Daytime sleepiness in patients with untreated restless legs syndrome

• Published in: Somnologie : Schlafforschung und Schlafmedizin = Somnology : sleep research and sleep medicine 2024-06, Vol.28 (2), p.149-155
• Main Authors: Eich, Anna-Lena, Ottersbach, Julia, Geisler, Peter, Hajak, Göran, Wetter, Thomas C, Popp, Roland F. J.
• Format: Article
• Language: English
• Subjects: Cardiology; Disease; Dopamine; Health surveys; Internal Medicine; Medicine; Medicine & Public Health; Mental health; Movement disorders; Neurology; Original Studies; Otorhinolaryngology; Pneumology/Respiratory System; Psychology; Quality of life; Questionnaires; Restless legs syndrome; Sleep disorders
• ISSN: 1432-9123; 1439-054X
• DOI: 10.1007/s11818-024-00455-6

Background Restless legs syndrome (RLS), a disorder characterized by an urge to move one’s legs during sleep or rest, leads to impaired sleep quality. Many patients with RLS report increased daytime sleepiness, but this has seldom been the focus of clinical research. The current study empirically investigated the prevalence and severity of daytime sleepiness in RLS. Methods This prospective study included 29 newly diagnosed treatment-naïve patients with RLS and 31 healthy controls and assessed standardized subjective (tiredness symptom scale [TSS], Stanford Sleepiness Scale [SSS], Epworth Sleepiness Scale [ESS]), cognitive (psychomotor vigilance task [PVT], Mackworth Clock Test [MCT]), and physiological measures (pupillary unrest index [PUI]). RLS symptom severity was assessed, and the effects of RLS on general health aspects and subjective sleep quality (Pittsburgh Sleep Quality Index) were compared to control data. Results Patients had moderate to severe RLS with significant negative effects on general health, quality of life, and sleep quality. Patients with RLS showed more subjective daytime sleepiness (ESS) and current sleepiness (TSS, SSS) than controls. The objective performance of patients in sustained attention tasks (P VT, MCT) was significantly worse than that of controls. Additionally, patients showed higher PUI scores. Conclusion In the present study, RLS was associated with markedly impaired subjective sleep quality and with subjectively and objectively increased daytime sleepiness. Since daytime sleepiness can be a major factor leading to compromised quality of life, assessing and treating sleepiness should be incorporated into standard diagnostics and treatment.