Patterns of sleep disorders after a new coronavirus infection COVID-19

Background. Sleep disorders have a negative impact on many aspects of life. COVID-19 exacerbates this problem in the context of the post-COVID syndrome where sleep disorder is one of the common complaints. Objective. We aimed to assess the frequency of sleep disorders after COVID-19 and the presence of associations between post-COVID sleep disorders and the severity of COVID-19. Material and methods. A cross-sectional study was carried out in Novosibirsk. It included 115 people aged 26 to 74 years (an average age of 54.22 ± 12.48 years) after recovery from COVID-19, which occurred two to eleven months before. Patients underwent questionnaire survey (Spiegel sleep score questionnaire, HADS Anxiety and Depression Scale, International Restless Legs Syndrome (RLS) Severity Scale), examination by a somnologist, and screening night computer pulse oximetry. If an index of desaturations was more than five per hour, we performed overnight somnography by WAtch PAT 200 or polysomnography. Patients were divided into groups depending on the presence of sleep disorders, COVID-19 severity, and their age. Statistical analysis included a descriptive analysis. Odds ratio was assessed by determining the risk measure for dichotomous variables in the contingency table. Results. RLS was the most common post-COVID sleep disorder (n = 63, 75%). However, primary insomnia was diagnosed only in patients with moderate-to-severe course of COVID-19 (n = 3, 9%). There were 40 patients with post-COVID sleep disorder;they had significantly lower sleep time on workdays (7.00 [6.00;7.50] vs. 7.50 [6.50;8.00] hours, p = 0.021) and significantly higher mean HADS depression score (5.00 [3.00;7.00] vs. 3.00 [1.00;6.00] points, p = 0.006) compared with the corresponding parameters in patients without deterioration of sleep quality. The chance of reduced sleep quality was 11.6 times higher after moderate-to-severe COVID-19 infection than that after mild infection only in patients aged 26-59 years (95% confidence interval 1.42-94.32, p = 0.007). Conclusion. The chance of worsening sleep quality was significantly higher after a moderate-to-severe COVID-19 infection than after mild infection in 26-59-year-old old patients. At the same time, RLS was the most common post-COVID sleep disorder according to our study. Given the importance of sleep disorders, working-age patients after moderate-to-severe COVID-19 infection require active monitoring by doctors in order to timely correct emerging complaints. © 2022 Tomsk State University. All rights reserved.

Contemporary Concise Review 2022: Sleep.

COVID-19 AND SLEEP: The COVID-19 pandemic is associated with an increase in insomnia and impaired sleep quality Health care workers are particularly susceptible and improved with cognitive behavioural therapy for insomnia (CBT-I) Long COVID has significant effects on sleep OSA impacts on the severity of acute COVID-19 illness OBSTRUCTIVE SLEEP APNOEA: Large trials of clinically representative patients confirm the cardiovascular benefits of CPAP treatment in OSA CPAP may improve long-term cognitive outcomes in OSA, but further research is needed Racial disparities in OSA prevalence and mortality risk are becoming evident Periodic evaluation of OSA risk in pregnancy is important as timing may be key for intervention to prevent or treat cardiovascular risk factors INSOMNIA: Comorbid insomnia and obstructive sleep apnoea (COMISA) can frequently co-exist and the combined negative effects of both may be deleterious, particularly to cardiovascular health There is evidence for effectiveness with novel orexin receptor antagonists.

Prevalence of restless legs syndrome during the 2019 coronavirus disease pandemic in South Korea: A nationwide cross-sectional population-based study.

