effectiveness of Buerger Allen exercise among pregnant women with Restless Leg Syndrome. Methods: A Quasi experimental design was carried out to evaluate the effectiveness of buerger allen exercise with a total of 60 pregnant women (n = 30 in the control group who did not receive exercise intervention and n = 30 in the experimental group who received Buerger Allen Exercise). The data was collected within the period of 27th November 2017 to 27th December 2017 using non-probability purposive sampling technique. Data was collected through modified International Restless Legs Syndrome Scale (IRLSS). Collected data were entered in Statistical Package 21 version and analyzed by using mean and repeated measures analysis of variance. When analyzing symptoms of Restless leg syndrome over time a significant difference was found between two groups where the mean restless leg syndrome severity score of the experimental group who had performed buerger allen exercise as an adjunct to no intervention being noted to be lower than that of the control group. A statistically significant reduction of symptoms was observed in the experimental group (P < .005). Conclusion: The study concluded that the Buerger Allen exercise helps in reduction of symptoms of Restless leg syndrome among pregnant women.

Restless legs syndrome in chronic renal failure patients on dialysis.

Restless legs syndrome (RLS) occurs in patients with chronic renal failure (CRF). To determine the prevalence and morbidity of RLS in CRF patients on dialysis. This cross-sectional questionnaire-based study included 100 dialysis patients (50 on haemodialysis [HD]; 50 on peritoneal dialysis [PD]). A focused lower limb examination was done. Patients were classified with RLS when reporting uncomfortable feelings in their legs that improved with movement and worsened when resting and at night. Gender distribution was equal. The median age was 43 (19-67) years. Six patients (HD and PD n=3 each) had international criteria-confirmed RLS. Twenty-four patients reported symptoms suggestive of RLS. Fourteen and 16 patients with RLS symptoms were on HD and PD, respectively. Sleep disturbances occurred in 43.3% (n=13) of patients with RLS symptoms, compared to 20.0% (n=20) of the large cohort. Sleep disturbances, peripheral sensory loss, chronic disease-related anaemia, increased urea and decreased albumin levels were more common among patients with RLS symptoms. RLS symptoms occurred in 30.0% of the entire cohort, although only 6.0% met the international criteria. The type of dialysis had no impact on the incidence of symptoms. Identifying RLS in patients with CRF on dialysis will allow for early intervention.

The Relationship between Serum Selenium Levels and Restless Leg Syndrome in Chronic Kidney Disease Patients.

Background and Objectives: Chronic kidney disease (CKD) is a global public health issue with rising incidence linked to substantial morbidity and mortality. Selenium, an antioxidant trace element, has been linked to low serum levels in end-stage renal disease. Restless Leg Syndrome (RLS), a sleep disorder, is prevalent in CKD patients and significantly impacts their quality of life. The objective of this study was to examine the correlation between serum selenium levels and the prevalence of restless leg syndrome in individuals with chronic kidney disease. Materials and Methods: Forty-six CKD patients undergoing serum selenium level assessments between 1 January 2020 and 28 February 2022, at the Hitit University Faculty of Medicine Department of Nephrology Outpatient Clinic or Hemodialysis Unit, were included. Patients over 18 years of age with no history of hematological or oncological diseases or acute or chronic inflammatory conditions were included in the study groups. Patients taking selenium supplements were excluded. Demographic data, comorbidities, and laboratory values were collected, and RLS presence and severity were evaluated. Statistical analyses include descriptive statistics, correlation analysis, the Mann-Whitney U test, Student's t test, and Chi-square test. Results: Among the 46 patients, 16 (34.78%) had RLS symptoms. The patient group included 34.78% predialysis, 34.78% peritoneal dialysis, and 30.44% hemodialysis patients, with a median age of 47.98 years. There was no difference in age, gender, and Charlson comorbidity between patients with or without RLS (p = 0.881, p = 0.702, p = 0.650). RLS prevalence varied across CKD subgroups, with hemodialysis patients having a higher prevalence (p = 0.036). Clinical parameters such as blood urea nitrogen, creatinine, calcium, phosphorus, platelet counts, and parathyroid hormone levels exhibited significant differences between patients with and without RLS (p < 0.05). Serum selenium levels were not significantly different between patients with and without RLS (p = 0.327). Conclusions: With an increased comorbidity burden, CKD poses a significant healthcare challenge. When accompanied by RLS, this burden can be debilitating. The difference in CKD stages between groups has shed light on a critical determinant of RLS in this population, emphasizing the role of the chronic kidney disease stage. In our study, serum selenium levels were not associated with the presence and severity of RLS. However, prospective studies with larger numbers of participants are needed to draw a definitive conclusion.

