Quality of Sleep and Serum Lipid Profile in Patients with Restless Legs Syndrome

PURPOSE: The purpose of this study was to compare the quality of sleep with the serum lipid profile in patients who have restless legs syndrome (RLS). METHODS: The data were obtained from 116 patients with RLS through questionnaires and blood sampling. RESULTS: The results of this study showed correlations between lower quality of sleep and serum lipid profile (LDL Cholesterol) in patients with RLS (r=.19, p=.040). There were correlations for scores of quality of sleep from the, Pittsburgh Sleep Quality Index (PSQI) sub-region between lower subjective sleep quality and serum lipid profile (LDL Cholesterol) (r=.20, p=.026), between fewer hours of sleep duration and serum lipid profile (Total Cholesterol) (r=-.21, p=.024), and, between higher daytime dysfunction and serum lipid profile (LDL Cholesterol) (r=.42, p<.001) of patients with RLS. CONCLUSION: Patients with RLS have sleep disorders with lower quality of sleep and changes in the serum lipid profile for total cholesterol and LDL cholesterol. That is, patients with RLS have lower quality of sleep and dyslipidemia compared to persons without RLS. Further research is needed to monitor serum the lipid profile in early stage symptoms of midlife adult patients with RLS and especially older women.

Restless legs syndrome in Parkinson's disease: clinical characteristics and biochemical correlations / Síndrome das pernas inquietas na doença de Parkinson: características clínicas e correlações bioquímicas

Restless legs syndrome (RLS) is a neurological disorder that responds to dopaminergic drugs, indicating a common pathophysiology with Parkinson's disease (PD). The prevalence of RLS was estimated in a group of PD patients and its clinical and biochemical characteristics were analysed. Forty-eight patients with PD were evaluated into two groups, with and without RLS. Clinical characteristics assessed in both groups were age, gender, duration of PD, Hoehn and Yahr, and Schwab and England scales. Laboratory variables such as hemoglobin, s-iron, s-ferritin and creatinine were obtained. The prevalence of RLS was 18.75 percent. No significant differences regarding clinical variables and biochemical parameters were observed. The high prevalence of RLS found in PD patients suggests the concept of a common etiological link and it seems that secondary causes did not play a central role in the pathophysiology of RLS in this group of parkinsonian patients.

A síndrome das pernas inquietas (SPI) é um distúrbio sensitivo-motor que responde aos agentes dopaminérgicos, demonstrando uma possível semelhança fisiopatológica com a doença de Parkinson (DP). Foi avaliada a prevalência da SPI em um grupo de pacientes com DP e suas características clínicas e laboratoriais. Quarenta e oito pacientes diagnosticados com DP foram divididos em dois grupos: com e sem SPI. Características clínicas como idade, sexo, duração da DP, escalas de Hoehn e Yahr, e Schwab e England e achados bioquímicos como hemoglobina, ferro sérico, ferritina sérica e creatinina foram obtidos. A freqüência da SPI foi de 18,75 por cento. Não se observaram diferenças estatisticamente significativas quanto às características clínicas e aos achados bioquímicos. A alta prevalência de SPI encontrada em pacientes com DP sugere associação entre essas duas doenças. É provável que causas secundárias não exerçam papel central na fisiopatologia da SPI nesse grupo de pacientes parkinsonianos.

Evolution of non-treated restless legs syndrome / Síndrome das pernas inquietas: evolução após um ano sem tratamento

PURPOSE: The primary concern of this study is to evaluate the clinical course of restless legs syndrome (RLS) in a group of patients who refused treatment. METHOD: This study compares the outcome of a group of RLS patients after one year without any specific treatment. The International Restless Legs Syndrome Scale (IRLS) was applied at baseline (irls_1) and after one year (irls_2). The patients answered a simple questionnaire for the evaluation of possible environmental or life habit changes after one-year evolution. Serum ferritin was determined at baseline. An improvement index ( percentimprovement) was established through the formula: irls_1- irls_2/irls_1 ' 100. Results were compared and a correlation analysis performed. RESULTS: A negative significant correlation was found between the patientsí age and irls_2 (r= -0.9 p=0.0018) and between percentimprovement and irls_2 (r= -0.88 p=0.0039). A positive and significant correlation was determined between percentimprovement and age. There was only a marginally significant correlation between serum ferritin and ilrs_2 (r= -0.7 p=0.052). No significant changes were found in the other elements analyzed. CONCLUSION: A favorable outcome was found in this group of RLS patients after one year evolution without treatment. The outcome was positively influenced by the patientsí age.

OBJETIVO: O objetivo deste estudo é avaliar a evolução de oito pacientes com diagnóstico de síndrome das pernas inquietas (SPI) após doze meses sem tratamento. MÉTODO: Estudo de coorte, retrospectivo, consistindo na aplicação da escala de gravidade da SPI (IRLS), de questionário para avaliação de mudanças ambientais ou de hábitos de vida e dosagem de ferritina sérica. Realizada comparação da pontuação IRLS obtida na consulta inicial (irls_1) e após doze meses de evolução (irls_2) e estabelecido um índice de melhora percentual ( por centomelhora=irls_1 - irls_2 / irls_1 ' 100). Análise de correlação dos dados obtidos. RESULTADOS: Foi demonstrada correlação negativa e significativa entre a idade e a irls_2 (r= -0,9 e p=0,0018) e entre por centomelhora e irls_2 (r= -0,88 e p=0,0039). Encontrou-se correlação positiva e significativa entre por centomelhora e a idade. Houve apenas correlação negativa marginalmente não-significativa entre a dosagem de ferritina sérica e ilrs_2 (r= -0,7 e p=0,052). CONCLUSÃO: Neste grupo demonstrou-se evolução favorável da SPI após doze meses que se correlacionou positivamente com a idade dos pacientes, não tendo sido influenciada aparentemente por hábitos de vida ou mudanças ambientais.

Two pedigrees with restless legs syndrome in Brazil

Numerous studies have suggested a substantial genetic contribution in the etiology of the primary form of restless legs syndrome (RLS) and periodic leg movements (PLM). We describe the symptoms, the sleep profiles and physiological parameters of two families in which several members present RLS/PLM. The proband of family 1 is a 70-year-old woman and the proband of family 2 is a 57-year-old woman; both have exhibited the symptoms since the age of 20 years. All patients in both families were diagnosed with RLS according to the criteria of the International RLS Study Group. Polysomnographic recordings were performed to quantify and to describe PLM during sleep. Sleep parameters showed decreased sleep efficiency, increased sleep latency in the arousal index and the presence of PLM in all subjects. One of the families showed an exact profile of dominant inheritance with anticipation of age at onset. In the other family, the founders were blood relatives and there was no affected member in the third generation suggesting a recessive mode of inheritance. RLS/PLM is a prevalent sleep disorder affecting about 5 to 15 percent of the population and one that substantially impairs healthy sleep patterns. Efforts to understand the underlying pathophysiology will contribute to improve the sleep and life quality of these patients.