Background: The 2019 coronavirus disease (COVID-19) pandemic has been associated with a significant increase in sleep disorders. This study aimed to determine the prevalence of restless leg syndrome (RLS) and the effect of COVID-19 on RLS during the pandemic in Korea. Methods: The National Sleep Survey of South Korea 2022 was employed in this study. This study was a large population-based web survey using a structural questionnaire of a four thousand representative sample of individuals aged 20-69 years in Korea. The survey was conducted between January 2022 and February 2022 during the COVID-19 pandemic. RLS was diagnosed using the Korean version of the paradigm of questions for epidemiological studies of RLS. Chronic persistent RLS was defined for individuals with RLS symptoms at least twice a week. Results: Six hundred forty-nine (16.2%) and 172 (4.3%) patients were classified as having RLS and chronic persistent RLS, respectively. Female sex, being employed, the presence of COVID-19 vaccine-related adverse events, decreased sleep duration, the presence of EDS, and current treatment for insomnia were significantly associated with chronic persistent RLS. Conclusion: During the COVID-19 pandemic, the prevalence of RLS and chronic persistent RLS in the adult Korean population was higher than that reported in previous studies.

Evaluation Of Usefulness Of Ropinirole In The Treatment Of Post Covid Restless Leg Syndrome - A Homogenous Quasi-Experimental Feasibility Study

Background: Restless legs syndrome (RLS), also known as Willis-Ekbom disease, is a widely known, prolonged, multifactorial limb movement disorder wherein patients have an insatiable desire to move their legs. This is frequently associated with abnormal, non-painful sensations that begin at rest and improve with activity and pain may be the distressing symptom in a few. Ropinirole, a dopamine agonist, is a proven drug for this disease. Method(s): In this study of thirty-two post covid restless leg syndrome, selected by well-established criteria, a course of ropinirole 2 mg in the night was given for three weeks. The drug compliance was maintained more than 95% by telephonic interview. The pain scores (VAS 0- 10), Likert scores of satisfactions, were observed after three weeks and three months. Result(s): The scores significantly decreased after three weeks which maintained the same and an insignificant decrease after three months. The median score decreased from 7 to 3 (three weeks) to 2 in three months. The Likert satisfaction scores improved to 1.81 from three (p value= 0.00). There was improvement in scores from three weeks to three months. There were no side effects. Conclusion(s): In this single centre, quasi experimental study on the efficacy of ropinirole on post covid restless syndrome, we found the drug dosage of 2 mg in the night for three weeks is effective in the control of symptoms. The drug gives better satisfaction which prolonged to three months even if the drug is stopped in three weeks. There were no clinically significant side effects. Copyright © 2022 Wolters Kluwer Medknow Publications. All rights reserved.

Insomnia as a concerned mental health issue during COVID-19 pandemic: A google trend analysis

Introduction: Insomnia is one of the most common major health issues during the COVID-19 pandemic. There has been limited evidence that showed the correlation between insomnia and COVID-19 using Google trend. Objective(s): To investigate the impact of the COVID-19 pandemic on interest in insomnia, including national mental health by a Google trend analysis that implicitly represents the state of distress and concern for this pandemic. Method(s): We examined the Google trend search query data from these sleep-related keywords: insomnia, restless leg, and obstructive sleep apnea (OSA) from 1 Jan 2020 to 30 May 2020 and explored the correlation between the internet search volumes for insomnia and the cumulative number of new COVID-19 cases. In addition, we investigated the internet search pattern over time, before and during the COVID-19 pandemic. Result(s): During the early phase of the COVID-19 pandemic between January and May 2020, the Relative Search Volumes (RSV) curves showed that the cumulative number of new COVID-19 cases was significantly correlated with the rising search for these keywords linking to sleep-related conditions as follows: 'insomnia' (r = 0.41, p < 0.001), and 'restless leg' (r = 0.19, p = 0.009). However, it was not correlated with the keyword 'OSA' (r = -0.14, p = 0.07). Conclusion(s): These findings emphasize the impact of the COVID- 19 pandemic on insomnia and the crucial need for public mental health interventions to be offered and accessible. The Google trend could be used as a new tool for public mental health surveillance in a new normal lifestyle.

