Toward a Definition of Quality Care for Patients with Restless Legs Syndrome

Trotti, Lynn Marie

doi:10.1016/j.jsmc.2015.05.007

Cited by 4 publications

(3 citation statements)

References 33 publications

(40 reference statements)

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“…Our study is strengthened by the use of a large sample size including a control group, rigorous electronic data collection, and adjustment for potential confounding factors. This study was also the first to utilize standardized IRLS questionnaires collected systematically in a clinic-based setting in accordance with AASM quality measures for RLS [12], and the first to evaluate PAP adherence in relation to IRLS score change. However, our study has limitations.…”

Section: Discussionmentioning

confidence: 99%

“…After RLS qualification and study entry, the IRLS questionnaire was given to patients during their clinic visit to assess RLS symptom severity by way of questions that target RLS diagnosis criteria: (i) strong urge to move the legs in association with paresthesia and disagreeable sensations, such as crawling, aching, or burning in the legs; (ii) associated sensations are relieved by movement; (iii) symptoms have circadian rhythmicity and are worse at night; and (iv) symptoms are worse during periods of rest, especially long periods of inactivity [11]. This well-validated [12], 10-item survey asked patients to rate their symptoms on a Likert-type scale from 0-4. A total score of 0 indicates no RLS, 1-10, mild; 11-20, moderate; 21-30, severe; and 30-40, very severe RLS [13].…”

Section: Data Collection From the Cleveland Clinic Knowledge Programmentioning

confidence: 99%

“…A total score of 0 indicates no RLS, 1-10, mild; 11-20, moderate; 21-30, severe; and 30-40, very severe RLS [13]. While clinical improvements can be seen with less change [12], a decrease of 4.2-6 points is indicative of clinically significant improvement [14,15].…”

Section: Data Collection From the Cleveland Clinic Knowledge Programmentioning

confidence: 99%

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Impact of Positive Airway Pressure on International Restless Legs Syndrome Score in Sleep Disordered Breathing

Lakshmanan

Thompson

Pascoe

et al. 2019

JCM

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Study Objective: Studies have shown increased prevalence of restless legs syndrome (RLS) in sleep disordered breathing (SDB), however limited data have focused on the impact of SDB therapy on RLS. We hypothesize that positive airway pressure (PAP) will improve the International Restless Legs Syndrome (IRLS) score among SDB patients compared to patients without PAP. Methods: Patients with AHI ≥ 5 who responded positively to a RLS qualifier question from January 2010 to May 2015 were included in this retrospective study. IRLS score was used to measure RLS symptom severity. Two-sample t-tests and one-way analysis of variance were used to compare changes in IRLS score and linear regression models were created to examine IRLS change with PAP use and PAP adherence (PAP usage ≥4 h nightly for ≥70% of nights), adjusting for potential confounders. Results: In 434 patients (51.9 ± 13.4years, 50.5% female, 77.6% Caucasian; 325 PAP, 109 control), IRLS scores improved from baseline to follow-up, with the PAP group achieving significant improvement after adjustment for covariates (difference in IRLS: −1.8 (CI −3.6,0.00), p = 0.050). In self-reported PAP adherent patients, IRLS improvement was greater than controls (−5.3 ± 7.4 vs. −2.7 ± 7.6 respectively, p = 0.045), and comparable to non-adherent patients (−5.3 ± 7.4 vs. −3.0 ± 7.0, p = 0.091). Conclusions: Among SDB patients with a positive RLS qualifier, those who used PAP therapy achieved significantly greater improvement in IRLS scores than patients who did not use PAP, with more significant changes in the PAP adherent group. This is the first large clinical study to examine these relationships, providing a basis for future prospective interventional trials and informing clinicians of expected improvement in IRLS score in PAP treated SDB populations.

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Section: Discussionmentioning

confidence: 99%