Investigation of chronic venous insufficiency in patients with sleep disorders due to restless legs syndrome

2020 ◽  
Vol 35 (10) ◽  
pp. 771-776
Author(s):  
Atıf Yolgösteren ◽  
Leyla Köse Leba ◽  
Aylin Bican Demir
Keyword(s):  
Sleep Disorder ◽  
Restless Legs Syndrome ◽  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Sleep Stage ◽  
Sleep Time ◽  
Sleep Stages ◽  
Restless Legs ◽  
Group 2 ◽  
Group 1

Background We aimed to investigate of chronic venous insufficiency on patients with sleep disorder due to restless legs syndrome. Method Five hundred forty-one cases on whom polysomnography was performed due to sleep disorder were evaluated retrospectively. Forty patients with restless legs syndrome were determined. They were examined by history, physical examination, and duplex ultrasonography in terms of chronic venous insufficiency. The sleep stage rates of both groups were compared (that the rate of total sleep time in polysomnography to sleep stages is expressed as minute and percentage has been defined as sleep stage rate). Result Chronic venous insufficiency was identified in 20 out of 40 patients (group 1; female, 90%). In group 2, there were patients with only restless legs syndrome but with no chronic venous insufficiency (female, 80%). The mean ages of both groups were 56.4 ± 11.8 and 54.3 ± 14.7 years. Stage 1 sleep rate in group 1 was 5% ± 2.7 and in group 2 was 8% ± 3.8 (p = 0.006). Periodic limb movement index (polysomnography finding evaluating involuntary leg movements during sleep) was 11.4 ± 17.5 in group 1, and it was 29.4 ± 37.9 in group 2 (p = 0.006). Conclusion We recommend that chronic venous insufficiency should be investigated in patients with primary restless legs syndrome diagnosis.

Features of postoperative period in patients with chronic venous insufficiency: phlebectomy versus thermal ablation

2020 ◽  
pp. 64-75
Author(s):  
E. Burleva ◽  
O. Smirnov ◽  
S. Tyurin
Keyword(s):  
Postoperative Period ◽  
Chronic Venous Insufficiency ◽  
Thermal Ablation ◽  
Venous Insufficiency ◽  
Clinical Symptoms ◽  
Varicose Veins ◽  
Statistical Processing ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

The purpose of the study was to conduct a comparative assessment of the course of the postoperative period after phlebectomy and thermal ablation in patients with varicose veins of the lower extremities in the system of the great saphenous vein (GSV) with class C2 of chronic venous insufficiency (CVI) — CEAP class C2. Materials and methods: 455 patients (455 limbs) with CEAP class C2. Group 1 (n = 154) received stripping + minimally invasive phlebectomy; Group 2 — endovenous laser ablation (EVLA) of GSV trunk + sclerotherapy of varicose veins; 3 group (n = 150) — radiofrequency ablation (RFA) of the GSV + sclerotherapy. All patients were united by a single tactical solution — the elimination of pathological vertical reflux in GSV. In each group, patients were with similar hemodynamic profile were selected (Group 1 = 63; Group 2 = 61; Group 3 = 61). The course of the postoperative period (from 2 days to 2 months) was compared for pain (visual analog scale — VAS), clinical symptoms of chronic venous insufficiency, degree of satisfaction (Darvall questionnaire), and duration of disability. Statistical processing was carried out using Excel programs for Windows XP, MedCalc® (version 11.4.2.0., Mariakerke, Belgium). Results: Postoperative pain is more pronounced (during day 1 for Group 1–4.0, Group 2–3.0, Group 3–2.0) and more prolonged (up to 4 days) after open surgeries (p < 0.05). The dynamics of the clinical symptoms of CVI (including varicose syndrome and use of compression therapy) could not be fully evaluated in connection with the ongoing sclerotherapy procedures for patients of Groups 2 and 3. Satisfaction of patients with aesthetic aspects was higher than expected in all groups. Reliable statistical differences proved decrease in days of disability (Group 1–14; Group 2–4; Group 3–3) and earlier return to physical activities and work in patients after thermal ablation in comparison with phlebectomy. Conclusion: The study shows that all three methods for eliminating vertical reflux in the GSV can be proposed for a large category of patients with CEAP of class C3 and C2. Medical and social rehabilitation of patients using endovascular thermal ablation technologies proceeds faster, which is beneficial both for the patients and for society.

