Restless Legs 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.

Elevated C-reactive protein levels and cardiovascular risk in prurigo nodularis patients with sleep disturbance: a multi-center cohort study.

Patients with prurigo nodularis (PN) present with pruritus which may lead to sleep disturbances and systemic comorbidities. The objective of our study was to determine the risk of sleep disorders in PN and its association with systemic inflammation and adverse cardiovascular outcomes. We conducted a retrospective population-level cohort using a global health records database to analyze the development of sleep disorders, C-reactive protein (CRP) levels, and risk of cardiovascular disease and mortality in PN compared to controls. PN patients had increased risk of general sleep disorders (RR 1.47, 95%CI 1.42-1.52, obstructive sleep apnea (1.61, 1.54-1.69), insomnia (1.37, 1.29-1.45), hypersomnia (1.47, 1.32-1.64), and restless legs syndrome (1.45, 1.28-1.65). Additionally, PN with sleep disorders had higher CRP levels than PN without sleep disorders (16.2mg/L vs. 10.6mg/L). PN patients with sleep disorders were more likely to develop cardiovascular comorbidities, including type 2 diabetes mellitus (RR 2.45, 95%CI 2.25-2.66), metabolic syndrome (4.16, 3.31-5.22), myocardial infarction (2.87, 2.52-3.22), venous thromboembolism (2.93, 2.55-3.39), and greater mortality (HR 1.47, 95%CI 1.34-1.62) compared to PN patients without sleep disorders. Our findings suggest that PN patients are at greater risk of developing various sleep disorders that are associated with adverse cardiovascular outcomes.

Features of sleep disorders in children with psoriasis and comorbid pathologies

Purpose of the study. To analyze observations of sleep disorders in children with psoriasis and comorbid diseases.Materials and methods. This article describes clinical cases of sleep disorders in 14- and 15-year-old patients with psoriasis and comorbid diseases (psoriatic arthritis (PsA) and exogenous-constitutional obesity of the 2nd degree) who were treated at National Medical Research Center for Children’s Health of the Ministry of Health of the Russia.Results. Based on the results of collecting anamnesis and polysomnographic study (PSG), it was found that a 14-year-old child with a combination of severe plaque psoriasis (PASI index-21.3 points) and PsA had restless legs syndrome (RLS) of moderate severity, decreased sleep efficiency, and increased sleep fragmentation due to frequent awakenings. A 15-year-old patient with severe plaque psoriasis (PASI-66 score) and grade 2 exogenous-constitutional obesity had moderate obstructive sleep apnea syndrome (OSAS), as well as increased time to fall asleep, reduced sleep efficiency, and increased sleep fragmentation due to frequent awakenings.Conclusions. Sleep disorders are common in children with psoriasis and comorbid pathologies. At the same time, the implementation of a specific variant of dyssomnia or parasomnia depends on both the underlying disease and the concomitant ones.

Association between iron intake and excessive daytime sleepiness in the community-dwelling Japanese: the Toon Health Study.

Brain iron deficiency is known to cause dopaminergic dysfunction in people with restless legs syndrome. Considering the role that dopamine plays in the wake-promoting system, we speculated that iron deficiency may contribute to the development of excessive daytime sleepiness (EDS). Therefore, we conducted the present study to examine the association between iron intake and EDS in the general population. We collected data from the participants of the Toon Health Study from 2009 to 2017 (N = 2405) and conducted a cross-sectional analysis. EDS was defined as an Epworth Sleepiness Scale score ≥ 11. Participants were divided into four groups according to quartiles of estimated iron intake from their responses to the Food Frequency Questionnaire. We used sex, age, body mass index, and sleep duration as adjustment variables. The mean age of the participants was 57.9 years, and 64.2% were women. Compared to the highest quartile of iron intake, the multivariable-adjusted odds ratio for EDS of the lowest quartile was 1.38 (95% confidence interval [CI]: 1.04-1.83, p for trend = 0.03). When the analysis was restricted to participants with a Pittsburgh Sleep Quality Index (PSQI) score < 6, the odds ratio was 1.57 (95% CI: 1.06-2.31, p for trend = 0.04). Significant inverse associations were observed between iron intake and EDS. This tendency was also observed in participants without substantial subjective sleep disturbance (i.e., PSQI score < 6), suggesting that iron deficiency may play a role in the wake-promoting system independently of sleep disturbances.

