title: Restless leg syndrome, sleep quality and fatigue in multiple sclerosis patients.
abstract: We have tested the hypothesis that restless leg syndrome (RLS) is related to quality of sleep, fatigue and clinical disability in multiple sclerosis (MS). The diagnosis of RLS used the four minimum criteria defined by the International Restless Legs Syndrome Study Group. Fatigue was assessed by the Fatigue Severity Scale (FSS >27), quality of sleep by the Pittsburgh Sleep Quality Index (PSQI >6), excessive daytime sleepiness by the Epworth Sleepiness Scale (ESS >10) and clinical disability by the Expanded Disability Status Scale (EDSS). Forty-four patients (32 women) aged 14 to 64 years (43 +/- 14) with disease from 0.4 to 23 years (6.7 +/- 5.9) were evaluated. Thirty-five were classified as relapsing-remitting, 5 as primary progressive and 4 as secondary progressive. EDSS varied from 0 to 8.0 (3.6 +/- 2.0). RLS was detected in 12 cases (27%). Patients with RLS presented greater disability (P = 0.01), poorer sleep (P = 0.02) and greater levels of fatigue (P = 0.03). Impaired sleep was present in 23 (52%) and excessive daytime sleepiness in 3 cases (6.8%). Fatigue was present in 32 subjects (73%) and was associated with clinical disability (P = 0.000) and sleep quality (P = 0.002). Age, gender, disease duration, MS pattern, excessive daytime sleepiness and the presence of upper motor neuron signs were not associated with the presence of RLS. Fatigue was best explained by clinical disability and poor sleep quality. Awareness of RLS among health care professionals may contribute to improvement in MS management.
authors.affiliation: Departamento de Medicina, Universidade Federal do Ceará, Fortaleza, CE, Brasil.
authors.forename: N C V
authors.initials: NC
authors.lastname: Moreira
authors.forename: R S
authors.initials: RS
authors.lastname: Damasceno
authors.forename: C A M
authors.initials: CA
authors.lastname: Medeiros
authors.forename: P F C de
authors.initials: PF
authors.lastname: Bruin
authors.forename: C A C
authors.initials: CA
authors.lastname: Teixeira
authors.forename: W G
authors.initials: WG
authors.lastname: Horta
authors.forename: V M S de
authors.initials: VM
authors.lastname: Bruin
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D006970:Disorders of Excessive Somnolence / Q000175:diagnosis / Q000209:etiology*; D005221:Fatigue / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications*; D012148:Restless Legs Syndrome / Q000150:complications* / Q000175:diagnosis; D012720:Severity of Illness Index; D055815:Young Adult