Management of movement disorders in primary care

Movement disorders (MDs), are a spectrum of neurological diseases consisting of motor and non-motor symptoms regarding the dysfunctional motor control circuitry and some parts of the nervous system including the basal ganglia, thalamus, cortex, cerebellum besides peripheral autonomic nervous system. Usually, movement disorders are a clinical syndrome which is a specific movement disorder with some other disorders besides neurological and non-neurological abnormalities. The clinical manifestations that should be considered as MDs are complex and heterogeneous. These conditions include symptoms of motor functions like tremor, myoclonus or dystonia, so-called hyperkinetic movements, problems with cognitive functioning like attention problems, prediction error, and sometimes emotion hyper-responsiveness. It is estimated that more than 500,000 individuals in Europe were affected by rare neurological diseases according to the European Reference Network for Rare Neurological Diseases - ERN-RND. Parkinson's Disease is the most common disease in the large spectrum of neurodegenerative disorders characterized by movement disorder and this affected more than 1 million persons over 55 years old in the United States. In response to the COVID-19 pandemic, movement disorders followed up by all forms of telemedicine usage increased across almost all of the countries in the world. In most countries, the patient's first contact is the primary care physician and it is important to disseminate the knowledge of primary care among movement disorders. It is important to be aware of and be an expert in neurological symptoms for diagnosing rare movement disorders. Due to technological improvements, it is feasible to implement continuing medical education and on-the-job training programs among MDs to exchange information, training, and skill. © 2022 Nova Science Publishers, Inc.

Sleep Disorders in Patients with Parkinson's Disease during COVID-19 Pandemic: A Case-Control Study.

Objective: To assess the impact of coronavirus disease 2019 (COVID-19) pandemic on sleep disorders among Parkinson's disease (PD) patients using validated questionnaires. Materials and Methods: This prospective study involved 50 PD patients and 50 age, gender, and body mass index-matched controls. All participants underwent assessment of cognition using Montreal Cognitive Assessment scale, sleep quality using Parkinson's disease sleep scale-2 (PDSS-2; for PD patients) and Pittsburgh Sleep Quality Index (PSQI; for PD patients and healthy controls), excessive daytime sleepiness (EDS) using Epworth sleepiness scale (ESS), insomnia symptoms and severity using insomnia severity index (ISI), restless legs syndrome (RLS) using International RLS Study Group criteria, rapid eye movement sleep behavior disorder (RBD) using RBD Single-Question Screen (RBD1Q), and depression using Patient Health Questionnaire-9 scale. Results: Eighty-eight percent of PD patients reported one or more sleep disorders, compared to 28% controls. While 72% of PD patients reported poor sleep quality (PDSS-2 ≥15, PSQI >5), 60% had insomnia, 58% reported RBD, 50% had EDS, and 36% reported RLS. Depressive symptoms were reported by 70% patients. PD patients with and without poor sleep quality were comparable with regards to demographic and clinical variables, except for depressive symptoms (P < 0.001). Depressive symptoms showed a significant association with EDS (P = 0.008), RBD (P < 0.001), and insomnia (P = 0.001). Conclusion: Prevalence of sleep disorders increased in PD patients during the COVID-19 pandemic. Prevalence of EDS, RBD, and RLS in PD patients was higher compared to that reported in studies during the pre-COVID-19 times. Presence of depressive symptoms was a significant correlate of presence of sleep disorders in PD patients.