Ar yra ryšys tarp migrenos ir neramių kojų sindromo?

Migraine and restless legs syndrome are diseases that disturb the normal quality of human life. Moreover, comorbidity of these disorders determines even more difficult condition of the patients. Migraine is a headache that can cause severe throbbing pain, usually on one side of the head, and it is often accompanied by nausea, vomiting, and extreme sensitivity to light and sound. Migraine is one of the reasons that can cause unhealthy sleep, and if sleep is disturbed, this leads to the provocation of migraine attacks. Sleep disorders have various clinical manifestations, one of which is restless legs syndrome. It is a neurosensory impairment which is characterized by an unrelenting urge to move the legs that occurs or worsens at rest. For this reason, patients may complain of impaired sleep. Although the relationship between migraine and restless legs syndrome and their pathogenesis is not fully understood, current research suggests that these diseases may be related. People with restless legs syndrome are 1.23 to 2.65 times more likely to develop migraine attacks. It is believed that the occurrence of both diseases is determined by several pathophysiological factors, such as the activity of the dopamin- ergic system, iron deficiency, genetic predisposition, and changes in the gray matter of the brain. Although the association between restless legs syndrome and migraine is being investigated, the predominant pathophysiological link has not yet been established. Separate treatment of these diseases has been known for a long time. The principle of migraine treatment is to suppress pain and reduce the frequency of attacks. Treatment for restless legs syndrome is based on the relief of symptoms. Unfortunately, a common treatment for both diseases in relation to each other has not yet been approved. Because of the similar pathophysiology of these disorders, drugs that affect the dopaminergic system (e.g., pramipexole) are currently being investigated in order to relieve the symptoms of restless legs syndrome and migraine attacks.

Prevalence of Current Restless Legs Syndrome Symptoms Among Patients Treated with Buprenorphine/Naloxone for Opioid Use Disorder.

The purpose of this study was to determine the prevalence of Restless Legs Syndrome (RLS) in patients with Opioid Use Disorder (OUD) taking buprenorphine/naloxone maintenance therapy, and to assess symptom frequency, severity, and sleep disruption due to RLS. Surveys inquired about demographic information, amount of time on maintenance treatment, previous drug use, current prescribed medications and alcohol use, and RLS symptoms. Participants were determined to have definite, probable, possible, or no RLS symptoms based on pre-established criteria from the Cambridge-Hopkins Questionnaire. The sample (n=129) was 33.3% female, 81.5% white, and the mean age was 40.6 years (SD=11.9). The median duration of buprenorphine/naloxone use was 3 years. 13.2% of participants had definite/probable RLS symptoms; these symptoms tended to be of moderate severity, occur at least 5-15 times a month, and disrupt sleep to a moderate degree. Of the 17 participants with definite/probable RLS symptoms, just four were taking a medication commonly used to alleviate RLS. An additional 7.0% had possible RLS symptoms. Relatively high rates of current RLS symptoms were observed; the prevalence of clinically significant RLS was notably higher than that seen in the general population or in previously assessed clinical populations. RLS is common in those acutely withdrawing from opioids, and our data demonstrate that these symptoms are present in a sizable portion of patients on OUD maintenance therapy. Most patients with definite/probable current RLS symptoms did not report taking prescribed medications that have established efficacy for RLS.

Exploring the causes of augmentation in restless legs syndrome.

Long-term drug treatment for Restless Legs Syndrome (RLS) patients can frequently result in augmentation, which is the deterioration of symptoms with an increased drug dose. The cause of augmentation, especially derived from dopamine therapy, remains elusive. Here, we review recent research and clinical progress on the possible mechanism underlying RLS augmentation. Dysfunction of the dopamine system highly possibly plays a role in the development of RLS augmentation, as dopamine agonists improve desensitization of dopamine receptors, disturb receptor interactions within or outside the dopamine receptor family, and interfere with the natural regulation of dopamine synthesis and release in the neural system. Iron deficiency is also indicated to contribute to RLS augmentation, as low iron levels can affect the function of the dopamine system. Furthermore, genetic risk factors, such as variations in the BTBD9 and MEIS1 genes, have been linked to an increased risk of RLS initiation and augmentation. Additionally, circadian rhythm, which controls the sleep-wake cycle, may also contribute to the worsening of RLS symptoms and the development of augmentation. Recently, Vitamin D deficiency has been suggested to be involved in RLS augmentation. Based on these findings, we propose that the progressive reduction of selective receptors, influenced by various pathological factors, reverses the overcompensation of the dopamine intensity promoted by short-term, low-dose dopaminergic therapy in the development of augmentation. More research is needed to uncover a deeper understanding of the mechanisms underlying the RLS symptom and to develop effective RLS augmentation treatments.

