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. 2013 Aug 19;8(8):e71499.
doi: 10.1371/journal.pone.0071499. eCollection 2013.

Diseases in patients coming to a sleep center with symptoms related to restless legs syndrome

Shih-Wei Lin  1 , Yen-Lung Chen, Kuo-Chin Kao, Cheng-Ta Yang, Li-Pang Chuang, Yu-Ting Chou, Szu-Chia Lai, Rou-Shayn Chen, Ning-Hung Chen
Affiliations

Diseases in patients coming to a sleep center with symptoms related to restless legs syndrome

Shih-Wei Lin et al. PLoS One. .

Abstract

Study objective: To explore the profile of patients who visit a sleep center with symptoms that fulfill the four essential criteria for restless legs syndrome (RLS).

Design: A prospective study.

Setting: Outpatients from one sleep disorders clinic in Taiwan.

Participants: 1,200 consecutive patients visit sleep disorders clinic with any sleep complaints.

Interventions: After completing a history and physical examination, all participants answered the RLS questionnaire. Subjects who fulfilled the four essential criteria for RLS were referred to a special clinic. A work-up including blood tests, polysomnography, and specialized neurological tests etc. was performed to make the final diagnosis.

Measurements and results: A total of 1,185 participants were enrolled, and, of these, 131(11.1%) fulfilled the four essential criteria for RLS, and 121 completed the supplemental work-up. Their mean age was 47.6±13.3 and 52.9% were male. Insomnia and snoring were the most common chief complaints. Obstructive sleep apnea syndrome and other diseases were found in 103 patients. Only 18 (14.9%) patients had no comorbid condition and were diagnosed with primary RLS.

Conclusions: Symptoms of RLS are common in patients with sleep complaints. Even in a sleep clinic, using a questionnaire approach for identification of RLS has a low positive predictive value. Clinicians should pay attention to the limitations of the 4-item questionnaire in diagnosis of RLS and also the importance of a careful differential diagnosis to identify possible secondary causes of RLS.

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Conflict of interest statement

Competing Interests: This study is partly sponsored by GlaxoSmithKline (XMRPG380121). The GlaxoSmithKline Company sponsored manpower of a research assistant for 6 months which cost around 8,000 USD. However, they have no role in study design and conduct, collection, analysis, and interpretation of the data, or writing or approval of the manuscript. This does not alter the authors’ adherence to all the PLOS ONE policies on sharing data and materials.

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