Faculty Collaboration Database

The high prevalence of restless legs syndrome symptoms in liver disease in an academic-based hepatology practice. J Clin Sleep Med 2008 Feb 15;4(1):45-9

Date

03/21/2008

Pubmed ID

18350962

Pubmed Central ID

PMC2276829

DOI

10.5664/jcsm.27078

Scopus ID

2-s2.0-43549110946 (requires institutional sign-in at Scopus site)   55 Citations

Abstract

STUDY OBJECTIVES: Survey-based epidemiologic studies suggest that restless legs syndrome (RLS) affects approximately 10% of the general population and can cause significantly reduced quality of life due to sleep disturbance. This condition is more prevalent in certain disease states, such as iron deficiency anemia, neuropathy, and renal insufficiency. No such prevalence data exists for RLS in liver disease. The aim of the present project was to assess the self-reported prevalence of RLS using an RLS symptom specific questionnaire in patients presenting to a tertiary hepatology clinic with chronic liver disease (CLD). This was a convenience cohort study of established chronic liver disease patients being seen at a tertiary referral center. A one-page survey querying RLS symptoms was administered in hepatology clinic to patients with chronic liver disease. Restless legs syndrome (RLS) symptoms as agreed upon by the International RLS Study Group were incorporated as 5 key questions. Of 141 completed surveys, 88 were positive yielding a questionnaire based prevalence of RLS of 62% in this select population. RLS risk factors were further assessed through chart review and self-report and using a logistical regression analysis. Comparison between those reporting RLS symptoms and those who did not revealed only self-reported neuropathy to be significantly higher in those with RLS. RLS associated with risk factors accounted much of the total prevalence. Of those with RLS symptoms, 23 surveyed were without known RLS risk factors. This yields a convenience sample prevalence of unexplained RLS symptoms of 16.3% (CI: 10.6-23.5) in this population. There did not appear to be a correlation between the severity of liver dysfunction including the presence of cirrhosis or the etiology and the prevalence of RLS symptoms. Quality of Life (QoL) surveys specific to RLS completed suggest RLS symptoms result in significantly diminished QoL, with an average QoL score of 68 on a 0-100 scale.

CONCLUSION: This study is the first investigation of RLS prevalence in liver dysfunction. This select population of medically complex patients who all have some degree of liver dysfunction appear to have a surprisingly high prevalence of RLS symptoms. While much of this prevalence may be the result of known secondary causes further investigation is warranted to explore the relationship between RLS and liver dysfunction.

Author List

Franco RA, Ashwathnarayan R, Deshpandee A, Knox J, Daniel J, Eastwood D, Franco J, Saeian K

Authors

Rose Franco MD Professor in the Medicine department at Medical College of Wisconsin
Kia Saeian MD Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Academic Medical Centers
Adult
Aged
Chronic Disease
Comorbidity
Cross-Sectional Studies
Female
Health Surveys
Humans
Liver Cirrhosis
Liver Diseases
Liver Function Tests
Male
Middle Aged
Restless Legs Syndrome
Risk Factors
Wisconsin