The four diagnostic criteria for Restless Legs Syndrome are unable to exclude confounding conditions (“mimics”)

Hening, Wayne A.; Allen, Richard P.; Washburn, Mystinna; Lesage, Suzanne; Earley, Christopher J.

doi:10.1016/j.sleep.2008.09.015

Cited by 234 publications

(160 citation statements)

References 24 publications

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“…It establishes for the first time, a reasonably accurate estimate of RLS prevalence in a community population of patients with IDA referred for treatment. The overall RLS prevalence in IDA is four to five times higher than in the general population (31% vs. 7%) [15], but not the six times higher reported in the very small, prior studies [6,7] not using a validated diagnosis or acknowledging any effort to exclude RLS "mimics" [11]. The important finding, however, is the confirmation of the expected high prevalence of clinically significant RLS in IDA.…”

Section: Discussionmentioning

confidence: 70%

“…This questionnairebased RLS diagnosis requires answers consistently indicating presence of all four of the basic RLS diagnostic criteria [10], i.e: (1) A compelling urge to move the legs usually accompanied by uncomfortable feelings in the legs that must be, (2) engendered or exacerbated by rest (sitting or lying still), (3) relieved by movement, and (4) worse in the evening and night than the morning except for very severe cases when it occurs at all times of the day. Common RLS "mimics" [11] were excluded by these questions. A diagnosis as "uncertain" was assigned to patients who on the diagnostic items provided inconsistent responses that would require an interview to resolve.…”

Section: Methodsmentioning

confidence: 99%

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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: 70%

Section: Methodsmentioning

confidence: 99%

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

et al. 2013

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“…We took a careful systematic approach when administering the 4 essential diagnostic criteria of RLS. However, methodology to exclude RLS "mimics" 29,30 was not available during data collection for this study. Therefore, our study most likely included cases of secondary RLS and RLS mimics, which could potentially affect the prevalence of RLS noted in both HMD and NHW.…”

Section: Study Limitationsmentioning

confidence: 99%

Ethnic Differences in the Prevalence and Predictors of Restless Legs Syndrome between Hispanics of Mexican Descent and Non-Hispanic Whites in San Diego County: A Population-Based Study

Sawanyawisuth

Palinkas

Ancoli‐Israel

et al. 2013

Journal of Clinical Sleep Medicine

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“…There are several disorders in which the diagnostic criteria may be met but the patient does not have RLS (Table 3). Careful interview will usually result in distinguishing these disorders from RLS [2].…”

Section: Introductionmentioning

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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The four diagnostic criteria for Restless Legs Syndrome are unable to exclude confounding conditions (“mimics”)

Cited by 234 publications

References 24 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

Ethnic Differences in the Prevalence and Predictors of Restless Legs Syndrome between Hispanics of Mexican Descent and Non-Hispanic Whites in San Diego County: A Population-Based Study

Treatment of Restless Legs Syndrome

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