Chronic pulmonary disease is associated with pain spreading and restless legs syndrome in middle-aged women—a population-based study

Zou, Ding; Stehlik, Romana; Hedner, Jan; Ulfberg, Jan; Grote, Ludger

doi:10.1007/s11325-018-1673-z

Cited by 10 publications

(4 citation statements)

References 26 publications

(45 reference statements)

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“…al. showed that chronic pulmonary disease ( emphysema, chronic bronchitis and asthma) is an independent risk factor for RLS. [23] Previous studies have shown that there was no age difference between COPD with RLS and without RLS. [5,6] Similar to these studies, we found that there were no age differences between the two groups.…”

Section: Discussionmentioning

confidence: 94%

Prevalence, risk factors and effects of restless leg syndrome in COPD patients

Anand

Jain

Gothi

et al. 2022

Monaldi Arch Chest Dis

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Restless leg syndrome (RLS), a sensory motor disorder, is commonly seen amongst chronic obstructive pulmonary disease (COPD) patients. We conducted a study to know its prevalence in COPD and analyse the possible cause and effect of RLS. It is an analytical cross-sectional study conducted between July 2016- December 2020.The prevalence of RLS was evaluated in patients of COPD using RLS diagnostic criteria. Spirometry, iron profile and arterial blood gas analysis was performed in all the patients to evaluate the cause of RLS. The effect was evaluated with diagnostic criteria for insomnia and patient health questionnaire (PHQ2) for depression. There were 205 participants with a mean age of 59±8 years, 182 (88.7%) men and 23 (11.2%) women. The mean body mass index (BMI) was29±3.9 kg/m2. The prevalence of RLS was31.2%. RLS was more common amongst women compared to men (60.8% vs 27.4%). RLS was more prevalent among hypoxaemic (PaO2<60 mm Hg) and hypercapnic (PaCO2>45 mm Hg) patients (p<0.016; p<0.017). The ROC curve plotted between PaO2 and RLS occurrence showed that the patients having PaO2 less than 76 mm of Hg were more prone to develop RLS. RLS patients had a higher incidence of insomnia as compared to those without RLS (68.8%vs 36.8%, p<0.001). COPD with RLS patients had more depressive symptoms with a higher patient health questionnaire 2 (PHQ2) score (35.9%vs 14.2%, p< 0.001) compared to non RLS COPD patients. The multiple regression analysis also confirmed that RLS led to insomnia and depressive symptoms in COPD patients.

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Section: Discussionmentioning

confidence: 94%

Prevalence, risk factors and effects of restless leg syndrome in COPD patients

Anand

Jain

Gothi

et al. 2022

Monaldi Arch Chest Dis

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“…Previous studies have found that restless legs symptoms may have a recurrent affiliation with pain. Widespread pain had been linked to restless legs symptoms in patients with asthma, severe bronchitis, emphysema and they additionally had often tension-type headache, migraine and fibromyalgia (9)(10)(11)(12). The hypothesis assumed either the mechanisms of pain intensity defused restless legs symptoms or the symptoms compounded the sense of pain.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover some patients experienced the symptoms as pain intrinsically without any other source of pain (8). Often restless legs symptoms occur with widespread pain and distressing ailments such as tension-type headaches, migraines and fibromyalgia (9)(10)(11)(12)(13). Knowledge of the pathophysiology and clinical experience of restless legs symptoms have increased during the last decade, but the definite pathophysiology is still not completely elucidated.…”

