Restless legs syndrome has been gaining more attention lately, not only because of its impact on a person’s quality of life, but because of links to serious medical conditions such as heart disease, diabetes, and depression.
A study funded by the National Institutes of Health released last Wednesday in the journal Neurology followed more than 12,500 men for six years through a series of surveys and found that the impact of restless legs syndrome symptoms took a bigger toll on health than other chronic conditions and lifestyle factors such as smoking, obesity, and hypertension.
The symptoms of restless legs syndrome — estimated to affect 4 percent to 14 percent of Americans — can sound like something out of a psychothriller movie: Those with severe symptoms report feeling uncomfortable or painful sensations in their legs while sitting, as if being attacked by a colony of small ants or worms.
Because moving helps relieve pain, many with moderate to severe symptoms thrash their legs when lying in bed — both before they fall asleep and after they drift off. Many move through their days like zombies, sleep deprived and unable to perform much physical exertion.
During the six-year-long study, lead researcher Dr. Xiang Gao, a research scientist in the department of nutrition at Harvard School of Public Health, and his colleagues surveyed men diagnosed with restless legs syndrome, asking them to score their ability to perform certain physical tasks such as climbing stairs, lifting heavy objects, carrying groceries, and getting dressed. Researchers found that physical functioning scores decreased as symptoms of restless legs syndrome increased. Sleep complaints also increased in those who had more frequent symptoms.
Based on the survey scores, the researchers then determined that the decline in physical function due to restless legs syndrome was sometimes greater than the decline they observed in men without the syndrome who were obese, smoked, or had other heart risk factors.
Gao said this is the first study of its kind to link restless legs syndrome and long-term physical debilitation, and it highlights the disease’s burden on quality of life, especially as those with the condition move into their senior years. Future studies, he added, will include women, since the condition is nearly twice as prevalent in females.
“There’s something going on that’s more than a matter of simple discomfort for these folks,” said Dr. Sanford Auerbach, director of the Sleep Disorders Center at Boston Medical Center and associate professor of neurology and psychiatry at the Boston University School of Medicine. In an editorial that accompanied the study, Auerbach argued that doctors who see patients with restless legs syndrome should treat the condition as a red flag for other chronic diseases that may not be immediately evident.
“If you have restless legs syndrome, it doesn’t necessarily mean you have other medical problems, but it’s worth [your doctor] taking another look,” Auerbach said. Some may want to screen more carefully for heart disease, depression, and other conditions associated with the syndrome.
Treatments typically include dietary changes to adjust for a possible vitamin deficiency, which is more common with restless legs syndrome, lifestyle habits that worsen symptoms, and eliminating alcohol. Prescription medications such as pramipexole (Mirapex) have been approved for the condition and can provide some symptom relief, but they also have side effects, including sometimes making the symptoms worse. Pregabalin (Lyrica) has recently shown more dramatic symptom improvement in clinical trials.
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