Restless legs syndrome and cardiovascular disease and kidney disease

Restless legs syndrome (RLS) is a chronic neurological condition that causes discomfort in the legs in the evening before sleep. Studies have linked RLS with certain cardiovascular diseases such as high blood pressure. This article is about a study that examined RLS in veterans. Specifically, the researchers studied the relationship between RLS and stroke, heart disease, kidney disease, and mortality rate. The researchers compared about 3700 veterans with and without RLS. Results showed higher amounts of stroke, coronary heart disease, chronic kidney disease, and mortality in those that had RLS compared to those that did not.

The results are not surprising. And as the article points out, the findings don't show that RLS causes strokes, heart disease, or kidney disease. One issue is whether the RLS in these veterans was primary, or secondary to another disorder, such as obstructive sleep apnea (OSA). OSA can significantly worsen RLS, meaning that it may be the OSA that is increasing the incidence of cardiovascular or kidney disease - not necessarily the RLS. Also, RLS is known to be common in patients with chronic kidney disease, especially those on dialysis. More studies are needed to tease out the relationship between RLS and these other disorders.

Restless legs syndrome and parkinson disease

I was taught that Restless legs syndrome (RLS) is not related to Parkinson Disease (PD), even though they can be treated with similar medications. However, here is a study that shows a potential relationship between RLS and PD. Researchers studied almost 23,000 men with self-reported RLS and documented PD. The results showed that RLS symptoms were associated with higher risk of developing PD during the first 4 years of follow up. This relationship was only statistically significant in the men with severe RLS symptoms, occurring 15 or more times per month.

The researchers speculate that RLS may be an early feature of PD, and be a distinct entity from RLS that is not associated with PD.

Restless legs syndrome and mortality rate

This study is getting alot of press, so thought I would post it. It is about restless legs syndrome (RLS). RLS is a neurological sleep disorder that causes uncomfortable sensations in the legs at night. It makes you want to move your legs to relieve the sensation. This study showed that men with RLS have a higher chance of dying than those without RLS. I don't have access to the full study in the Neurology Journal, so some details can not be provided. It's not clear how RLS increases mortality rate. However, RLS is often present along with obstructive sleep apnea (OSA), and OSA is known to increase mortality rate. The study authors asked patients if they have OSA, but most won't know if they have OSA unless they have a sleep study. So many of these men could have had undiagnosed OSA and RLS - but the OSA would be the factor in the increased mortality rate, not the RLS.

Restless legs syndrome linked to erectile dysfunction

Restless legs syndrome (RLS) is a neurological sleep disorder characterized by an overwhelming urge to move the legs at night. This study showed a link between RLS and erectile dysfunction (ED). Men with RLS had a 38% increased risk of ED compared with men without RLS, after adjusting for age, smoking status, and other potential confounders. What's not known, is if the men had obstructive sleep apnea (OSA). RLS is often seen in OSA. The OSA could have attributed to the ED, not the RLS.

Yoga may improve restless legs syndrome

This article demonstrates in a small group of women with restless legs syndrome (RLS) improved with regular yoga. There is no control group, so it's not clear that the yoga itself improved their RLS. In many patients, RLS symptoms wax and wane, so some of the improvement may be regression toward the mean - the RLS may have gotten better with time alone, and the yoga may not have anything to do with it. Also, exercise has been shown to help RLS - not just yoga.

Periodic limb movements in sleep, heart abnormalities, and hemodialysis

Periodic limb movements in sleep (PLMS) are repetitive, small leg jerks that occur during sleep, usually without any memory of it happening. However, PLMS can fragment sleep and have been linked to increased cardiovascular risk factors. Restless legs syndrome (RLS) is linked to PLMS - most RLS patients have PLMS. RLS and PLMS are common in hemodialysis patients. And hemodialysis itself is linked to cardiovascular disease. This study sought to determine if patients with RLS and PLMS on hemodialysis had a deterioration in heart structure and function compared to those RLS patients without PLMS.

Researchers used a cutoff value for the PLMS that puts them in the moderate to severe amount - this is most likely to be clinically significant. Results showed that resting heart rate and blood pressure (BP) were similar in those with and without PLMS. The minimum systolic BP (referring to the 120 in "120 over 80" for example) was higher in the PLMS group. Also, the percent reduction of BP during sleep, compared to being awake, was 50% smaller in the PLMS group. This means that those with PLMS did not experience as much a dip in BP during sleep - something that could lead to high blood pressure in the daytime. The mass of the left side of the heart was greater in PLMS group, but both groups had hearts that could pump out the same amount of blood per beat.

The authors concluded that PLMS can alter the structure of the heart, but not necessarily its function. They feel that PLMS do this by raising blood pressure during sleep. The heart gets larger when it has to pump against a higher blood pressure, which can lead to the results obtained in this study. Of note, the RLS itself was not associated with the heart structure changes.

What does this mean? It means that patients with RLS on hemodialysis may need to be studied for PLMS. More studies will be needed though to find out if treating PLMS improves results.

