Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Nov 1;18(11):2653-2661.
doi: 10.5664/jcsm.10184.

Sleep microstructure and clinical characteristics of patients with restless legs syndrome

Hamed Amirifard  1 , Melika Jameie  2 , Samaneh Akbarpour  3 , Khosro Sadeghniiat Haghighi  1 , Mahsa Shojaei  1 , Reyhaneh Heidari  4 , Arezu Najafi  1
Affiliations

Sleep microstructure and clinical characteristics of patients with restless legs syndrome

Hamed Amirifard et al. J Clin Sleep Med. .

Abstract

Study objectives: Restless legs syndrome (RLS) is a sleep-related movement disorder, often accompanied by sleep disruption. Obstructive sleep apnea (OSA) has a controversial prevalence among patients with RLS. We evaluated the clinical and sleep features of patients who attended our sleep clinic considering RLS and OSA.

Methods: In this cross-sectional study, we obtained health records of 1,497 patients during 2015-2019 who underwent polysomnography (PSG). Baseline characteristics, sleep-related and RLS questionnaires, and sleep microstructure were assessed. Descriptive and analytical assessments were performed. RLS was assessed according to the International Restless Legs Syndrome Study Group criteria.

Results: RLS was found in 19.4% of patients, with more prevalence among women (26.9% vs 16.4%). RLS affected 19.1% of patients with OSA. Patients with RLS were significantly older with higher insomnia and depression and worse PSG results. As the respiratory disturbance index increased, the odds of RLS slightly decreased (adjusted odds ratio [95% confidence interval]: 0.80 [0.67-0.94]). The odds of OSA (respiratory disturbance index ≥ 5) was not affected by RLS. OSA in patients with RLS was significantly associated with a higher limb movement index. RLS in patients with OSA was significantly associated with higher insomnia, depression, and limb movement index (men and women), higher wake after sleep onset and percentage of N1 sleep (men), and lower sleep efficiency (men).

Conclusions: Patients with RLS had worse PSG results, higher insomnia, and depression. Although men with OSA+/RLS+ had worsened PSG results, PSG parameters in women with OSA+/RLS+ did not differ from the OSA+/RLS- group. Patients with either OSA or RLS should be evaluated for possible comorbidities, including insomnia and depression. Notably, sex-specific characteristics need more consideration in sleep clinics.

Citation: Amirifard H, Jameie M, Akbarpour S, et al. Sleep microstructure and clinical characteristics of patients with restless legs syndrome. J Clin Sleep Med. 2022;18(11):2653-2661.

Keywords: intrinsic; obstructive; polysomnography; restless legs syndrome; sleep apnea; sleep apnea syndromes; sleep disorders.

PubMed Disclaimer

Conflict of interest statement

All authors have seen and approved the manuscript. Work for this study was performed at the Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran. The authors report no conflicts of interest.

Similar articles

See all similar articles

Cited by

References

    1. Young T , Palta M , Dempsey J , Peppard PE , Nieto FJ , Hia KM . Burden of sleep apnea: rationale, design, and major findings of the Wisconsin Sleep Cohort study . WMJ. 2009. ; 108 ( 5 ): 246 – 249 . - PMC - PubMed
    1. Heinzer R , Vat S , Marques-Vidal P , et al. . Prevalence of sleep-disordered breathing in the general population: the HypnoLaus study . Lancet. 2015. ; 3 ( 4 ): 310 – 318 . - PMC - PubMed
    1. Allen RP , Walters AS , Montplaisir J , et al. . Restless legs syndrome prevalence and impact: REST general population study . Arch Intern Med. 2005. ; 165 ( 11 ): 1286 – 1292 . - PubMed
    1. Gheshlagh RG , Parizad N , Zahednezhad H , Sarokhani M , Sayehmiri K , Baghi V . Prevalence of restless leg syndrome in Iran: a systematic review and metanalysis . J Sleep Sci. 2016. ; 1 ( 3 ): 131 – 138 .
    1. Naini AE , Amra B , Mahmoodnia L , Taheri S . Sleep apnea syndrome and restless legs syndrome in kidney transplant recipients . Adv Biomed Res. 2015. ; 4 : 206 - PMC - PubMed

MeSH terms