SLEEP DISORDERS IN RESTLESS LEGS SYNDROME: CLINICAL AND GENDER-RELATED FEATURES
Keywords:
restless legs syndrome, idiopathic RLS, secondary RLS, sleep disturbances, sex differences, ferritin, vitamin and mineral deficiency, thyroid dysfunction, comorbidity, quality of lifeAbstract
Aim: to study the pattern of sleep disturbances and the clinical and neurological features of idiopathic (iRLS) and secondary (sRLS) restless legs syndrome with regard to patients’ sex, deficiency states and comorbidities. Material and methods. A total of 176 patients meeting the IRLSSG (2014) diagnostic criteria were examined: iRLS, 51 (29%); sRLS, 125 (71%), including RLS associated with diabetes mellitus (62), chronic kidney disease (21) and neurological disorders (42). The Pittsburgh Sleep Quality Index (PSQI), the RLS-QoL questionnaire and the Beck Depression Inventory were used; iron status, vitamin and thyroid status were assessed. Results. Compared with sRLS, patients with iRLS more often reported daytime sleepiness (88.2% vs 36.8%) and sleep fragmentation (76.5% vs 42.4%; p<0.001), whereas difficulty falling asleep was the leading complaint in sRLS (70.4%). Ferritin and mineral deficiency was the most frequent deficiency in both sexes; vitamin deficiency in women with iRLS was almost twice as frequent as in men (49% vs 25%). In women, sleep disturbances and depressive symptoms were most often associated with ferritin deficiency. Sex differences in the frequency of comorbidities showed only a trend (p>0.05). Conclusion. The pattern of sleep disturbances depends on the clinical form of RLS; the high frequency of ferritin deficiency supports routine assessment of iron status in all patients with RLS, and sex-related features should be considered when choosing treatment.
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