Restless legs syndrome in systemic lupus erythematosus: A case‑control study

Abstract

Sleep disturbances in systemic lupus erythematosus (SLE) are not well understood. The restless legs syndrome (RLS) is one of the frequent occurring sleep disturbances in SLE. The aim of this study was to evaluate the prevalence of RLS and its characteristics in SLE. We evaluated, in a prospective case-control study, 26 patients with SLE and 26 patients without SLE in an age-and sex-matched control group. An RLS-positive diagnosis met International RLS Study Group (IRLSSG) criteria. We used standardized questionnaires, which included demographic data, medical history and sleep assessment. We used validated questionnaires and scales to assess sleep. There were 23/26 females (88.46%) in each group; the mean patient age in the SLE subgroup was 51.65 years, while in the control subgroup, 52.07 years (range 30-74). Nine (34.2%) patients had RLS-positive criteria in the SLE group and 2 (7.69%) of 26 in the control group. Eight out of 9 patients described RLS onset after SLE was diagnosed. In the SLE group, 8 cases were of moderate severity and 1 was considered mild. The control group had one mild and one moderate case of RLS. RLS prevalence in SLE is higher and the quality of sleep is poorer compared with the control group.

Is Restless Legs Syndrome De Facto Thyroid Disease?

“…A 2015 Turkish study showed that RLS is more common in patients with SLE than in the general population (30.6% vs. 4.3%), especially when accompanied by iron deficiency anemia [ 21 ]. Similar results were achieved in a 2018 U.S. study (34% vs. 10%) and a 2021 Romanian study (34.2% vs. 7.69%) [ 22 , 23 ]. It is speculated that in genetically susceptible patients, antibodies against cells responsible for dopaminergic signaling in the central nervous system may play a predominant role in the coincidence of RLS with SLE [ 24 ].…”

Chronic inflammation markers and cytokine-specific autoantibodies in Danish blood donors with restless legs syndrome

“…Elevated levels of IFN-α autoantibodies have been shown to have a protective effect in SLE, thereby capable of lowering disease severity 23 , 38 , 39 . Several smaller studies have found that the prevalence of RLS is higher in SLE patients than in controls 40 – 42 , although whether they are caused by a common pathophysiological pathway involving IFN-α is unknown. A case report by LaRochelle and Karp 43 documented a patient that developed RLS after IFN-α therapy for chronic hepatitis C. Between 50 and 75% of patients treated with recombinant IFN-α develop anti-interferon antibodies 44 .…”

Anemia in patients with inflammatory bowel disease as a risk factor for restless legs syndrome. Literature review

“…Системная красная волчанка. Как и в случае с РА, распространенность СБН у пациентов с СКВ значительно выше, чем в общей популяции -30,6-37,5 % [40][41][42]. По сравнению с контрольной группой, пациенты набирали значительно больше баллов по шкале тяжести IRLS [41,42].…”

“…Как и в случае с РА, распространенность СБН у пациентов с СКВ значительно выше, чем в общей популяции -30,6-37,5 % [40][41][42]. По сравнению с контрольной группой, пациенты набирали значительно больше баллов по шкале тяжести IRLS [41,42]. Более того, даже в группе пациентов наблюдалась определенная неоднородность: при наличии анемии (ЖДА, АХЗ) СБН встречался чаще, и тяжесть его была выше, чем у пациентов с СКВ без анемии.…”

“…Не исключено, что механизм развития СБН будет разным в зависимости от особенностей патогенеза основного заболевания. Например, при ХОБЛ существенную роль играет гипоксия, запускающая гиперактивацию дофаминовой системы, как и в случае с анемией [29], а при СКВ -наличие аутоантител к дофаминергическим нейронам [42].…”