Prevalence of restless legs and association with MS disease duration and course.

TitlePrevalence of restless legs and association with MS disease duration and course.
Publication TypeJournal Article
AuthorsBamer AM, Amtmann D, Johnson KL, Kraft GH
JournalMultiple Sclerosis
Issue9 Suppl
Animals, Humans, Multiple Sclerosis

Background: Though studies done to date suggest that sleep difficulties are common in persons with multiple sclerosis (MS), sleep disorders are often under recognized clinically. In addition, comparatively little research has been done regarding causes of and treatments for sleep disturbance. Restless leg type symptoms are commonly recognized as a cause of sleep disturbance in MS. However, little is known about overall prevalence in individuals with MS and their association with other factors including disease duration and course of MS. Methods: Survey respondents included 473 community-dwelling persons with MS enrolled in an ongoing longitudinal self-report survey study of outcomes in MS recruited through the Greater Washington National MS Society chapter. Participants who responded positively to a single question developed for rapid screening of restless leg were classified as having restless legs (RL) in this study. Course of MS was defined using a self report question with associated graphics and sleep problems assessed using the Medical Outcomes Study Sleep scale. Disease severity was categorized using a self-report version of the EDSS scale. Descriptive statistics were calculated and differences in duration and course examined using t-tests and x^2 tests of association. Results: 50.7% of the participants indicated problems with RL. Overall sleep problems in individuals with RL were significantly higher than those without these symptoms (p=0.004). Individuals with moderate disease severity (EDSS 4.5-6.5) had the highest prevalence (60%) of RL. Mean disease duration in those with RL was 1.5 years longer, though this was not statistically significant (p=0.09). RL prevalence did not appear to vary by MS disease course. Discussion: The prevalence of RL in this MS population is high, with over 50% endorsing RL symptoms using the one item screening question. Prevalence reports of restless leg syndrome (RLS) in other MS studies range from 19-36%, suggesting that while many individuals may not have true RLS, nocturnal leg problems are very common. These results reiterate the importance of screening for RL symptoms in individuals with MS and evaluating their potential impact on sleep quality. This study is also inconsistent with one study suggesting an association between RLS and disease duration and the primary progressive form of MS. Additional studies are needed to identify risk factors for RL and develop measures for screening in clinical settings.

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