Varicosis, Aesthetics, and Pain

1998 ◽  
Vol 15 (2) ◽  
pp. 143-149 ◽  
Author(s):  
Timothy D. Parish
Keyword(s):  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Perceived Intensity ◽  
Large Vein ◽  
Functional Classes ◽  
Group 3 ◽  
Group 2 ◽  
The Aesthetic ◽  
Vein Disease ◽  
Group 1

Introduction: The aesthetic presentation and subsequent management of varicosis are well accepted. However, the association of pain and its impact on varicosis is less well understood. The purpose of this study is to define the interrelationship of pain with the anatomic and physiological presentation of patients with primary varicosis. Materials and Methods: This is an ongoing prospective demographic study of sequential patients presenting randomly at the Varicosis and Laser Center of Alabama for the evaluation of varicosis. All patients were given standard questionnaires to evaluate their reasons for presentation. Later in the study, those who selected pain were asked to identify the perceived intensity of their pain by the use of “smiley faces.” Patients were clinically divided into three groups: group 1, those with spider and reticular vein disease; group 2, those with mixed large- and small-vein disease; and group 3, those with large-vein disease (>4 mm). Results: Seventy-seven percent of patients presenting with varicosis had pain. The correlation of pain with varicosis may indicate a more prevalent association with chronic venous insufficiency. This association was of greater significance in those patients with large-vein disease (>4 mm). The use of smiley faces to monitor perceived intensity of pain revealed a significant result in all clinical groups. The character of the pain was described in multiple terms. Discussion: Pain is a prevalent condition in those patients presenting with primary varicosis. Pain is associated with a greater likelihood of chronic venous insufficiency, in large-vein disease. The association of varicosis with pain and chronic venous insufficiency allows categorization into four functional classes.

The aetiology and influence of age and gender on the development of advanced chronic venous insufficiency in the population of patients of semi-urban county outpatient vascular clinic in Poland

2010 ◽  
Vol 26 (2) ◽  
pp. 56-61 ◽  
Author(s):  
Ł Dzieciuchowicz ◽  
Z Krasiński ◽  
K Motowidlo ◽  
M Gabriel
Keyword(s):  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Varicose Veins ◽  
Severe Trauma ◽  
Control Group ◽  
Age And Gender ◽  
History Of ◽  
Group 2 ◽  
And Gender ◽  
Group 1

Objective To determine the aetiology and influence of age and gender on the development of advanced chronic venous insufficiency in patients of semi-urban county outpatient vascular clinic. Methods One hundred and fourteen patients with venous ulcers were divided, based on the ultrasound examination, into group 1 or group 2, with or without post-thrombotic lesions in the deep venous system, respectively. The control group consisted of 352 patients with varicose veins and without leg ulceration. The demographic data and thrombotic risk factors were compared between the groups. Results Group 1 patients ( n = 109) were older than group 2 patients ( n = 5) and control group patients, 64.7 versus 47.2 years ( P = 0.016) and versus 53.8 years ( P < 0.001), respectively. The percentage of women did not differ between group 1 and the control group, but was lower in group 2 ( P = 0.01). The history of lower limb fracture or severe trauma increased the risk of post-thrombotic syndrome (PTS) in patients with venous ulcer. Conclusion In the population studied, the venous leg ulcer develops mainly due to primary varicose veins and its risk increases with age and is equal for both sexes. PTS should be suspected in younger patients with a history of severe trauma or leg fracture.

scholarly journals 0928 Heart Rate Variability During Sleep in Children and Adolescents with Restless Sleep Disorder or Restless Legs Syndrome and Normal Controls

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A353-A353
Author(s):  
R Ferri ◽  
O Bruni ◽  
L M DelRosso
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Sleep Disorder ◽  
Restless Legs Syndrome ◽  
Time Domain ◽  
Sleep Stages ◽  
Sympathetic Activation ◽  
Restless Legs ◽  
And Gender ◽  
Normal Controls

