https://doi.org/10.4081/monaldi.2022.2167
Prevalence, risk factors and effects of restless legs syndrome in COPD patients
Submitted: December 13, 2021
Accepted: June 27, 2022
Published: July 4, 2022
Accepted: June 27, 2022
Abstract Views: 1213
PDF: 522
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Restless legs syndrome (RLS), a sensory motor disorder, is commonly seen amongst chronic obstructive pulmonary disease (COPD) patients. We conducted a study to know its prevalence in COPD and analyse the possible cause and effect of RLS. It is an analytical cross-sectional study conducted between July 2016-December 2020.The prevalence of RLS was evaluated in patients of COPD using RLS diagnostic criteria. Spirometry, iron profile and arterial blood gas analysis was performed in all the patients to evaluate the cause of RLS. The effect was evaluated with diagnostic criteria for insomnia and patient health questionnaire (PHQ2) for depression. There were 205 participants with a mean age of 59±8 years, 182 (88.7%) men and 23 (11.2%) women. The mean body mass index (BMI) was 29±3.9 kg/m2. The prevalence of RLS was 31.2%. RLS was more common amongst women compared to men (60.8% vs 27.4%). RLS was more prevalent among hypoxemic (PaO2<60 mm Hg) and hypercapnic (PaCO2>45 mm Hg) patients (p<0.016; p<0.017). The ROC curve plotted between PaO2 and RLS occurrence showed that the patients having PaO2 less than 76 mm of Hg were more prone to develop RLS. RLS patients had a higher incidence of insomnia as compared to those without RLS (68.8% vs 36.8%, p<0.001). COPD with RLS patients had more depressive symptoms with a higher patient health questionnaire 2 (PHQ2) score (35.9% vs 14.2%, p<0.001) compared to non-RLS COPD patients. The multiple regression analysis also confirmed that RLS led to insomnia and depressive symptoms in COPD patients. To conclude, RLS is common in COPD patients. RLS leads to insomnia and depression, thus should be identified and treated.
Ekbom KA. Restless legs syndrome. Neurology 1960;10:868–73.
DOI: https://doi.org/10.1212/WNL.10.9.868
Tan EK, Seah A, See SJ, et al. Restless legs syndrome in an Asian population: A study in Singapore. Mov Disord 2001;16:577-9.
DOI: https://doi.org/10.1002/mds.1102
Berger K, Luedemann J, Trenkwalder C, et al. Sex and the risk of restless legs syndrome in the general population. Arch Intern Med 2004;164:196–202.
DOI: https://doi.org/10.1001/archinte.164.2.196
Ulfberg J, Nyström B, Carter N, Edling C. Prevalence of restless legs syndrome among men aged 18 to 64 years: an association with somatic disease and neuropsychiatric symptoms. Mov Disord 2001;16:1159–63.
DOI: https://doi.org/10.1002/mds.1209
Lo Coco D, Mattaliano A, Lo Coco A, Randisi B. Increased frequency of restless legs syndrome in chronic obstructive pulmonary disease patients. Sleep Med 2009;10:572–6.
DOI: https://doi.org/10.1016/j.sleep.2008.04.014
Kaplan Y, Inonu H, Yilmaz A, Ocal S. Restless legs syndrome in patients with chronic obstructive pulmonary disease. Can J Neurol Sci 2008;35:352–7.
DOI: https://doi.org/10.1017/S0317167100008957
Allen RP, Walters AS, Montplaisir J, et al. Restless legs syndrome prevalence and impact: REST general population study. Arch Intern Med 2005;165:1286–92.
DOI: https://doi.org/10.1001/archinte.165.11.1286
Gothi D. Sleep disorders in chronic obstructive pulmonary disease. Indian J Sleep Med 2015;10:11–21.
DOI: https://doi.org/10.5005/IJSM-10-1-11
Mitchell UH, Obray JD, Hunsaker E, et al. Peripheral dopamine in restless legs syndrome. Front Neurol 2018;9:155.
DOI: https://doi.org/10.3389/fneur.2018.00155
Koo BB, Bagai K, Walters AS. Restless legs syndrome: Current concepts about disease pathophysiology. Tremor Other Hyperkinetic Mov (N Y) 2016;6:401.
DOI: https://doi.org/10.5334/tohm.322
Global Initiative for Chronic Obstructive Lung Disease [Internet]. Pocket guide to COPD diagnosis, management and prevention. 2017 Report. Available from: https://goldcopd.org/wp-content/uploads/2016/12/wms-GOLD-2017-Pocket-Guide.pdf
Allen RP, Picchietti D, Hening WA, 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;4:101-19.
DOI: https://doi.org/10.1016/S1389-9457(03)00010-8
Miller MR, Hankinson J, Brusasco V, et al. Standardisation of spirometry. Eur Respir J 2005;26:319–38.
DOI: https://doi.org/10.1183/09031936.05.00034805
Mahajan K, Batra A. Obesity in adult asian indians- the ideal BMI cut-off. Indian Heart J 2018;70:195.