Sleep Disturbances and Mental Health: A Transdiagnostic View of Sleep Disorders Symptoms in a Representative Canadian Sample

Introduction: Sleep problems can actively contribute to the onset, maintenance and worsening of mental disorders. Beyond insomnia, several other sleep pathologies may be associated with adverse mental health outcomes, and having multiple sleep disorders may be an aggravating factor. This study aimed to delineate the current landscape of sleep difficulties and symptoms of sleep disorders linked to poor mental health, investigate associations between the age at onset of sleep problems and subsequent mental health, and assess the perceived impacts of sleep problems. Materials and Methods: A representative sample of 1,200 Canadians (16 to 88 years old, 53% females) completed an online survey on sleep and mental health between 21 and 24 September 2021 (i.e. after the acute phase of the COVID-19 pandemic in Canada). The survey included questions inspired form the Sleep Disorders Questionnaire, Sleep Disorders Symptom Checklist-25, Pittsburgh Sleep Quality Index, STOP-Bang, and Insomnia Severity Index. The sample was stratified in two groups based on self-reported current mental disorder diagnosis: mental disorder diagnoses [219 (18.2%)] vs no diagnosis [960 (80.0%)]. Total scores on the General Anxiety Disorder-7 and Patient Health Questionnaire were used to determine anxiety and depression symptoms severity. Results: Of those with mental disorder diagnoses, 80.4% (176/219) endorsed symptoms of at least one sleep disorder, a proportion significantly higher compared to the 42.7% observed in the rest of the sample (p<.001, V=.29). The mental disorder diagnoses group included higher proportions of respondents endorsing symptoms of insomnia disorder, sleep apnea, bruxism, restless legs syndrome, nightmare disorder, hypersomnia and somnambulism. After adjusting for age, sex, income level and total sleep time, having a mental disorder diagnosis was associated with: insomnia (OR=3.52, p<.001), obstructive sleep apnea (OR=1.95, p=.006) and bruxism (OR=2.77, p<.001). Half of those with mental disorders diagnoses endorsed symptoms of multiple sleep disorders, a proportion significantly higher than what was observed in the rest of the sample (p<.001, V=.35). Endorsing symptoms of insomnia, sleep apnea, bruxism, restless legs syndrome, and hypersomnia were associated with more severe anxiety and depression symptoms after adjusting for age, sex, income level, total sleep time, and mental disorders diagnoses (B>.98, p<.012). Younger age at onset of sleep problems was a significant independent predictor for current self-reported diagnosis of mental disorders (OR=.96, p<.001). Compared to the rest of the sample, the mental disorder group reported significantly worse impacts of sleep problems on mental health, family relationships, physical health, cognitive functioning, productivity level, and global daily functioning. Conclusions: These results reinforce the transdiagnostic nature and cumulative impacts of the various profiles of sleep problems associated with mental health issues. These findings also suggest that the relationship between sleep and mental health is not solely driven by short sleep duration or insomnia. There is a need to enhance awareness about the diverse profiles of sleep issues linked to poor mental health and the relevance of early intervention, notably during youth. Should future longitudinal studies based on objective measures confirm these observations, this may inform further development of transdiagnostic sleep interventions for people with mental disorders.

A finger in every pie - The versatility of chemokines.

In this issue of Biomedical Journal we encounter the chemokine superfamily and its clinical potential. The time course from 56 days zero COVID-19 to a resurgence in cases is presented, as well as a possible solution to overcome rejection in vascularized composite allotransplantation. We are shown the opportunity deep learning (DL) offers in the case of tracking single cells and particles, and also use of DL to bring all hands on deck to counter the current challenge of the COVID-19 pandemic. This issue contains articles about the effect of low energy shock waves in cystitis; the negative effect of high fructose on aortic valve stenosis; a study about the outcome of fecal microbiota transplantation in case of refractory Clostridioides difficile infection; a novel long non-coding RNA that could serve in treating triple-negative breast cancer; the benefits of acupressure in patients with restless leg syndrome; and Filamin A mutations in abnormal neuronal migration development. Finally, a link between jaw surgery and the psychological impact on the patient is explored; a method presented that allows identification of cervical characteristics associated with difficult embryo transfer; and a letter suggesting new parameters to evaluate the use of bone-substitute augmentation in the treatment of osteoporotic intertrochanteric fractures.

Daily concordance between ecological stressors and sleep in young minority children during the pre-COVID-19 outbreak period.