Identification of Causal Genes and Potential Drug Targets for Restless Legs Syndrome: A Comprehensive Mendelian Randomization Study

Background: Restless legs syndrome (RLS) is a common sensorimotor sleep disorder that affects sleep quality of life. Much effort has been made to make progress in RLS pharmacotherapy; however, patients with RLS still report poor long-term symptom control. Methods: Comprehensive Mendelian randomization (MR) was performed to search for potential causal genes and drug targets using the cis-pQTL and RLS GWAS data. Robustness was validated using the summary-based Mendelian randomization (SMR) method and co-localization analysis. Further evidence of pleiotropy of the target genes and their potential side effects was provided by phenome-wide MR analysis (MR-PheWAS). Finally, molecular docking simulations were conducted on drug candidates corresponding to these targets, which revealed promising binding affinities and interaction patterns and underscored the druggable potential of the target gene. All of the analyses above were conducted in the context of Homo sapiens. Results: MAN1A2 showed a statistically significant result in the MR analysis, which was validated through SMR and co-localization analysis. The MR-PheWAS showed a low probability of pleiotropy and prospective side effects. Molecular docking was used to visualize the binding structure and fine affinity for MAN1A2 and the drugs predicted by DSigDB. Conclusions: Our study provides comprehensive evidence supporting MAN1A2 as a promising causal gene and therapeutic target for RLS, offering insights into the underlying molecular mechanisms and paving the way for future drug development efforts.

Small vessel disease in patients with restless legs syndrome evidenced by elevated peak width of skeletonized mean diffusivity

Peak width of skeletonized mean diffusivity (PSMD) is a novel marker of small vessel disease. This study aimed to investigate small vessel disease in patients with restless legs syndrome (RLS) using PSMD. We prospectively enrolled 65 patients with primary RLS and 59 age- and sex-matched healthy controls. Diffusion tensor imaging (DTI) was performed using a 3-T magnetic resonance imaging scanner in patients with RLS and healthy controls. We obtained PSMD by DTI in several steps, including preprocessing, skeletonization, application of a custom mask, and histogram analysis. We compared the PSMD between patients with RLS and healthy controls and performed a correlation analysis between the PSMD and clinical characteristics in patients with RLS. The PSMD significantly differed between patients with RLS and healthy controls; it was higher in patients with RLS than that in healthy controls (2.423 vs. 2.298 × 10−4 mm2/s, p = 0.017). The PSMD significantly differed according to the RLS severity (2.305 × 10−4 mm2/s, moderate RLS; 2.368 × 10−4 mm2/s, severe RLS; 2.477 × 10−4 mm2/s, very severe RLS; p = 0.003). Additionally, the PSMD was positively correlated with age (r = 0.522, p < 0.001) and RLS severity (r = 0.263, p = 0.033). Patients with RLS exhibited a higher PSMD than that in healthy controls, indicating the evidence of small-vessel disease in RLS and that the severity increased as RLS severity increased. These findings provide crucial information for clinical management and treatment strategies, highlighting the importance of addressing small vessel disease in patients with RLS.

Estudio prospectivo del síndrome de piernas inquietas en una muestra de donantes de sangre