DOI: https://doi.org/10.1016/j.ihj.2017.11.020
American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-5, 5th ed. Arlington: American Psychiatric Publishing, Inc.; 2013.
DOI: https://doi.org/10.1176/appi.books.9780890425596
Schutte-Rodin S, Broch L, Buysse D V, et al. Clinical guideline for the evaluation and management of chronic insomnia in adults. J Clin Sleep Med 2008;4:487–504.
DOI: https://doi.org/10.5664/jcsm.27286
Budhiraja R, Siddiqi TA, Quan SF. Sleep disorders in chronic obstructive pulmonary disease: etiology, impact, and management. J Clin Sleep Med 2015;11:259–70.
DOI: https://doi.org/10.5664/jcsm.4540
Kroenke K, Spitzer RL, Williams JBW. The Patient Health Questionnaire-2: validity of a two-item depression screener. Med Care 2003;41:1284–92.
DOI: https://doi.org/10.1097/01.MLR.0000093487.78664.3C
Allen RP, Stillman P, Myers AJ. Physician-diagnosed restless legs syndrome in a large sample of primary medical care patients in western Europe: Prevalence and characteristics. Sleep Med 2010;11:31–7.
DOI: https://doi.org/10.1016/j.sleep.2009.03.007
Nichols DA, Allen RP, Grauke JH, et al. Restless legs syndrome symptoms in primary care: a prevalence study. Arch Intern Med 2003;163:2323–9.
DOI: https://doi.org/10.1001/archinte.163.19.2323
Rangarajan S, Rangarajan S, D’Souza GA. Restless legs syndrome in an Indian urban population. Sleep Med 2007;9:88–93.
DOI: https://doi.org/10.1016/j.sleep.2006.11.004
Broman J-E, Mallon L, Hetta J. Restless legs syndrome and its relationship with insomnia symptoms and daytime distress: epidemiological survey in Sweden. Psychiatry Clin Neurosci 2008;62:472–5.
DOI: https://doi.org/10.1111/j.1440-1819.2008.01825.x
Ding Z, Stehlik R, Hedner J, et al. Chronic pulmonary disease is associated with pain spreading and restless legs syndrome in middle-aged women—a population-based study. Sleep Breath 2019;23:135–42.
DOI: https://doi.org/10.1007/s11325-018-1673-z
Gao X, Schwarzschild MA, Wang H, Ascherio A. Obesity and restless legs syndrome in men and women. Neurology 2009;72:1255–61.
DOI: https://doi.org/10.1212/01.wnl.0000345673.35676.1c
Salminen AV, Rimpilä V, Polo O. Peripheral hypoxia in restless legs syndrome (Willis-Ekbom disease). Neurology 2014;82:1856–61.
DOI: https://doi.org/10.1212/WNL.0000000000000454
Kayacan O, Beder S, Deda G, Karnak D. Neurophysiological changes in COPD patients with chronic respiratory insufficiency. Acta Neurol Belg 2001;101:160–5.
Gupta R, Ulfberg J, Allen RP, Goel D. High prevalence of restless legs syndrome/Willis Ekbom Disease (RLS/WED) among people living at high altitude in the Indian Himalaya. Sleep Med 2017;35:7-11.
DOI: https://doi.org/10.1016/j.sleep.2017.02.031
Shah A, Ayas N, Tan W-C, et al. Sleep quality and nocturnal symptoms in a community-based COPD cohort. COPD 2020;17:40–8.
DOI: https://doi.org/10.1080/15412555.2019.1695247
Lee SH, Lee H, Kim YS, et al. Factors associated with sleep disturbance in patients with chronic obstructive pulmonary disease. Clin Respir J 2020;14:1018–24.
DOI: https://doi.org/10.1111/crj.13235
Leschziner G, Gringras P. Restless legs syndrome. BMJ 2012;344:e3056.
DOI: https://doi.org/10.1136/bmj.e3056
Nutt D, Wilson S, Paterson L. Sleep disorders as core symptoms of depression. Dialogues Clin Neurosci 2008;10:329–36.
DOI: https://doi.org/10.31887/DCNS.2008.10.3/dnutt
Rezaeetalab F, RezaeiTalab F. Restless legs syndrome in chronic obstructive pulmonary disease. Rev Clin Med 2017;4:73–7.
Garcia-Borreguero D, Kohnen R, Silber MH, et al. The long-term treatment of restless legs syndrome/Willis-Ekbom disease: evidence-based guidelines and clinical consensus best practice guidance: a report from the International Restless Legs Syndrome Study Group. Sleep Med 2013;14:675–84.
DOI: https://doi.org/10.1016/j.sleep.2013.05.016
How to Cite
Anand, Shweta, Anshul Jain, Dipti Gothi, Sameer Vaidya, and Rambabu Sah. 2022. “Prevalence, Risk Factors and Effects of Restless Legs Syndrome in COPD Patients”. Monaldi Archives for Chest Disease 93 (1). https://doi.org/10.4081/monaldi.2022.2167.
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