Efficacy of oral iron in patients with restless legs syndrome and a low-normal ferritin: A randomized, double-blind, placebo-controlled study

Wang, James; O’Reilly, B. M.; Venkataraman, Ramesh; Mysliwiec, Vincent; Mysliwiec, Angela

doi:10.1016/j.sleep.2008.11.003

Cited by 182 publications

(104 citation statements)

References 13 publications

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“…Correcting the anemia without fully correcting iron levels may not resolve the RLS indicating that correction of serum ferritin, TIBC, and percent transferrin saturation, should be a therapeutic goal for IDA-RLS. The appropriate levels for iron parameters for RLS IDA recovery have not been established but full resolution of the RLS with IDA may require raising the levels of peripheral iron stores to that desired for non-anemic RLS patients (serum ferritin > 75 mg/l) [19]. IV iron may also provide more rapid relief from IDA RLS than oral iron.…”

Section: Discussionmentioning

confidence: 99%

The prevalence and impact of restless legs syndrome on patients with iron deficiency anemia

et al. 2013

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Restless Legs Syndrome (RLS) a common, under-recognized disorder disrupts sleep and diminishes quality of life. Despite a clear relation between low peripheral iron and increased prevalence and severity of RLS, the prevalence and clinical significance of RLS in iron-deficient anemic (IDA) populations is unknown. In this study all new patients referred for anemia to a community-based hematology practice over a 1-year period (March 2011(March -2012 were included if they had IDA and no RLS treatment. Patients completed a validated questionnaire identifying RLS, blood tests, and a sleep-vitality questionnaire (SVQ). Patients with RLS were compared to patients with no RLS for differences on SVQ, blood tests, baseline characteristics, and sleep quality. Three hundred forty-three patients were evaluated and 251 (89.2% female, average age of 45.6 years) included in the study. The prevalence of clinically significant RLS (RLS sufferers) was 23.9%, nine times higher than the general population. IDA-RLS sufferers reported poorer quality of sleep, decreased sleep time, increased tiredness, and decreased energy during the day compared to patients with IDA without RLS. Blood tests did not relate to RLS diagnosis but RLS was less likely for African-American than Caucasian patients. Clinically significant RLS occurs commonly with IDA producing much greater disruption of sleep and shorter sleep times than does IDA alone. This indicates the need for identification of RLS with IDA and consideration of appropriate therapeutic interventions for this sizeable subgroup: either aggressive iron treatment to reduce the RLS symptoms or medications for RLS or both. Am. J. Hematol. 88:261-264, 2013. V C 2013 Wiley Periodicals, Inc. IntroductionIron deficient anemia (IDA) occurs commonly particularly among American women of child-bearing age [1] The Willis-Ekbom Disease, better known as the restless legs syndrome (RLS) is exacerbated and engendered by reduced peripheral iron stores and therefore should be both common and moderately severe in IDA. RLS is well-defined but commonly over-looked cause of significant morbidity with established relationships to genetics [2] and iron biology [3]. Moderately severe to severe RLS is a major health problem [4] producing periods of torturous restlessness during sleep often reducing sleep times to 5 hr or less [5]. Presumably RLS occurring with IDA if not adequately treated will have the same adverse health effects, but this has not been previously studied.The only two prior studies of RLS in patients with IDA reported a very high RLS prevalence of about 40% [6,7]. These studies used small, academic-hospital-based populations with limited, nonvalidated, nonstandardized criteria to make the diagnosis. The accuracy of these prevalence estimates is therefore questionable. More significantly, the severity of RLS was not reported. RLS has a broad range of severity from a rarely occurring mild annoyance to a clinically significant disease severely impairing sleep, quality of life, health, and ability to work...

