Prevalence and Associated Comorbidities of Restless Legs Syndrome (RLS): Data from a Large Population-based Door-to-door Survey on 19176 Adults in Tehran, Iran

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2017 Feb 18

PMID 28212408

Citations 5

Authors

Seyed-Mohammad Fereshtehnejad

Arash Rahmani

Mahdiyeh Shafieesabet

Mahshid Soori

Ahmad Delbari

Mohammad Reza Motamed

Johan Lokk

Affiliations

Soon will be listed here.

Abstract

Background: Discrepancies have been reported in the prevalence rate of restless legs syndrome (RLS) among different ethnic groups and geographic populations. Furthermore, there are disagreements on determinant factors and associated comorbidities of RLS. We aimed to estimate prevalence of RLS and investigate its associated comorbid conditions and risk factors in a large population-based door-to-door survey.

Methods: Following a multistage random sampling from the households lived in 22 urban districts of Tehran, Iran, 19176 participants with ≥30 years of age were recruited. Trained surveyors filled study checklist consisting of baseline characteristics, risk factors and comorbidity profile and the International RLS Study Group (IRLSSG) diagnostic criteria through face-to-face interviews.

Results: In total, 1580 individuals were positively screened for RLS resulting in a standardized prevalence rate of 60.0/1000. There was a gradual increase in RLS prevalence by advancing age, however, sex difference disappeared after adjustment. Parkinsonism [adjusted odds' ratio (adj-OR) = 7.4 (95% CI: 5.3-10.4)], peripheral neuropathy [adj-OR = 3.7 (95% CI: 3.3-4.1)], subjective cognitive impairment (SCI) [adj-OR = 3.1 (95% CI: 2.7-3.4)], acting out dreams [adj-OR = 2.8 (95% CI: 2.5-3.2)], hyposmia [adj-OR = 2.5 (95% CI: 2.2-2.9)], active smoking [adj-OR = 1.5 (95% CI: 1.3-1.9)] and additional number of cardiometabolic diseases associated with higher risk of RLS [adj-OR = 1.6 (95% CI: 1.2-2.3)].

Conclusion: Our findings showed that neuro-cognitive co-morbidities such as parkinsonism, peripheral neuropathy, SCI, acting out dreams and hyposmia as well as cardio-metabolic risk factors and diseases were independent determinants of RLS. It is recommended to screen individuals with either these comorbid conditions for RLS or the ones with RLS for the accompanying diseases.

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References

Fereshtehnejad S, Shafieesabet M, Shahidi G, Delbari A, Lokk J . Restless legs syndrome in patients with Parkinson's disease: a comparative study on prevalence, clinical characteristics, quality of life and nutritional status. Acta Neurol Scand. 2014; 131(4):211-8. DOI: 10.1111/ane.12307. View

Wong J, Li Y, Schwarzschild M, Ascherio A, Gao X . Restless legs syndrome: an early clinical feature of Parkinson disease in men. Sleep. 2014; 37(2):369-72. PMC: 3900617. DOI: 10.5665/sleep.3416. View

Hening W, Allen R, Washburn M, Lesage S, Earley C . The four diagnostic criteria for Restless Legs Syndrome are unable to exclude confounding conditions ("mimics"). Sleep Med. 2009; 10(9):976-81. PMC: 2769267. DOI: 10.1016/j.sleep.2008.09.015. View

Rijsman R, Schoolderman L, Rundervoort R, Louter M . Restless legs syndrome in Parkinson's disease. Parkinsonism Relat Disord. 2013; 20 Suppl 1:S5-9. DOI: 10.1016/S1353-8020(13)70004-X. View

Meneghini F, Rocca W, Anderson D, Grigoletto F, Morgante L, Reggio A . Validating screening instruments for neuroepidemiologic surveys: experience in Sicily. Sicilian Neuro-Epidemiologic Study (SNES) Group. J Clin Epidemiol. 1992; 45(4):319-31. DOI: 10.1016/0895-4356(92)90033-j. View

Szentkiralyi A, Volzke H, Hoffmann W, Happe S, Berger K . A time sequence analysis of the relationship between cardiovascular risk factors, vascular diseases and restless legs syndrome in the general population. J Sleep Res. 2013; 22(4):434-42. DOI: 10.1111/jsr.12040. View

