Outcome of restless legs severity after continuous positive air pressure (CPAP) treatment in patients affected by the association of RLS and obstructive sleep apneas.
OBJECTIVE
The association of obstructive sleep apnea syndrome (OSAS) and restless legs syndrome (RLS) has been reported in the literature for many years. Nevertheless, this pathological association has not yet been extensively studied and many questions remain unanswered. The primary concern of this study is to evaluate the influence of nasal continuous positive airway pressure (n-CPAP) therapy on daytime sleepiness and fatigue as well as the presence of a possible long-term beneficial effect on RLS severity and, secondarily, to ascertain the clinical, neurophysiological and polysomnographic characteristics of a group of patients with both OSAS and RLS.


METHODS
All patients had a diagnostic polysomnography (PSG) and a second polysomnography for titration of n-CPAP. Laboratory tests (blood glucose, serum ferritin), body mass index (BMI) calculation and a neurophysiological evaluation (auditory P300 and electroneuromyography) were done. The Epworth Sleepiness Scale (ESS) and the Pichot's questionnaire of fatigue/depression (PIC) were applied to all patients before and after three months of n-CPAP treatment. The International Restless Legs Syndrome Study Group rating scale (IRLS) was applied before and after n-CPAP. Results were compared.


RESULTS
The ESS scores decreased from 10.64+/-4.83 at baseline to 7.41+/-3.5 (P<0.05). PIC scores decreased from 16.65+/-7.27 to 10.12+/-6.40 (P<0.01). IRLS scores decreased from 17.60+/-7.11 before to 12.52+/-9.25 after n-CPAP (P<0.05).


CONCLUSIONS
Our findings suggest that not only fatigue and sleepiness but also the severity of RLS show a favorable response to n-CPAP in the group of patients with OSAS and RLS.
Sleep Disorders Center, Hospital Universitário de Brasília, University of Brasilia, Brasilia, DF, Brazil. reno@unb.br
Raimundo Nonato
RN
Delgado Rodrigues
Aída Alexandra
AA
Alvim de Abreu E Silva Rodrigues
Riccardo
R
Pratesi
Jean
J
Krieger
D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D045422:Continuous Positive Airway Pressure / Q000379:methods*; D006970:Disorders of Excessive Somnolence / Q000175:diagnosis / Q000453:epidemiology; D005221:Fatigue / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D005293:Ferritins / Q000097:blood; D006801:Humans; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D012148:Restless Legs Syndrome / Q000097:blood / Q000453:epidemiology* / Q000628:therapy*; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000097:blood / Q000453:epidemiology* / Q000628:therapy*; D012895:Sleep, REM / Q000502:physiology; D011795:Surveys and Questionnaires; D013972:Thyrotropin / Q000097:blood; D014168:Transferrin / Q000378:metabolism; D016896:Treatment Outcome
D001786:Blood Glucose; D014168:Transferrin; D013972:Thyrotropin; D005293:Ferritins