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Section: Discussionmentioning

confidence: 99%

The prevalence and impact of restless legs syndrome on patients with iron deficiency anemia

et al. 2013

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“…34 The pathogenesis of RLS, ASD, and ADHD are uncertain, although the dopamine-opiate system and iron as a cofactor have been implicated in each of these disorders. 32,[34][35][36] Given these linkages, it is suggested that future bench and clinical research examine further these relationships that could expand our knowledge of the complex relationships between Table 3-Sleep and behavior scales for children with autism spectrum disorder. these disorders and lead to interventions to ameliorate symptoms and improve child and family quality of life.…”

Section: Discussionmentioning

confidence: 99%

Symptoms of Restless Legs Syndrome in Biological Caregivers of Children with Autism Spectrum Disorders

Russell

Baldwin

McClain

et al. 2017

Journal of Clinical Sleep Medicine

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Study Objectives: In this study, we investigated the prevalence of symptoms of restless legs syndrome (RLS) in biological caregivers of children with a diagnosis of autism spectrum disorder (ASD).The relationship of RLS symptoms to caregiver health-related quality of life (HRQoL) was also examined. Finally, we compared the sleep quality and daytime behaviors of children with ASD in caregivers with and without symptoms of RLS. Methods: Biological caregivers (n = 50) of children ages 6 to 11 y with a diagnosis of ASD completed a Sleep Habits Questionnaire (SHQ) that included RLS as determined by four questions. HRQoL was assessed using the Medical Outcomes Survey (MOS) 12-Item Short Form (SF-12). Caregivers also completed the Children's Sleep Habits Questionnaire (CSHQ) and Child Behavior Checklist (CBCL6/18). Results: Eleven caregivers (22%) fit the criteria for RLS symptomatology and caregivers with RLS reported poorer mental health. Caregivers with RLS described more night waking and greater internalized behavior problems in their children with ASD than the caregivers without RLS. Conclusions: Biological caregivers of children with ASD demonstrated a high prevalence of RLS symptoms and poorer mental health. RLS is known as a sleep disorder that has strong heritability, and it is possible that many of the children with ASD also have symptoms of RLS. RLS as a possible disruptor of sleep should be considered in caregivers and in their children with ASD. Keywords: autism spectrum disorder, caregivers, health-related quality of life, restless legs syndrome Citation: Russell M, Baldwin C, McClain D, Matthews N, Smith C, Quan SF. Symptoms of restless legs syndrome in biological caregivers of children with autism spectrum disorders.

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“…The most reliable indicator of body stores of iron is the serum ferritin, transferrin, and transferrin saturation. Prior studies have shown that lower ferritin levels correlate with increased severity of RLS [29] and that replacement of iron in iron-deficient RLS patients improves symptoms [30][31][32], although not all studies demonstrate similar findings [33]. The current recommendation is that all patients diagnosed with RLS be evaluated for iron deficiency.…”

Section: Treatment Of Secondary Rlsmentioning

confidence: 99%

Treatment of Restless Legs Syndrome

Comella¹

2014

Neurotherapeutics

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Restless legs syndrome (RLS) is a common disorder diagnosed by the clinical characteristics of restlessness in the legs associated often with abnormal sensations that start at rest and are improved by activity, occurring with a diurnal pattern of worsened symptoms at night and improvement in the morning. RLS is the cause of impaired quality of life in those more severely afflicted. Treatment of RLS has undergone considerable change over the last few years. Several classes of medications have demonstrated efficacy, including the dopaminergic agents and the alpha-2-delta ligands. Levodopa was the first dopaminergic agent found to be successful. However, chronic use of levodopa is frequently associated with augmentation that is defined as an earlier occurrence of symptoms frequently associated with worsening severity and sometimes spread to other body areas. The direct dopamine agonists, including ropinirole, pramipexole, and rotigotine patch, are also effective, although side effects, including daytime sleepiness, impulse control disorders, and augmentation, may limit usefulness. The alpha-2-delta ligands, including gabapentin, gabapentin enacarbil, and pregabalin, are effective for RLS without known occurrence of augmentation or impulse control disorders, although sedation and dizziness can occur. Other agents, including the opioids and clonazepam do not have sufficient evidence to recommend them as treatment for RLS, although in an individual patient, they may provide benefit.

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Efficacy of oral iron in patients with restless legs syndrome and a low-normal ferritin: A randomized, double-blind, placebo-controlled study

Cited by 182 publications

References 13 publications

The prevalence and impact of restless legs syndrome on patients with iron deficiency anemia

The prevalence and impact of restless legs syndrome on patients with iron deficiency anemia

Symptoms of Restless Legs Syndrome in Biological Caregivers of Children with Autism Spectrum Disorders

Treatment of Restless Legs Syndrome

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