title: Restless legs syndrome, insomnia and quality of life in patients on maintenance dialysis.
abstract: BACKGROUND
  In a cross-sectional study, we analysed the complex relationship between restless legs syndrome (RLS), insomnia and specific insomnia symptoms and health-related quality of life (QoL) in patients on maintenance dialysis.
  
  
  METHODS
  Data were obtained from 333 patients on chronic maintenance dialysis. To assess the prevalence of RLS, we used the RLS Questionnaire (RLSQ). The Athens Insomnia Scale (AIS) was used to assess insomnia and QoL was measured with the Kidney Disease Quality-of-Life Questionnaire.
  
  
  RESULTS
  The prevalence of RLS was 14%. The number of comorbid conditions was significantly higher in patients with vs without RLS (median: three vs two; P<0.05). RLS patients were twice as likely to have significant insomnia as patients without RLS (35% vs 16%; P<0.05). Furthermore, RLS was associated with impaired overall sleep quality (median AIS score: 8 vs 4; P<0.01) and poorer QoL. RLS was a significant and independent predictor of several of the QoL domains after statistical adjustment for clinical and socio-demographic covariables. Importantly, this association remained significant even after adjusting for sleep quality.
  
  
  CONCLUSIONS
  RLS is associated with poor sleep, increased odds for insomnia and impaired QoL in patients on maintenance dialysis. Based on the present results, we suggest that both sleep-related and sleep-independent factors may confer the effect of RLS on QoL.
authors.affiliation: Institute of Behavioral Sciences, Semmelweis University, Budapest, Hungary.
authors.forename: Istvan
authors.initials: I
authors.lastname: Mucsi
authors.forename: Miklos Zsolt
authors.initials: MZ
authors.lastname: Molnar
authors.forename: Csaba
authors.initials: C
authors.lastname: Ambrus
authors.forename: Lilla
authors.initials: L
authors.lastname: Szeifert
authors.forename: Agnes Zsofia
authors.initials: AZ
authors.lastname: Kovacs
authors.forename: Rezso
authors.initials: R
authors.lastname: Zoller
authors.forename: Szabolcs
authors.initials: S
authors.lastname: Barótfi
authors.forename: Adam
authors.initials: A
authors.lastname: Remport
authors.forename: Marta
authors.initials: M
authors.lastname: Novak
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000523:psychology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011788:Quality of Life / Q000523:psychology; D006435:Renal Dialysis; D012148:Restless Legs Syndrome / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology; D007319:Sleep Initiation and Maintenance Disorders / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology