Restless Leg Syndrome in Patients with Multiple Sclerosis and its Effect on Frequency of Daytime Sleepiness and Fatigue of the Patients

Authors

  • Nahid Ashjazadeh Shiraz Neuroscience Research Center, Neurology Department, Shiraz University of Medical Sciences, Shiraz, Iran
  • Zahra Shamszadeh

DOI:

https://doi.org/10.31661/gmj.v5i1.422

Keywords:

Restless Legs Syndrome, Multiple Sclerosis, Fatigue, Daytime Sleepiness

Abstract

Background: Restless leg syndrome (RLS), fatigue and daytime sleepiness are three known co-morbidities in patients with multiple sclerosis (MS). The aim of this study was to evaluate the frequency of RLS in patients with MS and its effect on the frequency of fatigue and daytime sleepiness in these patients. Material and Methods: One hundred twenty patients who referred to the Inpatients Neurology Ward of Chamran hospital, affiliated with the Shiraz University of Medical Sciences, from June 2014 to March 2015, were selected as the study participants. The patients with clinically definite MS, according to the 2010 Revised Mc-Donald criteria, and expanded disability status scale (EDSS) ≤5.5 were included. RLS, fatigue and daytime sleepiness were assessed by the criteria of the International RLS study group (IRLSSG), fatigue severity scale (FSS) and Epworth sleepiness scale (ESS) respectively and the related statistical analyzes were conducted. Results: Seventy eight patients (65%) met all the four IRLSSG criteria, 77 patients (64.1%) suffered from fatigue and only 36 patients (30%) had excessive daytime sleepiness. RLS was not significantly linked to mean age, sex, MS duration, and daytime sleepiness of the studied MS patients, but fatigue was more frequent in MS patients with RLS, which was statistically significant (P=0.018). Conclusion: The main result of this study is that RLS is a common comorbidity in MS and the patients with MS, who also suffer from RLS. They have frequently experienced higher fatigue symptoms than those without RLS. Therefore, the appropriate diagnosis and management of RLS may improve both RLS and fatigue in these patients. [GMJ. 2016;5(1):7-12]

Author Biography

Nahid Ashjazadeh, Shiraz Neuroscience Research Center, Neurology Department, Shiraz University of Medical Sciences, Shiraz, Iran

Dr. Nahid Ashjazadeh, Associate Professor of Neurology, Shiraz Neuroscience Research Center, Department of Neurology, Shiraz University of Medical Sciences, Shiraz, Iran

References

Allen RP, Picchietti D, Hening WA, Trenkwalder C, Walters AS, Montplaisi J, et al. Restless legs syndrome: diagnostic criteria, special considerations, and epidemiology. A report from the restless legs syndrome diagnosis and epidemiology workshop at the National Institutes of Health. Sleep Med 2003; 4(2): 101-19.

Ekbom KA. Restless legs: a clinical study. Acta Med Scand 1945; 158 (Suppl. 1): 1-122.

Allen RP, Walters AS, Montplaisir J, Hening W, Myers A, Bell TJ, et al. Restless legs syndrome prevalence and impact: REST general population study. Arch Intern Med 2005; 165(11): 1286-92.

Ferri R, Zucconi M, Manconi M, Bruni O, Ferini-Strambi L, Vandi S, et al. Different periodicity and time structure of leg movements during sleep in narcolepsy/cataplexy and restless legs syndrome. Sleep 2006; 29(12): 1587-94.

Hornyak M, Feige B, Riemann D, Voderholzer U. Periodic leg movements in sleep and periodic limb movement disorder: prevalence, clinical significance and treatment. Sleep Med Rev 2006; 10(3): 169-77.

Tison F, Crochard A, Léger D, Bouée S, Lainey E, El Hasnaoui A. Epidemiology of restless legs syndrome in French adults: a nationwide survey. The INSTANT study. Neurology 2005; 65(2): 239-46.

Rothdach AJ, Trenkwalder C, Haberstock J, Keil U, Berger K. Prevalence and risk factors of RLS in an elderly population: the MEMO study. Memory and morbidity in Augsburg elderly. Neurology 2000; 54(5): 1064-8.

Sun ER, Chen CA, Ho G, Earley CJ, Allen RP. Iron and the restless legs syndrome. Sleep 1998; 21(4): 371-7.

Winkelman JW, Chertow GM, Lazarus JM. Restless legs syndrome in end-stage renal disease. Am J Kidney Dis 1996; 28(3): 372-8.

Goodman JD, Brodie C, Ayida GA. Restless leg syndrome in pregnancy. BMJ 1988; 297(6656): 1101-2.

Lee KA, Zaffke ME, Baratte-Beebe K. Restless legs syndrome and sleep disturbance during pregnancy: the role of folate and iron. J Womens Health Gend Based Med 2001; 10(4): 335-41.