Objective: As the COVID-19 pandemic brings widespread changes in families, the sociology of sleep becomes noticeable. Yet, the socio-contextual determinants of a biopsychosocial phenomenon as sleep are poorly investigated. We examine changes concomitantly occurring in the child's sleep per familial and community stressors. Methods: During the pre-COVID-19 outbreak period, in 24 minority children (5.4 ± 1.7 years old, 54.2% girls), sleep was objectively measured 24 h for two consecutive weeks, and this was repeated three times over the study period of three months. The caregiver filled out questionnaires surveying sociodemographic, community and family aspects. Results: Children went to bed at 22:26 and woke up at 07:04, with each a variability of about 50 min. Money and time were revealed as related key stressors to sleep. Five dimensions best fitted their association. In general, concurrent changes within the individual child indicate that mean sleep variables seem to relate to predominantly features of the stressors (explained variance of 34.7 to 56.7%), while variability of sleep tends to associate to situational aspects of the stressors (explained variance of 30.4 to 61.8%). Associations were best explained in terms of the 24 h dimension, particularly exposing sleep variability. Conclusion: Individual variabilities in a child's sleep are associated with familial resources, such as caregiver's time to self, money and basic needs. Time spent in bed, a modifiable factor by society and shaper of sleep quantity and quality, plays a key role in stressor-sleep associations. Insights from biopsychosocial perspectives may be valuable for understanding COVID-19 sleep studies, and the development of (post-) COVID-19 sleep recommendations.

Restless legs syndrome is associated with long-COVID in women.

STUDY OBJECTIVES: Sleep disturbance is common in long-COVID (LC). Restless legs syndrome (RLS) is characterized by sleep disturbance and has been reported after viral infections. Therefore, we evaluated RLS symptoms cross-sectionally in individuals with LC at both current and pre-coronavirus disease 2019 (pre-COVID-19) time points. METHODS: Adults on LC-focused Facebook pages were recruited for an online assessment of symptoms before COVID-19 infection and during their present LC state in a cross-sectional manner. The LC group documented baseline symptoms retrospectively. Questions were included about the presence/severity of RLS symptoms and assessments of fatigue, quality of life, and sleep apnea. A control group was recruited and included individuals ≥ 18 years of age who never had overt symptoms of COVID-19. Pregnancy was an exclusion criterion for both groups. RESULTS: There were 136 participants with LC (89.7% females, age 46.9 ± 12.9 years) and 136 controls (65.4% females, age 49.2 ± 15.5). RLS prevalence in females with LC was 5.7% pre-COVID-19 and 14.8% post-COVID-19 (P < .01) vs 6.7% in control females. Severity of RLS was moderate in both groups. Logistic regression predicting post-COVID-19 RLS among females with LC failed to find significant effects of hospitalization, sleep apnea, neuropathic pain severity, or use of antihistamines and antidepressants. CONCLUSIONS: The baseline prevalence of RLS in females with LC was similar to the general population group as well as to patients in epidemiological studies. The prevalence significantly increased in the LC state. Postinfectious immunological mechanisms may be at play in the production for RLS symptoms. CITATION: Weinstock LB, Brook JB, Walters AS, Goris A, Afrin LB, Molderings GJ. Restless legs syndrome is associated with long-COVID in women. J Clin Sleep Med. 2022;18(5):1413-1418.

COVID-19 and restless leg syndrome

The deadly COVID-19 pandemic has affected more than 200 million people and has killed more than 4 million people worldwide. A number of neurological manifestations of COVID-19 infection have been described, though sleep related problems are less reported. We describe a case of restless leg syndrome related to COVID-19 infection, which improved after treatment with dopaminergic therapy. We discuss the possible pathophysiological mechanisms underlying sleep disturbances and RLS in a patient with COVID-19. The sleep related problems could be another important manifestation of the deadly virus and need to be actively looked for.

