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

Abstract

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.

Incidence of Restless Legs Syndrome in Pakistan and Its Relationship With Depression, Gender, and Age: A Cross-Sectional Study

“…Furthermore, inflammatory reaction or immune responses are might also be involved in development of RLS [8]. The exact mechanism is unknown but it does suggest involvement of dopaminergic pathway as dopamine antagonist makes the symptoms worse while dopamine drugs improve them [9].…”

“…It is made based on symptoms described by the patient. A diagnostic criteria called URGE can be used [9]: U, urge to move the legs, associated with uncomfortable/unpleasant leg sensation; R, rest exasperate symptoms; G, gets better with movement; and E, worse in evening/night.…”