Background and objectivesBlood donation is suggested to increase the risk of Restless Legs Syndrome (RLS). This study aims to assess the prevalence of RLS in Spanish blood donors and determined its potential correlation with iron metabolism parameters. Materials and methodsProspective cohort study of 129 blood donors (54.3% men, 39.44 years±11.0) that underwent a physical examination, blood analysis (hemoglobin, ferritin, transferrin saturation index and soluble transferrin receptor) and a RLS screening questionnaire followed by a prospective follow-up study including a clinical phone interview. A multivariate logistic regression model was performed to examine the association between RLS and other variables. ResultsEighty-four (65.1%) participants were repeat blood donors (mean of 2.11 donations/year) at inclusion and 61 (47.4%) at follow-up (mean of 2.09 donations/year). Non-anemic iron deficiency (ferritin<50μg /L) was high in women P<.001 and in repeat donors (P=.003). The prevalence of RLS was 14.1% at inclusion increasing prospectively (19.5%; P=.065). On multivariate analysis, gender was the only variable significantly associated with a RLS diagnosis, being higher in women (OR 5.1; 95% CI 1.71-15.3; P=.003). ConclusionsDespite the high prevalence of non-anemic iron deficiency there was no association between ferritin, soluble transferrin receptor concentration values and RLS diagnosis. Gender was associated with RLS diagnosis regardless of other variables.

Using Cannabis and CBD to Sleep: An Updated Review.

Cannabis sativa and constituent cannabinoids are in widespread use for the treatment of sleep disorders where many patients desire pharmacotherapy. Previous reviews highlight a lack of high-quality evidence to support the efficacy and long-term safety of cannabinoids in various conditions. We aim to provide an update of recent original research evaluating cannabinoid-based therapeutics in sleep disorders. We identified twenty-one recent studies of cannabinoids for insomnia, subjective sleep impairment, obstructive sleep apnoea, rapid eye movement sleep behaviour disorder, and restless legs syndrome. We note trends towards the use of minor cannabinoids, studies using decentralised approaches and increased utilisation of objective measures in clinical trials. The evidence-base does not match widespread use of cannabinoids for the treatment of sleep disorders. There is a growing need for adequately funded well-designed clinical trials with longer treatment durations and decent sample sizes to inform both the clinician and patient.

The hidden impact of sleep disorders in the post-pandemic world

Studying sleep disorders is crucial due to their substantial influence on behavior and health in all age groups. The complex interplay of genetic, environmental, and lifestyle factors, including hormonal fluctuations, stress, and ozone exposure, is the cause of these disorders, which include insomnia, parasomnia, central hypersomnolence disorder, sleep-disordered breathing, and circadian rhythm sleep&amp;ndash;wake disorders. They impact behavior, deteriorate social connections, and impair cognitive abilities, physical well-being, and emotional stability. The complex relationship between sleep and mental health frequently eludes attention, with approximately 17% of adults experiencing mental disorders during their lifetime. Frequently, insomnia is associated with anxiety and depression, indicating a bidirectional relationship. Conversely, individuals with mental health issues are susceptible to sleep disorders such as narcolepsy, restless legs syndrome, and sleep apnea. Treatment modalities such as relaxation therapy, stimulus control, and cognitive-behavioral therapy provide prospects for improvement, along with preventive measures such as maintaining a regular sleep schedule and exercising daily. The pandemic&amp;rsquo;s effect on sleep health has led to the introduction of terms such as &amp;ldquo;coronasomnia&amp;rdquo; and &amp;ldquo;COVID-somnia,&amp;rdquo; urging further studies on post-COVID-19 conditions. This review examines various sleep disorders, their effects, treatments, and the pandemic&amp;rsquo;s impact on sleep patterns, aiming to guide readers through the evolving landscape of sleep health during this global upheaval.

Characteristics of the Differential Response to Exercise in Adults with Restless Legs Syndrome

