Sudden onset of sleep and dopaminergic therapy in patients with restless legs syndrome.
OBJECTIVE
Sudden onset of sleep (SOS) was recently reported in patients with Parkinson's disease (PD) under dopaminergic treatment. Here, we investigated as to what extent SOS is found in patients with restless legs syndrome (RLS), who are frequently treated with dopaminergic drugs, and controls.


METHODS
A questionnaire survey on SOS was administered to 156 RLS patients and 126 controls.


RESULTS
While no significant difference between RLS patients and controls was detected in Epworth sleepiness scale (ESS) scores (P=0.76), the prevalence of SOS was higher in RLS patients (32.7%) than in controls (19.8%) (P=0.02). Significant predictors of SOS in RLS were ESS score (odds ratio (OR) 16.4), male sex (OR 4.6), duration of night-time sleep (OR 3.0), and age (OR 2.9), while no association was observed for duration or severity of the disease. Patients on dopaminergic therapy usually featured a lower risk of SOS than untreated patients. Falling asleep while driving was reported by 14.6% of all RLS patients with a driver's license and associated with increased risk of accident (OR 7.1).


CONCLUSIONS
RLS patients who are untreated, male, and elderly should be assessed for the presence of SOS. In contrast to PD, dopaminergic drugs may reduce the risk of SOS in RLS. The possible benefit of the drugs should be investigated particularly in male patients.
Department of Neurology, Philipps-University, 35033 Marburg, Germany. moellerc@staff.uni-marburg.de
Jens Carsten
JC
Möller
Yvonne
Y
Körner
Werner
W
Cassel
Charlotte
C
Meindorfner
Hans-Peter
HP
Krüger
Wolfgang H
WH
Oertel
Karin
K
Stiasny-Kolster
D000063:Accidents, Traffic / Q000706:statistics & numerical data; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018491:Dopamine Agonists / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007980:Levodopa / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D012148:Restless Legs Syndrome / Q000175:diagnosis* / Q000188:drug therapy*; D012307:Risk Factors; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
D018491:Dopamine Agonists; D007980:Levodopa