Restless legs syndrome/Willis-Ekbom disease in multiple sclerosis: a contributing factor for anxiety, disability, sleep disorder, and quality of life

Abstract

Background: Restless legs syndrome (RLS) is one of the most common and burdensome sleep disorders in the course of multiple sclerosis (MS). Objective: To evaluate common MS-related symptoms and consequences between groups with and without RLS and further assess the association of quality of life determinants with RLS symptom severity. Methods: According to their RLS status, 46 relapsing-remitting MS patients were divided into MS-RLS+ (n=19) and MS-RLS- groups (n=27). Specific questionnaires were administered to assess the patients’ health-related quality of life (HRQoL), fatigue levels, sleep quality, daily sleepiness, anxiety, and depression symptoms. Functional capacity was examined using the Expanded Disability Status Scale (EDSS). Results: The prevalence of RLS was 41.3%. Compared to the MS-RLS- group, those with RLS had higher EDSS scores, more cranial and spinal lesions, longer disease duration, and were older. In the MS-RLS+ group, symptom severity scores were positively correlated with higher anxiety and poorer sleep quality. The symptom severity score was negatively correlated with mental HRQoL and pain scores. Conclusion: In conclusion, the findings of the current study indicate the negative impact of RLS on functional capacity, anxiety, sleep quality, and mental HRQoL of MS patients. Further studies using more accurate diagnostic strategies for identifying RLS and other sleep disorders are necessary to clarify the association of MS with RLS and explore relevant clinical implications.

Initial Cervical Spinal Cord Demyelinating Lesions are not Associated with Restless Legs Syndrome in Patients with Multiple Sclerosis

“…[ 8 , 24 ] The fatigue severity in MS patients with RLS may be explained by the adverse effects of the RLS on sleep, QoL, and mood following the literature. [ 9 , 25 , 29 ] However, we did not observe a significant association between RLS severity and fatigue among MS patients with RLS. Treating the symptoms of RLS in MS patients may reduce RLS-related fatigue and improve quality of life measures.…”

“…[ 24 ] Although the spinal cord lesions may have an essential effect on the ethiopathological mechanism of RLS, there are probably multiple etiological factors in PwMS. [ 25 ]…”

“…They had more severe fatigue and depression, which were known to be associated with QoL in PwMS, in line with previous reports. [ 9 , 25 ]…”

Associations of anxiety and depression with restless leg syndrome: a systematic review and meta-analysis

“…Recent studies based on large cross-sectional survey data suggested that RLS in individuals with multiple sclerosis (MS) may contribute to heightened anxiety and depression symptoms. The effects of RLS on patients with MS included negative effects on functional ability, anxiety levels, sleep quality, and health-related quality of life ( 43 , 44 ). Rana et al showed that individuals with Parkinson’s disease combined with RLS had the highest incidence of anxiety and depression ( 45 ).…”