Objective/Background: Restless legs syndrome (RLS) is a prevalent, sensorimotor sleep disorder characterized by the irresistible urge to move that is temporarily relieved by movement. Despite evidence for the benefits of exercise in RLS, inter-individual variation in the response to exercise exists, whereby some people experience symptom improvement while others report exacerbations. The present study examined factors that may account for differences in perceived responses to exercise in RLS. Patients/MethodsParticipants (N=527) completed a nationwide survey with items assessing RLS, physical activity, sedentary levels, and experiences with RLS responsiveness to exercise. Logistic regression analyses examined associations between individual characteristics (e.g., age, sex) and perceptions of improvement and exacerbation with exercise. Exploratory analyses examined characteristics associated with perceived positive responsiveness (i.e., exercise only improves RLS) or negative responsiveness (i.e., exercise only worsens RLS). ResultsOrdinal logistic regression identified lower RLS severity (OR=0.83,p=0.044), higher prevalence of a condition that could cause secondary RLS (OR=1.76,p=0.005), lower prevalence of periodic limb movements (OR=0.52,p=0.001), and higher physical activity levels (OR=1.47,p<0.001) as significant, independent predictors of exercise improving RLS symptoms. Individual feature ordinal logistic regression identified female sex as significantly associated with exercise exacerbating symptoms (OR=0.62,p=0.008). Exploratory logistic regression identified people with higher BMI (OR=0.69,p=0.019) and higher RLS severity (OR=0.70, p=0.026) had lower odds of being positive responders to exercise. ConclusionsThe present study presents factors that might account for individual differences in the response to exercise. Overall, our results suggest that milder cases of RLS (lower severity, absence of PLMs), people with secondary forms of RLS, and those with a lower BMI may perceive exercise as more beneficial for symptoms. These should be considered in exercise-based management aimed at managing symptoms as the collective body of research supports the benefits of exercise in adults with RLS.

Restless legs syndrome in multiple sclerosis: uncovering prevalence and clinical aspects.

The aim of the study is to determine the prevalence of restless legs syndrome (RLS) in patients with relapsing-remitting multiple sclerosis (RRMS) and explore its associations with sleep quality, comorbidities and quality of life. RLS and RRMS diagnosis were made using the latest criteria the International Classification of Sleep Disorders-3 (ICSD-3) criteria and 2017 McDonald criteria. A total of 210 individuals, including 105 patients diagnosed with RRMS and 105 healthy volunteers were included into the study. Data of demographical and disease characteristics and RLS properties were collected. Several scales to assess anxiety, depression, fatigue, sleep quality and quality of life scales were used. RLS prevalence was found in 21.9% of RRMS patients and 12.4%of healthy volunteers. RRMS patients with RLS exhibit significantly higher anxiety and depression scores in sleep quality, fatigue and quality of life compared to the patients without RLS. This study highlights a higher prevalence of RLS in patients with RRMS compared to healthy individuals. RRMS patients with RLS exhibited distinct characteristics, including lower sleep quality and higher quality of life scores while RLS was nod significantly associated with demographic or clinical variables. Recognizing RLS in patients with RRMS is important for the treatment and improving their overall well-being.

Concurrent Evaluation of Restless Leg Syndrome, Neuropathic Pain, and Quality of Life in Anti-neutrophil Cytoplasmic Antibody-Associated Vasculitis: Single-Center Data

Concurrent Evaluation of Restless Leg Syndrome, Neuropathic Pain, and Quality of Life in Anti-neutrophil Cytoplasmic Antibody-Associated Vasculitis: Single-Center Data

Exploring the pathophysiology of restless leg syndrome: focus on white matter structure and function.

Restless legs syndrome (RLS) is a sleep disorder characterized by an irresistible urge to move the legs, with pathogenesis involving genetic, environmental, and neurobiological factors. Recent advancements in imaging techniques have provided valuable insights into the pathophysiological mechanisms of RLS. To synthesize recent research on white matter fiber alterations in RLS and their role in disease pathology. This review synthesized recent research on RLS, focusing on neuroimaging findings, particularly white matter fiber alterations, and their implications for disease mechanisms. Studies involving structural and functional MRI were analyzed. Imaging studies suggested that RLS was associated with white matter integrity changes, affecting areas linked to sensory and motor control. These alterations may reflect disruptions in central nervous system pathways regulating movement. White matter changes provide valuable insights into the pathophysiology of RLS, enhancing our understanding of the disorder and potentially guiding future therapeutic strategies.

The clinical implications of the comorbidity between restless legs syndrome and migraines

The clinical implications of the comorbidity between restless legs syndrome and migraines

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.