Abstract Introduction Restless sleep disorder (RSD) has been recently characterized clinically and polysomnographically in children and differentiated from restless legs syndrome (RLS). Heart rate variability (HRV) is a reliable method to quantify autonomic changes during sleep. The aim of this study was to characterize HRV in children with RSD, RLS and normal controls, with the hypothesis that children with RSD have a shift toward sympathetic predominance during sleep. Methods Polysomnographic recordings from thirty-two children who fulfilled RSD diagnostic criteria (19 boys and 13 girls), 32 children with RLS (20 boys and 12 girls) and 33 controls (17 boys and 16 girls) were included. Four ECG epochs were chosen, one for each stage, and were analyzed for automatic detection of R waves. Time domain and frequency domain HRV parameters were obtained and analyzed. Results Age and gender were not statistically different between groups. In terms of time domain only the standard deviation of the average RR interval during stage N3 was slightly but significantly higher in RSD than in RLS patients. In terms of frequency domains, the LF band and the LF/HF ratio were increased in RSD and the HF percentage was lower in RSD during sleep stages N3 and R. The LF band and the LF/HF ratio increased in RLS and the HF percentage was lower in RLS during stage W. Conclusion Children with RSD have increased sympathetic activation during sleep, particularly N3 and REM, compared to controls but, as expected, not during wakefulness. Differently, children with RLS have sympathetic activation during relaxed wakefulness preceding sleep and during sleep. Support Partial support by a grant of the Italian Ministry of Health RC n. 2751598 (R.F.)

scholarly journals Role of conservative treatment of chronic venous insufficiency for regression of the features of desadaptive cardiac remodeling in patients with comorbid obesity

2017 ◽  
Vol 98 (2) ◽  
pp. 165-171
Author(s):  
I N Leukhnenko ◽  
O V Teplyakova ◽  
I F Grishina
Keyword(s):  
Conservative Treatment ◽  
Cardiac Remodeling ◽  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Left Ventricular ◽  
Right Atrial ◽  
Diastolic Filling ◽  
Maximal Velocity ◽  
Group 2 ◽  
Group 1

Aim. To evaluate the influence of conservative treatment tactics for chronic venous insufficiency on the processes of cardiac remodeling in patients with comorbid obesity. Methods. 32 males with obesity class 1 (BMI 32.57±2.25 kg/m2) at the age of 40.7±11.5 years and with clinical and instrumental signs of chronic venous insufficiency were divided into 2 groups: patients from group 1 (n=14) followed the recomendations to wear compression stockings and to use hesperidin + diosmin 500 mg twice a day, and the patients from group 2 (n=18) did not follow those recommendations. All patients had echocardiography performed before the treatment and 2 months after the first visit. For the evaluation of echocardiographic dynamics paired Student’s t-test was used. Results. After 2 months statistically significant dynamics of the following echocardiographic findings was revealed: in group 1 index of eccentric left ventricular shape increased from 0.94±0.06 to 1.01±0.03, in group 2 - from 0.96±0.08 to 0.97±0.07 (р=0.023). In group 1 tricuspid annular plane systolic excursion decreased from 30.07±5.31 to 26.64±4.14 mm, in group 2 - from 29.6±4.72 to 29.88±6.04 mm (р=0.008), and the right atrial volume in group 1 decreased from 53.57±11.48 to 46.64±13.18 ml, in group 2 - from 52.77±11.27 to 51.38±8.54 ml (р=0.044). In group 1 statistically significant trend to decreased ratio of maximal velocity of RV early diastolic filling to maximum diastolic tricuspid valve lateral annular velocity was revealed (from 4.75±1.35 to 4.25±1.23 cm/sec) compared to group 2 (from 4.79±1.62 to 4.75±1.58 cm/sec; р=0.076). Conclusion. Conservative treatment of chronic venous insufficiency in patients with obesity is associated with indirect indicators of decreasing volume overload of the heart and can influence positively on heart geometry leading to regression of spheric LV remodeling and decrease of RA volume.

scholarly journals The effect of electroacupuncture on hemodialysis patients with restless legs syndrome (RLS): study protocol for a randomized crossover trial

2020 ◽  
Author(s):  
Jia-Ming Chen ◽  
Ping-Fang Chiu ◽  
Yu-Jun Chang ◽  
Po-Chi Hsu ◽  
Chia-Chu Chang ◽  
...  
Keyword(s):  
Restless Legs Syndrome ◽  
Rating Scale ◽  
Severity Index ◽  
Hemodialysis Patients ◽  
Restless Legs ◽  
The Subject ◽  
Group 2 ◽  
And Control ◽  
The Relationship ◽  
Registration Date