Trenkwalder C, Paulus W. Restless legs syndrome: pathophysiology, clinical presentation and management. Nat Rev Neurol 2010; 6(6): 337-46.

Gómez-Choco MJ, Iranzo A, Blanco Y, Graus F, Santamaria J, Saiz A. Prevalence of restless legs syndrome and REM sleep behavior disorder in multiple sclerosis. Mult Scler 2007; 13(6): 805-8.

Shaygannejad V, Ardestani PE, Ghasemi M, Meamar R. Restless legs syndrome in Iranian multiple sclerosis patients: a case-control study. Int J Prev Med 2013; 4(Suppl 2): S189-93.

Caminero A, Bartolomé M. Sleep disturbances in multiple sclerosis. J Neurol Sci 2011; 309(1-2): 86-91.

Italian REMS Study Group, Manconi M, Ferini-Strambi L, Filippi M, Bonanni E, Iudice A, et al. Multicenter case-control study on restless legs syndrome in multiple sclerosis: the REMS study. Sleep 2008; 31(7): 944-52.

Deriu M, Cossu G, Molari A, Murgia D, Mereu A, Ferrigno P, et al. Restless legs syndrome in multiple sclerosis: a case-control study. Mov Disord 2009; 24(5): 697-701.

Manconi M, Rocca MA, Ferini-Strambi L, Tortorella P, Agosta F, Comi G, et al. Restless legs syndrome is a common finding in multiple sclerosis and correlates with cervical cord damage. Mult Scler 2008; 14(1): 86-93.

Polman CH, Reingold SC, Banwell B, Clanet M, Cohen JA, Filippi M, et al. Diagnostic criteria for multiple sclerosis: 2010 revision to the Mcdonald criteria. Ann Neurol 2011; 69(2): 292-302.

Johns MW. A new method for measuring daytime sleepiness; the Epworth Sleepiness Scale. Sleep 1991; 14(6): 540-5.

Sadeghniiat Haghighi K, Montazeri A, Khajeh Mehrizi A, Aminian O, Rahimi Golkhandan A, Saraei M, et al. The Epworth Sleepiness Scale: translation and validation study of the Iranian version. Sleep Breath 2013; 17(1): 419-26.

Azimian M, Shahvarughi Farahani A, Dadkhah A, Fallahpour M, Karimlu M. Fatigue severity scale: the psychometric properties of the Persian-version in patients with multiple sclerosis. Res J Biol Sci 2009; 4: 974-7.

Ondo WG. Restless legs syndrome. Neurol Clin 2009; 27(3): 779-99.

Najafi MR, Saadatnia M, Saffarifard A, Keyhanian K, Davoudi V. Epidemiology of restless legs syndrome in the Iranian population. Sleep Biol Rhythms 2011; 9(1): 56-9.

Cho YW, Shin WC, Yun CH, Hong SB, Kim JH, Allen RP, et al. Epidemiology of restless legs syndrome in Korean adults. Sleep 2008; 31(2): 219-23.

Mizuno S, Miyaoka T, Inagaki T, Horiguchi J. Prevalence of restless legs syndrome in non-institutionalized Japanese elderly. Psychiatry Clin Neurosci 2005; 59(4): 461-5.

Fragoso YD, Finkelsztejn A, Gomes S, Kaimen-Maciel DR, Oliveira CL, Lopes J, et al. Restless legs syndrome and multiple sclerosis: a Brazilian multicenter study and meta-analysis of the literature. Arq Neuropsiquiatr 2011; 69(2A): 180-3.

Aydar G, Kurt S, Karaer Unaldi H, Erkorkmaz U. Restless legs syndrome in multiple sclerosis. Eur Neurol 2011; 65(5): 302-6.

Miri S, Rohani M, Sahraian MA, Zamani B, Shahidi GA, Sabet A, et al. Restless legs syndrome in Iranian patients with multiple sclerosis. Neurol Sci 2013; 34(7): 1105-8.

Moreira NC, Damasceno RS, Medeiros CA, Bruin PF, Teixeira CA, Horta WG, et al. Restless leg syndrome, sleep quality and fatigue in multiple sclerosis patients. Braz J Med Biol Res 2008; 41(10): 932-7.

Ghajarzadeh M, Sahraian MA, Fateh R, Daneshmand A. Fatigue, Depression and Sleep Disturbances in Iranian Patients with Multiple Sclerosis. Acta Med Iran 2012; 50(4): 244-9.

Sieminski M, Losy J, Partinen M. Restless legs syndrome in multiple sclerosis. Sleep Med Rev 2015; 22: 15-22.

Published

2016-03-09

Issue

Section

Original Article