title: Restless-legs syndrome and insomnia in hemodialysis patients.
abstract: OBJECTIVE
  Restless legs syndrome (RLS) is a common neurological movement disorder which is commonly seen in hemodialysis (HD) patients. Insomnia, depression, and anxiety disorders frequently show concurrence. In this study, we aimed to investigate RLS and insomnia prevalence and related factors in HD patients.
  
  
  METHODS
  Patients who were under HD treatment and healthy controls with similar mean age, sex ratio, and hypertension and diabetes mellitus frequency were included in this study. Depression, insomnia, and daytime sleepiness assessments were performed by using Beck Depression Inventory, Insomnia Severity Index, and Epworth Sleepiness Scale. The diagnosis of RLS was made using the International RLS Study Group consensus criteria.
  
  
  RESULTS
  About 156 HD patients and 35 controls were enrolled. The mean age was 50.6 in the HD group and 49.7 in the control group. Female sex was 43.9% in the HD group and 57.1% in the control group. RLS was significantly more frequent in HD patients compared with controls. The rate of sub-threshold insomnia and insomnia with moderate severity was higher in HD patients. While insomnia severity score and diabetes mellitus were significantly associated with the presence of RLS, depression, RLS, older age, and being under HD treatment were independently associated with insomnia severity.
  
  
  CONCLUSIONS
  HD patients commonly have RLS and insomnia. Insomnia and diabetes mellitus seem to be major factors underlying RLS in HD patients. Furthermore, depression and RLS seem to be closely related to insomnia in these patients. Treatment of depression, insomnia, and RLS may be beneficial to improve quality of life in HD patients.
authors.affiliation: a Department of Neurology , Sevket Yilmaz Training and Research Hospital , Bursa , Turkey .
authors.forename: Demet
authors.initials: D
authors.lastname: Yildiz
authors.affiliation: b Department of Nephrology , Sevket Yilmaz Training and Research Hospital , Bursa , Turkey .
authors.forename: Serdar
authors.initials: S
authors.lastname: Kahvecioğlu
authors.affiliation: a Department of Neurology , Sevket Yilmaz Training and Research Hospital , Bursa , Turkey .
authors.forename: Nilufer
authors.initials: N
authors.lastname: Buyukkoyuncu
authors.affiliation: a Department of Neurology , Sevket Yilmaz Training and Research Hospital , Bursa , Turkey .
authors.forename: Ahmat Kasım
authors.initials: AK
authors.lastname: Kilic
authors.affiliation: c Department of Nephrology , Uludag University Medical School , Bursa , Turkey .
authors.forename: Abdulmecit
authors.initials: A
authors.lastname: Yildiz
authors.affiliation: b Department of Nephrology , Sevket Yilmaz Training and Research Hospital , Bursa , Turkey .
authors.forename: Cuma Bulent
authors.initials: CB
authors.lastname: Gul
authors.affiliation: d Department of Neurology , Inegol State Hospital , Bursa , Turkey , and.
authors.forename: Meral
authors.initials: M
authors.lastname: Seferoglu
authors.affiliation: e Department of Geriatrics , Istanbul School of Medicine, Istanbul University , Istanbul , Turkey.
authors.forename: Fatih
authors.initials: F
authors.lastname: Tufan
mesh_terms: D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D006435:Renal Dialysis / Q000009:adverse effects*; D012148:Restless Legs Syndrome / Q000453:epidemiology / Q000209:etiology*; D007319:Sleep Initiation and Maintenance Disorders / Q000453:epidemiology / Q000209:etiology*
keywords: Anxiety; depression; hemodialysis; insomnia; restless legs syndrome