Abstract Background The aim of the present study was to evaluate the effects of electroacupuncture (EA) in hemodialysis patients with restless leg syndrome (RLS) by heart rate variability (HRV) monitor. Methods112 subjects who were hemodialysis patients with RLS will be divided into 2 groups: experimental and control. Each subject will receive the treatment relevant to their group 2 times a week for 4 weeks. After 4 weeks of treatment the subject will enter a 2-week washout period, after which the subjects will switch groups. Measurements will include HRV recordings, International Restless Legs Syndrome Rating Scale (IRLSRS) and Insomnia Severity Index (ISI). DiscussionThis study is the first investigation to analyze the relationship between EA and the change of HRV by an objective monitor. If the findings of the current trial are positive, this study will also help support an effective, safe and cheap approach to clinical treatment of this challenging disorder, help foster improved understanding the relationship between RLS and HRV, and ultimately contribute to elucidate the mechanisms of EA. Trial registrationClinicalTrials.gov Identifier: NCT04356794; registration date: April 22, 2020.

scholarly journals Impact of sleep disordered breathing on behaviour among elementary school-aged children: a cross-sectional analysis of a large community-based sample

2016 ◽  
Vol 48 (6) ◽  
pp. 1631-1639 ◽  
Author(s):  
Dale L. Smith ◽  
David Gozal ◽  
Scott J. Hunter ◽  
Mona F. Philby ◽  
Jaeson Kaylegian ◽  
...  
Keyword(s):  
Sleep Disordered Breathing ◽  
Sleep Time ◽  
Community Based ◽  
Cross Sectional ◽  
Large Community ◽  
Habitual Snoring ◽  
Behavioural Regulation ◽  
Group 2 ◽  
Group 1 ◽  
Disordered Breathing

Sleep disordered breathing (SDB) in children has been associated with inattention, impulsivity and hyperactivity, but the associations between SDB severity and the type and severity of behavioural disruption are unclear.1022 children aged 5–7 years old prospectively underwent sleep studies and behavioural assessments through completion of standardised instruments. Participants were subdivided into four categorical groups based on the apnoea–hypopnoea index (AHI; measured per hour of total sleep time (hTST)), i.e. Group 1: nonsnoring and AHI <1 hTST–1; Group 2: habitual snoring and AHI <1 hTST–1; Group 3: habitual snoring and AHI 1–5 hTST–1; and Group 4: habitual snoring and AHI >5 hTST–1, followed by comparisons of behavioural functioning across the groups.All 10 behavioural variables differed significantly between Group 1 and all other groups. Post hoc comparisons indicated that Group 2 was the most impaired for most behavioural measures. Furthermore, differences between Group 2 and more severe sleep pathology conditions were rarely significant.This large community-based paediatric cohort confirms earlier findings highlighting a significant impact of SDB on behavioural regulation, with the greatest impact being already apparent among habitually snoring children. Thus, a likely low asymptote exists regarding SDB behavioural impact, such that further increases in severity do not measurably increase parent-rated difficulties with behavioural regulation relative to controls. Our findings do support the need for considering early intervention, particularly among those children manifesting a behavioural impact of SDB.

Paroven: not much effect in trials

1992 ◽  
Vol 30 (2) ◽  
pp. 7-8
Keyword(s):  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Control Agency ◽  
Restless Legs ◽  
Therapeutic Value

The Medicines Control Agency has recently restricted the licensed uses of Paroven (Zyma*) to ‘relief of symptoms of oedema associated with chronic venous insufficiency’. A mixture of oxerutins, Paroven had long been marketed for the relief of symptoms ‘associated with venous insufficiency, including painful heavy tired legs, night cramps, paraesthesia, restless legs, varicose states, and post-phlebitic syndrome’. Much work on the drug has been published since 1970, when we concluded that despite interesting pharmacological actions the evidence for its therapeutic value was poor.1 Is there now a clear rationale for its use?

scholarly journals Restless Legs Syndrome in Patients with Chronic Obstructive Pulmonary Disease