Sleep related injury and its correlates in isolated rapid eye movement sleep behavior disorder

ObjectivesTo evaluate factors associated with sleep related injury (SRI) and persistent SRI (pSRI) in patients with isolated rapid eye movement sleep behavior disorder (iRBD). MethodsThis is a retrospective cohort study. A total of 388 patients with iRBD were involved for a comprehensive review of sleep related injuries. SRI is defined as a lifetime history of injurious behaviors to self and/or bed partner, and pSRI is considered if injurious symptoms continued to occur frequently (≥ 1/month). Correlations of SRI/pSRI with clinical, lifestyle and polysomnographic characteristics were analyzed. ResultsLifetime SRI was reported in 322 (83%) patients (66.3 ± 8.5 years old, male 77.0%), with 19.3% having severe injuries, including fractures (2.5%) and subdural hemorrhage (1.2%), while 7.5% required medical attendance. SRI was related to more severe depressive features (Padj = 0.017), current alcohol drinking (Padj = 0.014) and higher mentalis phasic and tonic EMG activity (Padj = 0.042 and 0.048). After a mean follow-up of 5.1 years, 18.2% of SRI patients (38/209) had pSRI despite intense treatment. Frequent nightmare at baseline (OR [95% CI] = 1.43 [1.01, 2.03]), restless leg syndrome (OR [95% CI] = 5.68 [1.42, 22.64]) and adult-onset sleepwalking (OR [95% CI] = 2.52 [1.10, 5.76]) were associated with an increased risk of pSRI. ConclusionsSRI is common in patients with iRBD and 18% had pSRI despite intensive treatment, emphasizing the importance of bedside safety. The identification of risk factors for SRI and pSRI underscores the need for systematic clinical screening and targeted interventions for at-risk patients.

Investigating olfactory and gustatory dysfunction in patients with restless legs syndrome: A comparative analysis with healthy controls

Background/Aim: This study aims to examine the correlation between dopamine deficiency and olfactory dysfunction in patients with restless legs syndrome (RLS) and to juxtapose these findings with gustatory function. This comprehension of the relationship may illuminate the pathophysiology of RLS, suggesting possible therapeutic targets. Methods: We included a total of 100 male participants aged 40 and older, comprising 50 healthy volunteers and 50 patients with RLS. Participants were recruited from the Neurology Clinic at Sultan Abdulhamid Han Training and Research Hospital between September 2016 and April 2017. We objectively assessed olfactory function using the Sniffin’ Sticks Test Battery, while gustatory function was evaluated using the Taste Strip test—participants identified the flavors presented to them. Results: The mean age of the RLS patient group was 52.5 years, while it was 52.7 years for the healthy group. Olfactory test scores were significantly lower in the RLS group compared to the healthy group (P&lt;0.05). Likewise, gustatory test scores were also significantly lower in RLS patients (P=0.032). A strong positive correlation was observed between the olfactory and gustatory test results (r=+0.72), indicating a significant decline in both sensory functions in RLS patients. Conclusion: This study reveals a significant association between dopamine deficiency, olfactory dysfunction, and impaired taste perception in RLS patients. These findings suggest that RLS may involve underlying neurodegenerative processes affecting sensory perception. Further research is crucial to shed light on RLS mechanisms, which remain partially understood, and guide the development of targeted therapeutic strategies.

The prevalence of sleep disorders in Iranian adults - an epidemiological study

BackgroundSleep disorders can be harmful to our health and treating them can also be expensive. Due to the widespread occurrence and impact of sleep disorders, it is valuable to investigate and study them from an epidemiological perspective. Therefore, this study aimed to determine the prevalence of sleep disorders among Iranian adults in 2022.MethodThis is a cross-sectional study that examines the prevalence of sleep disorders and problems in Iranian society. The participants were selected using a mixed sampling approach (utilizing virtual space and cluster sampling). A two-part package was used for evaluating participants sleep problems, which included a demographic profile form and the Holland Sleep Disorders Questionnaire. After collecting the data, appropriate statistical tests in SPSS version 25 were utilized for analysis.ResultsA total of 6013 questionnaires were fully filled out for this research, with participants answering the specific questions. The participants’ score on sleep disorders was 1.94, which means 44.1% of them suffer from sleep disorders. The results indicated that the prevalence of sleep disorders in this study was as follows: insomnia (35%), parasomnia (35.3%), circadian rhythm sleep disorder (38.4%), hypersomnia and excessive daytime sleepiness (39%), restless leg syndrome and leg movements during sleep (43%), and breathing disorders related to sleep (38.4%). The prevalence of sleep disorders among the study participants demonstrated a significant relationship with most of their demographic variables (P < 0.001). The Pearson correlation coefficient also revealed an inverse and significant relationship between the prevalence of sleep disorders in the study participants and their age, monthly household income, and BMI (P < 0.001).ConclusionOverall, the results depicted a relatively high prevalence of sleep disorders in the studied community. These findings emphasize the need for interventions to prevent and treat sleep disorders in society.

