Restless Legs Syndrome in Multiple Sclerosis: Risk Factors and Effect on Sleep Quality

 

TAKE-HOME MESSAGE

  • This study examined the prevalence and clinical implications of restless legs syndrome (RLS) in patients with multiple sclerosis (MS). The study cohort consisted of 119 healthy controls and 117 patients with MS. Most of the MS patients had relapsing–remitting MS with low EDSS scores (average, 1.5). The prevalence of RLS was 23.9% compared with 3.4% in controls (P < .001). There were no significant differences in daily fatigue between controls and MS patients with RLS. However, MS patients with RLS had higher EDSS scores, more infratentorial and spinal cord lesions, worse sleep quality, and excessive daytime sleepiness compared with MS patients without RLS. Factors associated with the development of RLS were higher EDSS score (OR, 1.69; P = .013) and infratentorial or spinal cord lesions (OR, 6.94; P = .005).

  • Fatigue can be a debilitating condition in patients with MS. Providers should be aware of the high prevalence of RLS in patients with MS and treat as necessary.
–  Kyle Binder, MD

INTRODUCTION

Previous studies suggested an association between MS and Restless Legs Syndrome (RLS). Data on the prevalence of RLS in Austrian MS patients and on the influence of disease-modifying therapies (DMT) on RLS are lacking.

OBJECTIVE

To investigate (1) the prevalence of RLS in Austria compared to control persons (CP), (2) risk factors for RLS in MS, and (3) influence of DMTs on RLS prevalence and/or severity.

METHODS

Adult MS patients and CP were screened for RLS by face-to-face interviews, including questionnaires for RLS severity, sleep quality and daytime sleepiness.

RESULTS

23.9% of MS patients (n=117) had RLS compared to 3.4% (p<0.001) of CP (n=119). The MS+RLS group (n=28) had a higher rate of sleep impairment (78.6% vs 21.3%, p<0.001) and excessive daytime sleepiness (32.1% vs 15.7%, p=0.045) compared to the MS-RLS group. Multivariate regression analysis revealed higher Expanded Disability Status Scale and spinal lesions in MRI as risk factors for RLS in MS, while DMTs had no impact on RLS.

CONCLUSION

Roughly a quarter of MS patients suffers from RLS, significantly impacting quality of life by poor sleep quality and excessive daytime sleepiness. RLS risk increases with physical disability and spinal lesions but is independent of DMT.

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