Gupta R, Dhyani M, Kendzerska T, Pandi-Perumal S, BaHammam A, Srivanitchapoom P . Restless legs syndrome and pregnancy: prevalence, possible pathophysiological mechanisms and treatment. Acta Neurol Scand. 2015; 133(5):320-9. PMC: 5562408. DOI: 10.1111/ane.12520. View

Fulda S, Beitinger M, Reppermund S, Winkelmann J, Wetter T . Short-term attention and verbal fluency is decreased in restless legs syndrome patients. Mov Disord. 2010; 25(15):2641-8. DOI: 10.1002/mds.23353. View

Sevim S, Dogu O, Kaleagasi H, Aral M, Metin O, Camdeviren H . Correlation of anxiety and depression symptoms in patients with restless legs syndrome: a population based survey. J Neurol Neurosurg Psychiatry. 2004; 75(2):226-30. PMC: 1738920. View

10.

Gao X, Schwarzschild M, Wang H, Ascherio A . Obesity and restless legs syndrome in men and women. Neurology. 2009; 72(14):1255-61. PMC: 2677487. DOI: 10.1212/01.wnl.0000345673.35676.1c. View

11.

McCrink L, Allen R, Wolowacz S, Sherrill B, Connolly M, Kirsch J . Predictors of health-related quality of life in sufferers with restless legs syndrome: a multi-national study. Sleep Med. 2006; 8(1):73-83. DOI: 10.1016/j.sleep.2006.03.014. View

12.

Wali S, Abaalkhail B . Prevalence of restless legs syndrome and associated risk factors among middle-aged Saudi population. Ann Thorac Med. 2015; 10(3):193-8. PMC: 4518350. DOI: 10.4103/1817-1737.160839. View

13.

Li Y, Wang W, Winkelman J, Malhotra A, Ma J, Gao X . Prospective study of restless legs syndrome and mortality among men. Neurology. 2013; 81(1):52-9. PMC: 3770202. DOI: 10.1212/WNL.0b013e318297eee0. View

14.

Carlos K, Prado L, Carvalho L, Prado G . Willis-Ekbom Disease or Restless Legs Syndrome?. Sleep Med. 2015; 16(9):1156-9. DOI: 10.1016/j.sleep.2015.05.022. View

15.

McKinnon J, Evidente V, Driver-Dunckley E, Premkumar A, Hentz J, Shill H . Olfaction in the elderly: a cross-sectional analysis comparing Parkinson's disease with controls and other disorders. Int J Neurosci. 2010; 120(1):36-9. DOI: 10.3109/00207450903428954. View

16.

Duarte J, Claveria L, de Pedro-Cuesta J, Sempere A, Coria F, Calne D . Screening Parkinson's disease: a validated questionnaire of high specificity and sensitivity. Mov Disord. 1995; 10(5):643-9. DOI: 10.1002/mds.870100518. View

17.

Batool-Anwar S, Li Y, De Vito K, Malhotra A, Winkelman J, Gao X . Lifestyle Factors and Risk of Restless Legs Syndrome: Prospective Cohort Study. J Clin Sleep Med. 2015; 12(2):187-94. PMC: 4751426. DOI: 10.5664/jcsm.5482. View

18.

Fereshtehnejad S, Shafieesabet M, Rahmani A, Delbari A, Lokk J . Medium-to-high prevalence of screening-detected parkinsonism in the urban area of Tehran, Iran: data from a community-based door-to-door study. Neuropsychiatr Dis Treat. 2015; 11:321-32. PMC: 4327401. DOI: 10.2147/NDT.S77391. View

19.

Walters A, Rye D . Review of the relationship of restless legs syndrome and periodic limb movements in sleep to hypertension, heart disease, and stroke. Sleep. 2009; 32(5):589-97. PMC: 2675893. DOI: 10.1093/sleep/32.5.589. View

20.

Ohayon M, OHara R, Vitiello M . Epidemiology of restless legs syndrome: a synthesis of the literature. Sleep Med Rev. 2011; 16(4):283-95. PMC: 3204316. DOI: 10.1016/j.smrv.2011.05.002. View