The Association of Restless Legs Syndrome to History of Gestational Diabetes in an Appalachian Primary Care Population

Innes, Kim E.; Kandati, Sahiti; Flack, Kathryn L.; Agarwal, Parul; Selfe, Terry

doi:10.5664/jcsm.5084

Cited by 19 publications

(21 citation statements)

References 66 publications

(89 reference statements)

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“…This relationship was not explained by demographic or lifestyle factors, parity, history of GDM, or other reproductive characteristics, current BMI, or reported diagnosis of hypertension, diabetes, CVD, metabolic syndrome, apnea, or other chronic conditions associated with both RLS and PIH. Consistent with the findings of our previous studies in Appalachian adults, 1,52 the prevalence of RLS in this study was high, likely at least, in part, reflecting the elevated rates of obesity, hypertension, diabetes, and other chronic conditions that characterize this population. 1,52 Over 24% of participants met criteria for RLS, with *12% reporting symptoms three or more times per week.…”

Section: Discussionsupporting

confidence: 92%

“…Consistent with the findings of our previous studies in Appalachian adults, 1,52 the prevalence of RLS in this study was high, likely at least, in part, reflecting the elevated rates of obesity, hypertension, diabetes, and other chronic conditions that characterize this population. 1,52 Over 24% of participants met criteria for RLS, with *12% reporting symptoms three or more times per week. Similarly elevated prevalence rates in women have been reported in some, [62][63][64] but not other [65][66][67] U.S. and Western European studies targeting primary care and/or older adult populations and using comparable criteria.…”

Section: Discussionsupporting

confidence: 92%

“…While hypertensive disorders of pregnancy have been strongly and bidirectionally linked to diabetes, chronic hypertension, CVD, and related disorders, 50,78,79 conditions which are also associated with RLS, 2 controlling for these factors did not materially alter the relationship of PIH history to chronic RLS, suggesting that the observed association of PIH to RLS was not mediated or confounded by these conditions. Similarly, while GDM significantly increases risk for PIH, 59,60 and we recently showed history of GDM to be strongly and positively associated with chronic RLS, 52 adjusting for GDM only slightly attenuated the observed relationship of PIH to RLS in this study. However, other related shared risk factors could help explain the positive association between PIH and RLS noted in our study.…”

Section: Discussionsupporting

confidence: 55%

“…It is also unknown if this association persisted beyond pregnancy. In our recent companion study, 52 we documented a strong positive association between previous history of GDM and RLS that was independent of demographic and lifestyle factors, BMI, comorbid conditions, and reproductive history, including history of PIH.…”

Section: Discussionmentioning

confidence: 61%

“…38,49 PIH may thus be viewed as an early risk marker for these disorders, 45,50 conditions which have also been associated with RLS. 2,21,51,52 However, while several studies have examined risk factors for RLS during pregnancy as well as pregnancy-related risk factors for RLS in nonpregnant women, the association of RLS to common physiological complications of pregnancy, including PIH, remains little explored. One cross-sectional study of pregnant Peruvian women reported elevated prevalence of preeclampsia among those with RLS, 53 although findings were based on small numbers, estimates were not adjusted for several potentially confounding factors, and it is unknown if RLS persisted beyond pregnancy.…”

Section: Introductionmentioning

confidence: 99%

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The Relationship of Restless Legs Syndrome to History of Pregnancy-Induced Hypertension

Innes

Kandati

Flack

et al. 2016

Journal of Women's Health

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Background: Restless legs syndrome (RLS), a burdensome sleep disorder, has been associated with cardiovascular disease (CVD), hypertension, diabetes, and related disorders. However, the relationship of RLS to history of pregnancy-induced hypertension (PIH), a predictor of subsequent CVD, diabetes, and associated conditions, remains little explored. In this study, we investigated the relationship of RLS to history of PIH in a sample of primary care patients. Methods: Participants were women aged ‡40 years drawn from an anonymous survey study of West Virginia primary care patients. Data collected included detailed information on demographics, lifestyle factors, sleep patterns, and reproductive/medical history; the survey also included an RLS diagnostic questionnaire. Women who were pregnant or unsure about their pregnancy status were excluded from the analyses. Results: Of the 498 participants in the final analytic sample, 24.5% met diagnostic criteria for RLS (17.9% with symptoms ‡once/week, 11.9% with symptoms ‡3 times/week); 73 (16.5% of parous women) reported a history of PIH, defined as physician-diagnosed preeclampsia or gestational hypertension. After adjustment for demographics, lifestyle characteristics, obesity, reproductive history, health conditions, and other factors, those reporting a history of PIH were approximately twice as likely to meet criteria for RLS (odds ratio [OR] = 1.9; 95% confidence interval [CI] = 1.1, 3.6). These associations increased in magnitude with increasing symptom frequency (adjusted OR for RLS with symptoms ‡3 times/week = 3.8; CI 1.9, 7.6; p for trend = 0.003). Conclusions: History of PIH was strongly and positively related to current RLS in this study of primary care patients; these findings further support a possible role for metabolic dysregulation in RLS etiology.

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