Observation of the efficacy of parathyroidectomy for secondary hyperparathyroidism in hemodialysis patients: a retrospective study

PurposeParathyroidectomy (PTX) is commonly performed as a treatment for secondary hyperparathyroidism (SHPT) in patients with end-stage renal disease (ESRD). We aimed to evaluate the efficacy of PTX in patients with SHPT who underwent hemodialysis.MethodsThis retrospective study analyzed the clinical treatment of 80 hemodialysis patients with SHPT who underwent either total PTX with forearm auto transplantation (TPTX + AT) or subtotal parathyroidectomy (SPTX). We compared the changes in biochemical indices before and after surgery as well as the attenuation of intact parathyroid hormone (iPTH) in the TPTX and SPTX groups. We also evaluated clinical symptoms and quality of life using the Visual Analog Scale (VAS) and the Short Form-36 Questionnaire (SF-36) before and at 3, 6, and 12 months after surgery.ResultsSerum iPTH and serum phosphorus levels decreased significantly after surgery in 80 patients with SHPT (P < 0.05). Within one month of surgery, there was a difference in iPTH levels between the TPTX + AT and SPTH groups, but there was no difference over time. Patients experienced significant improvement in their clinical symptoms of restless leg syndrome, skin itching, bone pain, and joint pain at 1 week post operation (P < 0.001). Quality of life significantly improved after surgery, as assessed by SF-36 scores (P < 0.05). Hypocalcemia was the most common postoperative complication, occurring in 35% of patients. Within the first 12 months post surgery, 5 patients had a recurrence.ConclusionPTX is effective in rapidly reducing iPTH levels, improving calcium and phosphorus metabolism disorders, and enhancing patients’ quality of life by safely and effectively relieving clinical symptoms.

The Prevalence of Restless Legs Syndrome Among Pregnant Women in Saudi Arabia.

Pregnancy hasbeenassociatedwith restlesslegssyndrome (RLS). RLS is underdiagnosed in most countries. The purpose of this study was to assess the prevalence of RLS among Saudi pregnant women. This cross-sectional study included 459 pregnant women from all Saudi provinces between December 2022 and March 2023. A structured online questionnaire assessing demographic and pregnancy characteristics, medical conditions, sleep quality, and RLS symptoms was conducted. The prevalence of RLS was 26.6% among the participants. Calcium deficiency was significantly associated with RLS (adjusted odds ratio (OR)=2.16, 95% confidence interval (CI)=1.2-3.9, p=0.01), but there was no significant association between RLS and vitamin D and iron deficiencies (p>0.05), according to multivariate binary logistic regression analysis. Moreover, RLS increased the risk of insomnia and frequent waking up(adjusted OR=4.95, 95% CI=2.50-9.83, p<0.001, and adjusted OR=2.87, 95% CI=1.55-5.32, p=0.001, respectively). RLS is common among pregnant women in Saudi Arabia. The study indicates that RLS during pregnancy is linked tocalcium deficiency and negatively affects sleep quality.

Effects of Different Exercise Programs on Symptoms, Sleep, and Quality of Life in Patients with Primary Restless Legs Syndrome.