Section: Introductionmentioning

confidence: 99%

The influence of restless legs symptoms on musculoskeletal pain in depression

Auvinen

Koponen

Kautiainen

et al. 2020

Scandinavian Journal of Pain

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Background and aimsRestless legs syndrome is a sensorimotor disorder associated with mental health conditions notably depression. Restless legs symptoms and depression are commonly associated with pain. The study investigated the influence of restless legs symptoms on musculoskeletal pain in patients with depression or with increased depressive symptoms.MethodsA cross-sectional study of primary care patients in the Central Finland Hospital District. The prevalence of restless legs symptoms was studied in patients with depressive symptoms (n = 695) and controls without a psychiatric diagnosis (n = 410) by using a structured questionnaire. The depressive symptoms were evaluated with the Beck Depression Inventory and the psychiatric diagnosis was confirmed by means of a diagnostic interview (MINI). The prevalence and intensity of musculoskeletal pain was captured with form-based questions. A single-question screen for restless legs symptoms was applied.ResultsThere was a significant difference in the prevalence of continuous widespread musculoskeletal pain between the three study groups: the controls 4.6% (95% CI: 2.8–7.1), the patients with symptoms of depression without a diagnosis 16.0% (11.7–21.1), and the patients with diagnosed depression 22.1% (18.3–23.3) (p = 0.006 after being adjusted for age, sex, smoking, use of alcohol, education years, body mass index, use of antidepressants, and physical activity, after multiple corrections, all groups were significantly different from each other). Compared with those not having restless legs symptoms, subjects with restless legs symptoms had more often continuous widespread musculoskeletal pain in the control subjects (p = 0.001; 2.3% vs. 10.5%) and in the patients with depressive symptoms without a depression diagnosis (p = 0.024; 9.1 vs. 18.7%) but not in those with diagnosed depression (p = 0.98; 19.5 vs. 19.4%). The restless legs symptoms were associated with the intensity of pain in all groups (p < 0.001).ConclusionsRestless legs symptoms were related to continuous widespread musculoskeletal pain in subjects without depressive symptoms and in patients with depressive symptoms without a depression diagnosis. Pain intensity was higher in the subjects with restless legs symptoms regardless of depressive symtoms or depression.ImplicationsClinical management of pain in patients with restless legs symptoms should include an increased focus on the prevention and treatment of either conditions.

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“…At a more granular level, the relationship between RLS and SDB may be attributable to intermittent hypoxia, as respiratory event-associated hypoxia may cause dysfunction of the dopaminergic pathway [22]. This postulate is supported by the high prevalence (30-40%) of RLS among those with moderate to severe chronic obstructive pulmonary disease (COPD), association of smoking and RLS in epidemiology studies, increased use of inhalative respiratory medications in RLS populations [23], and the clinical experience of worsening RLS with acute exposure to high altitude [24]. Specifically, a 3-fold higher prevalence of RLS has been observed in those with COPD compared to age and sex-matched controls [25].…”

Section: Discussionmentioning

confidence: 99%

Impact of Positive Airway Pressure on International Restless Legs Syndrome Score in Sleep Disordered Breathing

Lakshmanan

Thompson

Pascoe

et al. 2019

JCM

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Study Objective: Studies have shown increased prevalence of restless legs syndrome (RLS) in sleep disordered breathing (SDB), however limited data have focused on the impact of SDB therapy on RLS. We hypothesize that positive airway pressure (PAP) will improve the International Restless Legs Syndrome (IRLS) score among SDB patients compared to patients without PAP. Methods: Patients with AHI ≥ 5 who responded positively to a RLS qualifier question from January 2010 to May 2015 were included in this retrospective study. IRLS score was used to measure RLS symptom severity. Two-sample t-tests and one-way analysis of variance were used to compare changes in IRLS score and linear regression models were created to examine IRLS change with PAP use and PAP adherence (PAP usage ≥4 h nightly for ≥70% of nights), adjusting for potential confounders. Results: In 434 patients (51.9 ± 13.4years, 50.5% female, 77.6% Caucasian; 325 PAP, 109 control), IRLS scores improved from baseline to follow-up, with the PAP group achieving significant improvement after adjustment for covariates (difference in IRLS: −1.8 (CI −3.6,0.00), p = 0.050). In self-reported PAP adherent patients, IRLS improvement was greater than controls (−5.3 ± 7.4 vs. −2.7 ± 7.6 respectively, p = 0.045), and comparable to non-adherent patients (−5.3 ± 7.4 vs. −3.0 ± 7.0, p = 0.091). Conclusions: Among SDB patients with a positive RLS qualifier, those who used PAP therapy achieved significantly greater improvement in IRLS scores than patients who did not use PAP, with more significant changes in the PAP adherent group. This is the first large clinical study to examine these relationships, providing a basis for future prospective interventional trials and informing clinicians of expected improvement in IRLS score in PAP treated SDB populations.

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Chronic pulmonary disease is associated with pain spreading and restless legs syndrome in middle-aged women—a population-based study

Cited by 10 publications

References 26 publications

Prevalence, risk factors and effects of restless leg syndrome in COPD patients

Prevalence, risk factors and effects of restless leg syndrome in COPD patients

The influence of restless legs symptoms on musculoskeletal pain in depression

Impact of Positive Airway Pressure on International Restless Legs Syndrome Score in Sleep Disordered Breathing

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