Restless legs and periodic leg movements in sleep syndromes

Wetter, Thomas C.; Pollmächer, Thomas

doi:10.1007/bf03160570

Cited by 85 publications

(36 citation statements)

References 75 publications

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“…They may be found in up to 34 % of patients over the age of 60 years. PLM are very common in a variety of sleep disorders including RLS (80-90 %) and RBD (≈70 %) [56]. & PLM are electrographic findings characterized by periodic episodes of repetitive and highly stereotyped limb movements that occur during sleep.…”

Section: Periodic Limb Movement Disorder Of Sleep (Plmds)mentioning

confidence: 99%

Neurodegenerative Disease and REM Behavior Disorder

Malhotra

Avidan

2012

Curr Treat Options Neurol

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Patients with cerebral degenerative conditions commonly suffer from a variety of sleep disorders, including sleep-disordered breathing, insomnia, parasomnias (REM sleep behavior disorder), circadian rhythm disturbances, and restless legs syndrome. When these sleep disorders go unrecognized and untreated, they can lead to decreased quality of life and worsening neurological symptoms related to the underlying condition. Appropriate management initially requires taking a careful history from the patient and bed partner regarding their sleep. In addition, polysomnography may be required to aid in the diagnosis of sleep-disordered breathing or parasomnias. Occasionally, adjusting the dosages of sedating or sleep disrupting medications and improving sleep hygiene may improve sleep complaints. However, in most cases restoring quality nighttime sleep requires specific therapeutic intervention. In patients that suffer from sleep apnea, this usually means treatment with continuous positive airway pressure (CPAP), positional therapy, dental appliances, upper airway surgery, or weight loss. Pharmacological treatment of insomnia in patients with cerebral degenerative conditions can be difficult due to side effects (worsening balance, cognition) and lack of data in this patient population. Behavioral strategies such as cognitive-behavioral therapy have been effective and are considered safer than hypnotic therapy, but can be limited due to access to trained providers (distance and number of providers) and limited cognitive functioning of the patient. Parasomnias, namely REM sleep behavior disorder, are managed by looking for any underlying cause of arousals (sleep apnea, periodic leg movements of sleep), implementing safety precautions, and pharmacologically with either benzodiazepines or melatonin. Restless legs syndrome may improve with iron replacement or dopamine agonist therapy, as it does in other patient populations. Light therapy may be beneficial in patients suffering from circadian rhythm disorders such as advanced sleep phase syndrome.

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Section: Periodic Limb Movement Disorder Of Sleep (Plmds)mentioning

confidence: 99%

Neurodegenerative Disease and REM Behavior Disorder

Malhotra

Avidan

2012

Curr Treat Options Neurol

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“…2 Therefore, it is sometimes referred to as`Ekbom syndrome'. 3 RLS occurs either as idiopathic or in association with many medical conditions. It is not uncommon, aicting 1% to 15% of the population and is equally distributed between men and women.…”

Section: Frequency and Onsetmentioning

confidence: 99%

“…Their periodic limb movements in sleep (PLMS) can arouse and awaken them. 3 In severe cases patients obtain only a few hours of sleep at night followed by excessive daytime sleepiness. PLMS and sensory symptoms in RLS are in¯uenced by a circadian rhythm that may be contributing to nighttime worsening.…”

Section: Sleep Disturbancementioning

confidence: 99%

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Restless Legs Syndrome

Glasauer

2001

Spinal Cord

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Restless Legs Syndrome (RLS) is a well-de®ned symptom complex and is frequently associated with sleep disturbance and a recognized family history. It occurs either as idiopathic RLS or in association with many medical, neurological or vascular disorders. The neurological examination and routine investigations in idiopathic RLS are normal. Polysomnography supports the diagnosis of RLS by documenting the associated sleep disturbances and periodic limb movements in sleep (PLMS). Although MRI studies disclose no intracerebral lesions, recent Positron Emission Tomography (PET) and single photon emission computed tomography (SPECT) studies point to some involvement of the basal and red nuclei and the cerebellum. No de®nitive etiology is known for this condition, but several pathophysiological mechanisms have been proposed. There is supportive evidence that RLS is a Central Nervous System (CNS) dysfunction, suggesting widespread involvement of the descending dopaminergic (DA) pathways, possibly originating in the diencephalon or upper brainstem. This is corroborated by the successful treatment of RLS with DA agents, sedatives, and neurotransmitters. However, RLS can also occur with spinal disorders and spinal cord lesions implying the existence of a spinal generator. The incidence of RLS in pregnancy is well known and its association with vascular disorders supports another mechanism in some patients. The primary treatment of RLS is largely symptomatic and quite eective with DA agents, DA agonists, opioids and other neurotransmitters. The treatment of RLS associated with various diseases is aimed at the correction of the underlying pathological or de®ciency states. Antidepressant medications frequently precipitate or worsen the condition of RLS. Spinal Cord (2001) 39, 125 ± 133

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“…Restless legs syndrome (RLS), widely recognized as a distinct clinical entity, is likely to be an underdiagnosed condition because its symptoms might frequently be ascribed to stress and anxiety [17,31,36,45].Various community-or population-based studies suggest a prevalence of 5-15 % of RLS among Caucasians and 0.1-0.5 % in some Asian populations [17,31,36,45]. It is not clear whether genetic and/or environmental factors or methodological differences explain this variance among different races.…”

Section: Introductionmentioning

confidence: 99%

Genetics of restless legs syndrome: evidence for a hereditary disorder

Tan

2007

J Neurol

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Restless legs and periodic leg movements in sleep syndromes

Cited by 85 publications

References 75 publications

Neurodegenerative Disease and REM Behavior Disorder

Neurodegenerative Disease and REM Behavior Disorder

Restless Legs Syndrome

Genetics of restless legs syndrome: evidence for a hereditary disorder

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