Worldwide pooled prevalence of restless legs syndrome in patients with coronary artery disease: A systematic review and meta-analysis

Abstract

Background: The prevalence of restless legs syndrome (RLS) in patients with coronary artery disease (CAD) varies across studies, and the aggregate RLS burden and causes of prevalence variability remain to be identified. This study aims to estimate the worldwide pooled prevalence of RLS among CAD populations and to identify the cause of variability.

Methods: We searched PubMed, Scopus, EMBASE, Web of Science, Google Scholar, and grey literature, including references from identified studies published up to June 2025. The studies reporting the prevalence of RLS in CAD patients were included in the review and assessed for risk of bias. Study and demographic details, as well as the total number of participants and the number of RLS patients, were extracted. A random effect model was used for the meta-analysis.

Results: A total of 5081 patients from nine studies were included in the meta-analysis. The pooled prevalence of RLS in CAD patients is 29 % (95 % CI: 17 %-43 %, I² = 98.08 %). The pooled prevalence of RLS among CAD in the Asian population (14 % [95 % CI: 1 %-35 %]) was significantly lower than that of people of other ethnicities (38 % [95 % CI: 23.0 %-54 %]). The cause of heterogeneity was ethnicity and the use of diagnostic criteria (p < 0.01). The overall risk of bias was moderate due to external validity, and the funnel plot revealed significant asymmetry.

Conclusion: RLS is highly prevalent among patients with CAD, and a future study including all CAD patients from different ethnicities with definitive diagnostic criteria is required.

Prospero registration: CRD42024545363.

Keywords: Coronary artery disease; Prevalence; Restless Leg syndrome; Systematic review and meta-analysis.