Non-drug treatment of restless legs syndrome

Restless legs syndrome (RLS) is an uncomfortable sensation in the legs that occurs at rest, more often in the evening, and is relieved temporarily with movement. We don't know what causes RLS, but researchers think it may have something to do with dopamine dysregulation. RLS is often treated with prescription medications. However, sometimes non-medicine treatments can help. This article reviews some of the evidence supporting those non-drug treatments.

Regular exercise has been shown to relieve RLS. Proposed mechanism is an increase in circulation, release of endorphins, and increase in dopamine. More recently, pneumatic compression stockings have shown to be helpful. These are air filled wraps worn around the legs - they repetitively fill and empty the air resulting in a massaging action and can improve circulation. If you don't have a pair of pneumatic compression stockings laying around, regular massage has been shown to be helpful, perhaps by increasing circulation, a counter stimulation action, or generation dopamine. Near-infrared light has been shown to be helpful, possibly by increasing circulation. Acupuncture has not been shown to be effective for RLS when compared to no treatment. Certain vitamins and minerals have been shown to be helpful - vitamin E, vitamin B12, multivitamins with vitamin C, glucosamine, zinc, folic acid, vitamin D, and magnesium made the list.

RLS has been associated with low iron, and sometimes I use iron therapy to help with the symptoms. This often takes months of daily iron intake to increase the levels. I don't recommend people taking iron though unless the level is low, as too much iron is not healthy.

Restless legs syndrome and heart disease

This link discusses research showing a potential link between restless legs syndrome (RLS) and heart disease. This was based on an observational study in thousands of women. The results showed that heart disease was twice as likely in those with RLS than in those without. This does not mean that RLS causes heart disease, only that the two conditions are related somehow. It could be that some of these women also have other conditions, like obstructive sleep apnea, that increases risk of heart disease.

Nighttime eating and restless legs syndrome

Over the past few years, nighttime eating has been studied more. We are only beginning to understand this problem. It's been in the news some since there have been cases of patients eating in their sleep while taking certain sleep aids. There is a good article in the August edition of the Journal of Clinical Sleep Medicine that reviews nighttime eating and its association to restless legs syndrome RLS).

In summary, the study authors explain that nighttime eating is common among RLS patients. In some cases, sleep aids contributed to the nighttime eating. Medications used to treat RLS may improve the nighttime eating as well. Finally, in patients with insomnia but without RLS typically do not have nighttime eating while taking sleep aids. Therefore, the authors concluded that there is something about RLS that triggers the nighttime eating in patients taking sleep aids.

Restless legs syndrome and soap

I saw this article titled "Can a bar of soap cure your nighttime leg cramps?" and wanted to comment. I think the author is confusing two separate disorders - restless legs syndrome and nocturnal leg cramps. They say that a bar of soap under the mattress may improve restless legs syndrome, but the title implies nocturnal leg cramps. The confusing part is that both conditions may respond to magnesium, which purportedly is given off by soap - I don't know if that is true. But it seems that if magnesium was given off by soap, how would putting it under your mattress help? Also, they mentioned lavender soap may help, as the lavender can help sleep. Maybe, but why not just use lavender aromatherapy? If you have leg cramps or restless legs, see your doctor first.

Restless Legs Syndrome Gene Found in Flies

Here is an article about a possible Restless legs syndrome gene found in fruit flies.

Restless Legs Syndrome Symptom Descriptions

Restless legs syndrome (RLS) symptoms are often difficult for patients to describe to me. The condition is not usually painful, but is uncomfortable and undesired. Here is an article about a study done that attempted to come up with the most appropriate words to describe RLS symptoms.

Restless Legs Syndrome and Erectile Dysfunction

A poster was presented at the annual Sleep meeting in Minneapolis involving research about restless legs syndrome (RLS) and erectile dysfunction (ED). Researchers studied 11,000 men with an average age of 64 years old and without ED, diabetes, or arthritis. The results showed that men with RLS were about 50% more likely to develop ED, even after controlling for age, weight, smoking status, antidepressant use, and other chronic diseases. Also, the more frequently the men experienced RLS symptoms, the more likely they were to develop ED. Researchers do not know why RLS and ED are linked, but some theorize that low dopamine levels could be involved. It is believed that low dopamine can contribute to RLS. It would be interesting to study whether medications that improve RLS that affect the brain's dopamine system can also improve ED.

Restless Legs Syndrome, Heat Damage and Heart Attack

Data was presented at a study at the American College of Cardiology about Restless Legs Syndrome (RLS) and cardiovascular health. RLS affects an estimated 12 million Americans. Researchers measured leg movements in patients with RLS during an overnight sleep study and then assessed their heart health. They divided the patients into two groups - those whose legs twitched more or less than 35 times per hour. Patients whose legs twitched more than 35 times per hour were more likely to have thickened heart muscle. In the three years of follow up, those with the most leg twitches and thickest heart walls were more than twice as likely to have suffered a heart attack or died. It's not clear if treating the RLS lowers cardiovascular risk. The study authors suggest that patients with restless legs symptoms consult with their doctor about monitoring their heart health.