Restless Legs Syndrome masquerades as chronic insomnia

• Published in: Sleep medicine 2020-11, Vol.75, p.106-111
• Main Authors: Bonakis, Anastasios, Androutsou, Anastasia, Koloutsou, Maria-Evangelia, Vagiakis, Emmanouil
• Format: Article
• Language: English
• Subjects: Chronic insomnia; Restless legs syndrome
• ISSN: 1389-9457; 1878-5506
• DOI: 10.1016/j.sleep.2020.06.003

The objective of this study is to emphasize the importance of the clinical suspicion of Restless Legs Syndrome (RLS) among patients with chronic insomnia. We conducted a retrospective study referring to the period 2009–2018. All patients presenting with the complaint of insomnia and fulfilling the criteria of Chronic Insomnia (C.I.) were enrolled. In this group we estimated how many patients finally had the diagnosis of RLS. Demographic and clinical characteristics (sleep related problems, fatigue, daytime sleepiness and psychological profile) were recorded and analyzed between C.I. and RLS patients using logistic regression models. A total of 532 patients presented with C.I. Among them 83 proved to have RLS. No differences in frequencies or odds were observed concerning the type of insomnia, daily fatigue, daytime sleepiness and depression. RLS is more frequent in women (p = 0.01) and in older patients (p = 0.05) who present with the picture of C.I. Anxiety levels are higher in the RLS group (p = 0.004). RLS and C.I. patients demonstrate a very similar profile which complicates the differential diagnosis. Physicians and especially psychiatrists who deal with insomnia must have increased clinical suspicion for RLS as RLS and insomnia have a totally different therapeutic approach. •Patients with insomnia may neglect the urge to move their limbs that accompanies RLS.•Anxiety levels are really increased in patients with insomnia due to RLS compared to those with pure Chronic Insomnia.•Anxiety and depression frequently comorbid with RLS.•Elderly women presenting with chronic insomnia should be screened for RLS.