title: Restless legs syndrome as a cause of sleep disturbances in cancer patients receiving chemotherapy.
abstract: BACKGROUND
  Sleep disturbances are frequent in cancer patients during chemotherapy; the contributory role of restless legs syndrome (RLS) in this setting has never been assessed.
  
  
  OBJECTIVE
  This study investigated the role of RLS in causing sleep disturbances and altering the quality of life in cancer patients during chemotherapy.
  
  
  METHODS
  Evaluation tools included the Pittsburgh Sleep Quality Index (PSQI), the RLS questionnaires, the Functional Assessment of Cancer Therapy-General, and the Hospital Anxiety and Depression Scale for quality of life and anxiety/depression assessment. The study population was 173 cancer patients. The questionnaires were administered during the third chemotherapy cycle. Patients positive for RLS were reassessed six months after the end of chemotherapy.
  
  
  RESULTS
  In all, 58.8% of patients reported experiencing sleep disturbances (PSQI≥5) and 20% screened positive for RLS. Neither sleep disturbances nor RLS was associated with anemia, neurotoxic cytotoxic drugs, or benzamide treatment. A direct relationship was found between the PSQI and RLS (P=0.007); both PSQI and RLS scores were significantly associated with poor quality of life (P=0.008 and 0.01, respectively) and anxiety (P=0.0001 and 0.01, respectively). PSQI score also was associated with depression (P=0.0001). RLS persisted in four of the 25 RLS-positive patients reassessed at six months after chemotherapy. RLS recovery was associated with a significant reduction in sleep disturbances and improvement in quality of life.
  
  
  CONCLUSIONS
  RLS can be a contributory factor in sleep disturbances in cancer patients undergoing chemotherapy. Screening for RLS could aid in tailoring a potentially more efficacious treatment of such disturbances.
authors.affiliation: Medical Oncology, Department of Clinical and Biological Sciences, University of Torino, San Luigi Gonzaga Hospital, Orbassano, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Saini
authors.forename: Alfredo
authors.initials: A
authors.lastname: Berruti
authors.forename: Luigi
authors.initials: L
authors.lastname: Ferini-Strambi
authors.forename: Vincenza
authors.initials: V
authors.lastname: Castronovo
authors.forename: Elena
authors.initials: E
authors.lastname: Rametti
authors.forename: Piero Luigi
authors.initials: PL
authors.lastname: Giuliano
authors.forename: Barbara
authors.initials: B
authors.lastname: Ramassotto
authors.forename: Rocco Luigi
authors.initials: RL
authors.lastname: Picci
authors.forename: Manuela
authors.initials: M
authors.lastname: Negro
authors.forename: Sara
authors.initials: S
authors.lastname: Campagna
authors.forename: Pier Maria
authors.initials: PM
authors.lastname: Furlan
authors.forename: Luca
authors.initials: L
authors.lastname: Ostacoli
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001007:Anxiety / Q000175:diagnosis / Q000523:psychology; D003863:Depression / Q000175:diagnosis / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications* / Q000188:drug therapy / Q000523:psychology; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D012148:Restless Legs Syndrome / Q000175:diagnosis / Q000209:etiology* / Q000523:psychology; D012720:Severity of Illness Index; D012890:Sleep; D012893:Sleep Wake Disorders / Q000175:diagnosis / Q000209:etiology* / Q000523:psychology; D011795:Surveys and Questionnaires
chemical_list: D000970:Antineoplastic Agents
keywords: Cancer; anxiety; chemotherapy; depression; quality of life; restless legs syndrome; sleep disturbances