A case of restless legs syndrome after BNT162b2 mRNA COVID-19 vaccination.

Restless legs syndrome (RLS) can be secondary to several disorders. We present an 87-year-old woman who developed RLS 2 days after the first injection of BNT162b2 mRNA coronavirus disease 2019 vaccine. The symptoms of RLS tended to improve and eventually resolved with the administration of gabapentin.

A case report of restless leg syndrome worsened after COVID-19 vaccine

Case Report Restless legs syndrome (RLS) is a poorly understood underdiagnosed neurological, sensorimotor disorder. RLS arises from central nervous system dysfunction leading to both sensory and motor symptoms. Limited cases of COVID-19 vaccines related neurological sequelae, such as Guillain-Barré syndrome (GBS), have been reported. Case presentation A 77-year-old male patient with a past medical history of well-controlled hypertension, diabetes mellitus, hypothyroidism, coronary artery disease status post percutaneous coronary intervention, obstructive sleep apnea on CPAP at night, and restless leg syndrome diagnosed 20 years ago, presented complaining of a 3-month history of worsening of his restless leg symptoms although being compliant with his medications 2 weeks after his 2nd dose of Moderna vaccine. He stated that the frequency and severity of his symptoms had increased from 3-4 times a week lasting for minutes to a daily basis lasting for hours at night, had improved partially with exercise, and affected his sleep hygiene and daily morning activities. He requested several refills of his previously prescribed ropinirole. A comprehensive evaluation, including clinical examination, laboratory workup, brain computed tomography, and polysomnography was unremarkable. He was commenced on pramipexole 0.5 mg daily and instructed to follow up in the clinic in 3 months and call back with no improvement or worsening of his symptoms. Conclusion This case fulfilled the four essential features of RLS, urge to move, worsening with rest, improvement with exercise, and worsening in the evening. To date, no case of RLS associated with COVID-19 vaccines has been previously reported. Although COVID-19 vaccines are relatively safe, long-term complications should be monitored closely.

Case report of restless anal syndrome as restless legs syndrome variant after COVID-19.

BACKGROUND: Coronavirus disease 2019 (COVID-19) has a broad spectrum from respiratory and nasopharyngeal symptoms, cerebrovascular diseases, impaired consciousness, and skeletal muscle injury. Emerging evidence has indicated the neural spread of this novel coronavirus. Restless legs syndrome (RLS) is a common neurological, sensorimotor disorder, but highly under diagnosis disorder. Restless anal syndrome as restless legs syndrome variant associated with COVID-19 has been previously not published. We report a case presenting with restless anal syndrome following COVID-19. CASE PRESENTATION: Although a 77-year-old male with COVID-19 improved to normal respiratory function 21 days after admission and treatment of favipiravir 200 mg per day for 14 days and dexamethasone 6.6 mg per day for 5 days, the insomnia and anxiety symptoms remained. Several weeks after discharge, he gradually began to experience restless, deep anal discomfort, approximately 10 cm from the perineal region. The following features were observed in the anal region; urge to move is essential, with worsening with rest, improvement with exercise, and worsening at evening. Colonoscopy revealed internal haemorrhoids without other rectal lesions. Neurological findings including deep tendon reflex, perineum loss of sensory and spinal cord injury, revealed no abnormalities. Diabetes militias, kidney dysfunction and iron deficiency status were not confirmed. Family history of RLS and periodic limb movements were not observed. Clonazepam at 1.5 mg per day resulted in the alleviation restless anal discomfort. CONCLUSIONS: We reported a case presenting with restless anal syndrome following affection of COVID-19 as restless legs syndrome variant. This case fulfilled 4 essential features of RLS, urge to move, worsening with rest, improvement with exercise, and worsening at evening. To date, no case of restless anal syndrome associated with COVID-19 has been previously published. This case report may reflect the associative impacts of COVID-19 on the neuropsychiatric state. The long-term outcomes of neuropsychiatric conditions should continue to be monitored.