Restless legs syndrome (RLS) is a sensorimotor disorder that can have a significant detrimental impact on the quality of life and sleep. Our aim was to examine the effects of aerobic exercise and stretching exercise programs on symptom severity, sleep, and quality of life in patients with primary RLS. A total of 18 patients between the ages of 22 and 61 were randomly divided into 3 groups as aerobic exercise, stretching exercises, and control. All exercise programs were applied 3 times a week for 8 weeks. Evaluations were performed before and after treatment. Symptom severity of the patients was evaluated by the International Restless Legs Syndrome Study Group Rating Scale, sleep was evaluated with the Pittsburgh Sleep Quality Index and actigraphy, and quality of life was evaluated with the John Hopkins Restless Legs Syndrome Quality of Life Questionnaire. Recovery status of the patients was determined using the post treatment global change scale. Aerobic exercise and the stretching exercise program were found to be effective in decreasing RLS symptoms (P = 0.025, P = 0.034) and improving subjective sleep quality (P = 0.034, P = 0.025), overall sleep quality (P < 0.001, P = 0.034), and quality of life (P = 0.009, P = 0016). Aerobic exercises were found to be more effective in reducing wake after sleep onset of sleep (P = 0.048), whereas stretching exercises reduced sleep disorders (P = 0.025). Both exercise approaches have been identified as highly effective approaches in patients with RLS. The treatment can be planned according to the choice of the available facilities, patient and clinician preference, and the advantages of the 2 exercise approaches.

Medicinal Mushroom, Ganoderma Lucidum, Improves Painful Symptoms in Patients with Restless Legs Syndrome

Restless legs syndrome (RLS) is a prevalent sensorimotor sleep disorder that worsens quality of life. All the currently available drug treatments for RLS have limitations. Extracts of the mushroom Ganoderma lucidum (GL) have shown several beneficial biological effects in neurodegenerative diseases. The objective of the present study was to evaluate the effect of a 2-month course of GL extract on the intensity of painful RLS symptoms.

Effect of Lower Limb Strengthening Exercises on Severity of Restless Leg Syndrome among Diabetic Patients: A Time Series Study

A disorder characterized by aching or burning sensations in the lower and rarely the upper extremities that occur prior to sleep or may awaken the patient from sleep. Objective: To evaluate the effect of lower limb strengthening exercises on the severity of restless leg syndrome (RLS) symptoms among diabetic patients. Methods: The time series Quasi experimental study design was conducted in the government sector (Services hospital) of Lahore for a sample size of 77 diabetic patients who were also suffering from RLS. In order to compensate dropout’s data were collected from 150 patients, from March 2018 to September 2019. IRRLSG Criterion was used to screen out presence of RLS in diabetic patients. After taking written informed consent, baseline data were collected through a questionnaire of close ended questions and proformas with pictures of lower limb muscle strengthening exercises was given to all patients. Follow-ups were taken twice through phone calls after every four weeks and the difference in the scores was noted down in both groups. Results: Patients who performed strengthening exercises reported reduced symptoms of RLS whereas those who didn’t perform exercises were excluded from the study. 96% patients reported reduced symptoms. While 4 patients did not have any improvement in their symptoms. At the end of 8 weeks majority had a significant improvement in the severity of their symptoms. Conclusions: It is concluded that an exercise program consisting of different strengthening exercises was effective in improving symptoms of RLS. No effort was made to discontinue medications that may aggravate RLS symptoms.

Perceptions of exercise and restless legs syndrome: Results from a nationwide survey.

Restless legs syndrome is a prevalent, sensorimotor sleep disorder temporarily relieved by movement, with evidence of symptomatic improvement with regular exercise. The present study describes perceptions of the effects of exercise on symptoms of restless legs syndrome. Participants (N = 528) completed a mixed-methods (i.e. numerical and narrative), nationwide survey including items assessing personal experiences with exercise and restless legs syndrome (both positive and negative), as well as restless legs syndrome diagnosis, restless legs syndrome severity, and demographic and clinical characteristics. Responses varied widely on specific experiences with exercise, but a higher percentage of participants indicated positive experiences with exercise than those who reported negative experiences (72%-40%, respectively) with exercise. Further, 54% of respondents reported that exercise only improves restless legs syndrome, while 24% reported exercise only worsens symptoms. Participants described that any abrupt change in exercise routine would almost always elicit restless legs syndrome symptoms (e.g. hiking for a long time, stopping an exercise routine), and that a consistent pattern of exercise improved restless legs syndrome symptoms with an overall beneficial effect on the frequency of symptomatic bouts. Participants further described time of day as impactful for their exercise experience, with > 50% indicating morning exercise improves symptoms and evening exercise worsens symptoms. Participants described several questions that they wanted answered regarding the evidence for exercise in restless legs syndrome and specific exercise prescription recommendations. The present study describes information crucial to the creation of stakeholder-informed health promotion programs for individuals with restless legs syndrome to optimize personalized treatment plans that could prevent and manage symptoms.