title: Daytime symptoms of restless legs syndrome--clinical characteristics and rotigotine effectiveness.
abstract: OBJECTIVE
  To elucidate the prevalence and clinical characteristics of daytime restless legs syndrome (RLS) among patients with idiopathic RLS and investigate the effectiveness of rotigotine for daytime RLS.
  
  
  METHODS
  In 256 enrolled RLS patients, we investigated factors associated with the presence of RLS symptoms throughout the day. We also assessed the duration of daytime RLS symptoms at hourly intervals, time of initial symptom onset during the day, and associations between duration of daytime and nighttime RLS symptoms. In addition, we compared changes in duration and frequency of RLS symptoms during daytime and nighttime after randomly assigning patients to a 13-week treatment with rotigotine, a dopamine agonist patch with 24-hour action, or placebo.
  
  
  RESULTS
  Eighty-one (31.6%) patients had daytime RLS symptoms. Only the International Restless Legs Syndrome Study Group rating scale total score was significantly associated with the presence of daytime RLS symptoms (p < 0.01) on multiple logistic regression analysis. Daytime RLS symptom onset was at 6 a.m. in 44.4% of patients; symptom duration increased significantly toward nighttime. There was a significant positive association between duration of daytime and nighttime RLS symptoms (p < 0.0001) and a greater statistically significant reduction of daytime RLS symptom duration with rotigotine treatment than with placebo (p = 0.03).
  
  
  CONCLUSIONS
  Daytime symptoms are frequent in patients with RLS and may be associated with increased severity of the disorder and prolonged nighttime RLS symptoms. Rotigotine could become an important treatment choice for daytime symptoms.
authors.affiliation: Department of Somnology, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku-ku, Tokyo 160-8402, Japan; Otsuka Pharmaceutical Co., Ltd., 2-9 Tsukasamachi, Chiyoda-ku, Tokyo 101-8535, Japan.
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Takahashi
authors.affiliation: Otsuka Pharmaceutical Co., Ltd., 2-9 Tsukasamachi, Chiyoda-ku, Tokyo 101-8535, Japan.
authors.forename: Junji
authors.initials: J
authors.lastname: Ikeda
authors.affiliation: Otsuka Pharmaceutical Co., Ltd., 2-9 Tsukasamachi, Chiyoda-ku, Tokyo 101-8535, Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Tomida
authors.affiliation: Department of Neurology, Dokkyo Medical University, 880 Kitakobayashi, Shimotsuga-gun, Mibumachi, Tochigi 321-0207, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Hirata
authors.affiliation: Department of Neurology, Juntendo University Hospital, 3-1-3 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan.
authors.forename: Nobutaka
authors.initials: N
authors.lastname: Hattori
authors.affiliation: Department of Somnology, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku-ku, Tokyo 160-8402, Japan. Electronic address: inoue@somnology.com.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Inoue
mesh_terms: D000279:Administration, Cutaneous; D000328:Adult; D000368:Aged; D002940:Circadian Rhythm; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012148:Restless Legs Syndrome / Q000175:diagnosis* / Q000188:drug therapy*; D013764:Tetrahydronaphthalenes / Q000627:therapeutic use*; D013876:Thiophenes / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D013764:Tetrahydronaphthalenes; D013876:Thiophenes; C047508:rotigotine
keywords: Daytime; Dopamine agonist; Patch; Restless legs syndrome; Rotigotine