Evaluation of pitolisant, sodium oxybate, solriamfetol, and modafinil for the management of narcolepsy: a retrospective analysis of the FAERS database.

Narcolepsy, a rare neurological disorder believed to have an autoimmune etiology, necessitates lifelong management. This study aimed to provide evidence supporting the safety of pharmacological treatment for narcolepsy. Five-year data on pitolisant, sodium oxybate, solriamfetol, and modafinil were extracted from the FDA Adverse Event Reporting System (FAERS) self-reporting database for the period spanning from 2019 to 2023. Various statistical methods, including the reporting odds ratio (ROR), proportional reporting ratio (PRR), Bayesian confidence propagation neural network analysis (BCPNN), and multi-item gamma Poisson shrinker (MGPS), were employed to quantify the signals. Finally, a comparative analysis was conducted between demographic data, outcomes, and inherent associations among the medications and the signals. After data analysis, we obtained 50 signals (a cumulative count of 762 cases) for pitolisant, 640 signals (corresponding to 46,962 cases) for sodium oxybate, 40 signals (equivalent to 1,228 cases) for solriamfetol, and finally, 72 signals (representing 632 cases) for modafinil. The majority of these patients were female. Psychiatric and nervous system disorders were identified as the predominant adverse drug events (ADEs). For sodium oxybate, it is crucial to consider psychiatric disorders (such as suicidal ideation), respiratory disorders (including sleep apnea syndrome and respiratory depression), and signs of pregnancy and congenital familial diseases. For solriamfetol, noteworthy new ADEs include drug inefficacy, suicidal ideation, restless legs syndrome, and somnambulism. Furthermore, a relationship has been observed between modafinil use and restricted fetal growth, spontaneous abortion, cognitive disorders, and drug inefficacy and abuse. The majority of observed adverse reactions in this study were consistent with those listed in the product instructions. However, potential novel or notable ADE signals were identified through real-world pharmacovigilance analysis. It is anticipated that this paper will offer additional information regarding safe and rational medication for narcolepsy.

Prevalence of restless genital syndrome and its impact on quality of life in women with restless legs syndrome

ABSTRACT Background Restless genital syndrome (RGS), also known as persistent genital arousal disorder, is a distressing condition characterized by unwanted genital arousal in the absence of sexual desire. This study explores the prevalence of RGS in women with restless legs syndrome (RLS), investigates the associated psychological impacts, and assesses the overall effect on quality of life. Methods This retrospective study included 69 female patients who were diagnosed with RLS at two university medical centers. Data were collected via the RGS diagnostic form, Beck Depression Inventory, Beck Anxiety Inventory, and WHOQOL-BREF quality of life scale. Statistical analyses were used to assess the correlation between RGS and psychological health measures. Results Approximately 44.9% of the participants with RLS also reported symptoms of RGS. Significant findings included increased nighttime and rest-related exacerbation of RGS symptoms. Compared with those without RGS, participants with RGS presented significantly higher anxiety and depression scores. Moreover, RGS significantly impacted physical health and social relationships, as indicated by lower WHOQOL-BREF scores. Conclusion This study highlights a significant overlap between RGS and RLS, with substantial impacts on psychological well-being and quality of life. These findings underscore the importance of considering RGS in the clinical management of RLS, suggesting a need for integrated treatment strategies to address both the neurological and the psychological aspects of these conditions.