New-onset restless leg syndrome in a COVID-19 patient: a case report with literature review.

Restless leg syndrome (RLS) is a sleep disorder characterized by the sudden urge to move the lower limbs during periods of rest accompanied by an unpleasant sensation like tingling or burning in the legs. Often, this urge is partially relieved by the movement of legs. However, it causes disturbance of sleep leading to daytime fatigue. Herein, we present an unusual case of new-onset of restless leg syndrome in a COVID-19 infected patient who presented three weeks after an uncomplicated delivery via caesarean section. The patient was managed with sleep hygiene measures, oral iron and vitamin C tablets apart from general COVID-19 management medications, subsequently leading to significant improvements. Here we have discussed possible associated factors, pathophysiological mechanisms and management of RLS in the case of COVID infected individuals.

Current Update on Clinically Relevant Sleep Issues in Parkinson's Disease: A Narrative Review.

Sleep disturbances are among the common nonmotor symptoms in patients with Parkinson's disease (PD). Sleep can be disrupted by nocturnal motor and nonmotor symptoms and other comorbid sleep disorders. Rapid eye movement sleep behavior disorder (RBD) causes sleep-related injury, has important clinical implications as a harbinger of PD and predicts a progressive clinical phenotype. Restless legs syndrome (RLS) and its related symptoms can impair sleep initiation. Excessive daytime sleepiness (EDS) is a refractory problem affecting patients' daytime activities. In particular, during the COVID-19 era, special attention should be paid to monitoring sleep problems, as infection-prevention procedures for COVID-19 can affect patients' motor symptoms, psychiatric symptoms and sleep. Therefore, screening for and managing sleep problems is important in clinical practice, and the maintenance of good sleep conditions may improve the quality of life of PD patients. This narrative review focused on the literature published in the past 10 years, providing a current update of various sleep disturbances in PD patients and their management, including RBD, RLS, EDS, sleep apnea and circadian abnormalities.

Feasibility and efficacy of a physical activity intervention for managing restless legs syndrome in multiple sclerosis: Results of a pilot randomized controlled trial.

BACKGROUND: This pilot randomized controlled trial examined the feasibility and efficacy of a physical activity behavior change intervention for improving restless legs syndrome (RLS) severity and secondary sleep outcomes among a sample of adults with multiple sclerosis (MS). METHODS: Participants with MS(N=15) were randomly assigned into intervention(n=8) or waitlist control(n=7) conditions. The physical activity intervention was delivered over a 16-week period and outcomes were assessed at baseline and immediately following the 16-week period in both conditions. RESULTS: There was a significant, positive effect of the intervention on overall RLS severity (p=.01;ηρ2=.43), severity during the night(p=.03,ηρ2=.35), severity during the day while resting(p=.01,ηρ2=.44), and severity during the day while active(p<.01,ηρ2=.61), and non-significant improvements in RLS severity while falling asleep (p=.33,ηρ2=.09). There were significant positive effects on sleep satisfaction(p<.01,ηρ2=.49) and non-significant improvements in self-reported global sleep quality(p=.35,ηρ2=.08). There was a significant intervention effect on self-reported time in bed(p=.03,ηρ2=.37) and total sleep time(p=.03,ηρ2=.36), and non-significant improvements in self-reported sleep latency (p=.08,ηρ2=.25), sleep efficiency(p=.27,ηρ2=.11), and daytime sleepiness (p=.52,ηρ2=.04;p=.35,ηρ2=.08;p=.51,ηρ2=.04). There was no significant effect of the intervention on device-measured sleep quality. CONCLUSIONS: We provide preliminary evidence for the feasibility and efficacy of a physical activity intervention for reducing RLS severity and potentially improving self-reported sleep outcomes in adults with MS. CLINICALTRIALS. GOV IDENTIFICATION NUMBER: NCT04061681.