Increased Electroencephalographic High Frequencies during the Sleep Onset Period in Patients with Restless Legs Syndrome

Abstract Study Objectives To assess the frequency of restless legs syndrome (RLS), periodic limb movements during sleep (PLMS) and their overlap in a large sample of patients with multiple sclerosis (MS). To compare clinical and paraclinical findings among four sub-groups of patients: RLS–/PLMS– (patients without RLS and PLMS), RLS+/PLMS– (patients with RLS and without PLMS), RLS–/PLMS (patients without RLS and with PLMS), RLS+/PLMS+ (patients with both RLS and PLMS). Methods In this cross–sectional, observational, instrumental study, eighty-six patients (M/F: 27/59; mean age 48.0 ± 10.8 years) with a diagnosis of MS underwent a telephone interview assessing the five standard diagnostic criteria for RLS. Seventy-six participants underwent polysomnography (PSG) and maintenance of wakefulness test. Instrumental and clinical findings were subsequently statistically compared to investigate their association with RLS and PLMS index (PLMSI). Results RLS and PLMS (PLMSI ≥15/h) frequency in patients with MS was of 31.4% and 31.6% respectively. Among patients with RLS, 37.5% had a PLMSI ≥15/h. RLS–/PLMS+ group showed higher wake after sleep onset (p = 0.01), stage shifts per hour (p = 0.03), increased stage N1 (p = 0.03) and reduction in stage N3 (p = 0.01) compared to RLS–/PLMS–. RLS had no influence on clinical and PSG parameters (p = 0.45). Conclusions RLS is highly frequent in patients with MS. The frequency of PLMS is comparable to the general population. The low percentage of patients with RLS having a high PLMSI, together with the absence of correlation between RLS and female gender and older age, support the existence of a distinct symptomatic form of RLS in MS.

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Restless Legs Syndrome and Periodic Limb Movement Disorder

10.1093/med/9780199937837.003.0172 ◽

2017 ◽

Author(s):

Jennifer Accardo

Keyword(s):

Movement Disorder ◽

Restless Legs Syndrome ◽

Dopamine Agonists ◽

Sleep Onset ◽

Limb Movement ◽

Periodic Limb Movements ◽

Periodic Limb Movement ◽

Periodic Limb Movement Disorder ◽

Restless Legs ◽

Dopaminergic Pathways

Restless legs syndrome (RLS), also known as Willis Ekbom disease (WED), is a sensory disorder with a circadian component. An irresistible urge to move the legs disrupts sleep onset and maintenance. Periodic limb movements in sleep, semirhythmic in nature, often overlap with RLS, though periodic limb movement disorder can be diagnosed in the absence of RLS’s distinctive sensory symptoms. Disruptions in dopaminergic pathways, iron metabolism, and the opioid system have all been implicated in pathogenesis, and there is a strong genetic component. RLS is common, affecting 5% to 10% of adults. Its best-known treatments are dopamine agonists; however, other treatments are effective.

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Restless Legs Syndrome and Sleep-Related Movement Disorders

Integrative Sleep Medicine ◽

10.1093/med/9780190885403.003.0033 ◽

2021 ◽

pp. 549-570

Author(s):

Stephen Paul Duntley

Keyword(s):

Restless Legs Syndrome ◽

Movement Disorders ◽

Sleep Onset ◽

Periodic Limb Movements ◽

Restless Legs ◽

Abnormal Movements ◽

Proper Diagnosis ◽

Normal Sleep ◽

Sleep Starts ◽

Pathological Event

Normal sleep is characterized by a relative lack of body movements. In a variety of sleep disorders, abnormal movements may result from pathological arousals, whereas in sleep-related movement disorders the movement itself is the pathological event. Sleep-related movement disorders are typically characterized by simple, often repetitive and stereotyped movements that occur at sleep onset or during sleep and may disrupt sleep. These include restless legs syndrome, periodic limb movements, sleep-related bruxism, sleep-related leg cramps, and sleep starts. These are common disorders that may be barely noticed or, as in the case of severe restless legs syndrome, can be life-altering. Proper diagnosis is essential because effective treatments are usually available.

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