2008 ◽  
Vol 35 (3) ◽  
pp. 352-357 ◽  
Author(s):  
Yuksel Kaplan ◽  
Handan Inonu ◽  
Ayse Yilmaz ◽  
Serpil Ocal
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Restless Legs Syndrome ◽  
Control Group ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Similar Frequency ◽  
Restless Legs ◽  
Copd Patients ◽  
Group 1

Objective:To evaluate the prevalence of restless legs syndrome (RLS) in patients with chronic obstructive pulmonary disease (COPD) and the relationship between RLS and clinical/laboratory findings of COPD.Methods:One hundred and thirty-four COPD patients without secondary causes of RLS were included. Thirty-nine (29.1%) patients were diagnosed with RLS and classified as Group 1. The control group consisted of 65 age-matched COPD patients without RLS. Group 1 was divided into subgroups according to the Johns Hopkins Severity (JHS) scale. Patients with a score of 0, 1, or 2 were classified as JHS 0-2 and those with a score of 3 as JHS 3. Group 1 and the control group and subgroups were compared for clinical and laboratory characteristics.Results:We found that the duration of COPD was longer and that airway obstruction, hypercapnia, and hypoxia were more evident in patients with RLS than those without. Similar differences were also detected between JHS subgroups 3 (more severe) and 0-2. Polyneuropathy frequency was significantly higher in Group 1 compared to controls. However, Group 1 subgroups showed a similar frequency of polyneuropathy. In a multivariate analysis, hypercapnia made a significant independent contribution to both JHS 0-2 and JHS 3 patients when RLS severity was set as the dependent variable. Polyneuropathy and the duration of COPD were significant independent variables for patients in the JHS 3 subgroup. Polyneuropathy was the strongest predictor for the JHS 3 patients.Conclusions:We conclude that RLS is frequent in COPD, particularly in patients with severe hypoxemia/hypercapnia and in late stages of the disease.

scholarly journals The prevalence of common sleep disorders in young adults: a descriptive population-based study

SLEEP ◽  
2020 ◽  
Vol 43 (10) ◽  
Author(s):  
Nigel McArdle ◽  
Sarah V Ward ◽  
Romola S Bucks ◽  
Kathleen Maddison ◽  
Anne Smith ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Young Adults ◽  
Sleep Disorders ◽  
Sleep Disorder ◽  
Restless Legs Syndrome ◽  
Survey Methods ◽  
Apnea Hypopnea Index ◽  
Restless Legs ◽  
Obstructive Sleep

Abstract Sleep disorders in adults are associated with adverse health effects including reduced quality of life and increased mortality. However, there is little information on sleep disorders in young adults. A cross-sectional observational study was undertaken in 1,227 young adults participating in the Western Australian Pregnancy (Raine) Study (2012–2014) to describe the prevalence of common sleep disorders. In-laboratory polysomnography (PSG) and validated survey methods were used, including the Epworth Sleepiness Scale, Pittsburgh Sleep Symptom Questionnaire-Insomnia, and International Restless Legs Syndrome Study Group criteria. A total of 1,146 participants completed a core questionnaire, 1,051 completed a sleep-focused questionnaire and 935 had analyzable PSG data. Participants had a mean age of 22.2 years and female to male ratio of 1.1 to 1. The respective sleep disorder prevalences in females and males were: obstructive sleep apnea (OSA) (apnea-hypopnea index [AHI]: ≥5 events/hour) 14.9% (95% CI: 11.8–18.5) and 26.9% (95% CI: 22.9–31.2); chronic insomnia, 19.3% (95% CI: 16.7–23.9) and 10.6% (95% CI: 8.3–13.9); restless legs syndrome, 3.8% (95% CI: 2.4–5.6) and 1.9% (95% CI: 0.9–3.4); and abnormal periodic leg movements during sleep (&gt;5 movements/hour), 8.6% (95% CI: 6.3–11.5) and 9.6% (95% CI: 7.1–12.7). There were statistically significant differences in prevalence between sexes for OSA and insomnia, which persisted after adjustment for body mass index and education. In those with complete data on all sleep-related assessments (n = 836), at least one sleep disorder was present in 41.0% of females and 42.3% of males. Sleep disorders are very common in young adults. Health practitioners should be aware of these high prevalences, as early identification and treatment can improve quality of life and may reduce later morbidity and mortality.

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