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Autonomic correlates of large muscle group movements during non-REM sleep in restless legs syndrome: a comparative analysis with periodic and non-periodic leg movements.

STUDY OBJECTIVES: Large muscle group movements during sleep (LMMS) have recently been recognized as a prevalent feature in patients with restless legs syndrome (RLS), yet their autonomic profile remains insufficiently characterized. This study aimed to compare heart rate (HR) changes associated with LMMS to those accompanying short-interval (SILMS), periodic (PLMS), and isolated leg movements (ISOLMS) during non-REM sleep in RLS. METHODS: Thirty drug-free RLS patients (20 women, mean age 57.6 ± 12.73 years) underwent full-night polysomnography. For each subject, five arousal-associated events…

The association of restless leg syndrome with sleep quality, depression symptoms, and quality of life in pregnancy: A systematic review and meta-analysis.

OBJECTIVES: Restless legs syndrome (RLS) is a prevalent neurological disorder during pregnancy, contributing to maternal discomfort, sleep disturbances, depression, and reduced quality of life. However, robust evidence on how RLS relates to maternal health outcomes remains limited. This study aimed to systematically quantify the relationships between RLS and sleep quality, depression, and quality of life in pregnant women. METHODS: A systematic review and meta-analysis were conducted, including studies from PubMed, Web of Science, CINAHL, Cochrane Library, and EMBASE up to October 2025. Metho…

Exploring the role of the endogenous opiate system in the pathogenesis of anemia in an opiate receptor knock-out model of Restless Legs Syndrome.

Restless Legs Syndrome (RLS) is characterized by bothersome leg discomfort accompanied by an urge to move to obtain relief and symptoms are worse at night and on lying down. There is at least partial and temporary relief with activity. It is also an opioid responsive disorder, often accompanied by iron deficiency with or without anemia, and inflammation may be a precipitating factor in some cases. We created two in-vivo opiate receptor knock out mouse models of RLS - a triple opiate receptor knock-out mouse and a mu opiate receptor knock-out mouse. Both sets of animals were restless during the…

Assessment and prediction of restless leg syndrome (RLS) in patients with diabetes mellitus type II through artificial intelligence (AI).

This study aimed to diagnose the incidence of restless leg syndrome (RLS) in patients with diabetes mellitus (DM) type-2, thorough artificial intelligence based multilayer perceptron (MLP). 300 cases of diabetes mellitus type-2, of age between 18-80 years were included. Point-biserial correlation/Pearson Chi-Square correlations were conducted between RLS and risk factors. We trained a backpropagation MLP via. supervised learning algorithm to predict clinical outcome for RLS. Majority of the patients were having hypertension (63%) and with peripheral neuropathy (69%). Two mostly reported scaled

Depression is differently associated with sleep measurement in obstructive sleep apnea, restless leg syndrome and periodic limb movement disorder.

Depression causes sleep disturbance and is associated with various sleep-related disorders. However, how depression affects the symptomatic presentation of different sleep-related disorders is unclear. In this study, we investigated the sleep parameters of different sleep-related disorders between depressive and non-depressive patients. A total of 785 patients underwent polysomnography in a mental hospital from Jan 2012 to Jun 2013. We first analyzed variables between the depressive and non-depressive groups. The patients were then divided into four groups: obstructive sleep apnea (OSA, n = 33

A Historical Overview of the Role of Benzodiazepines including Clonazepam in the Treatment of Adult Restless Legs Syndrome and Periodic Limb Movements in Sleep.

UNLABELLED: In a recent survey of 16,694 people receiving treatment for Restless Legs Syndrome (RLS), approximately 25% were treated with benzodiazepines either singly or in combination with other RLS treatments. Because of the large number of people receiving benzodiazepines for treatment of RLS, we conducted a historical overview of the therapeutic role of benzodiazepines in RLS and its associated condition Periodic Limb Movements in Sleep (PLMS). We found 17 articles on the use of clonazepam in RLS, PLMS, or both, 3 on triazolam and PLMS, 1 on alprazolam and RLS, 1 on temazepam and PLMS, an…

The relationship between dipping-non-dipping arterial blood pressure pattern and frequency of restless leg syndrome with related factors.

ObjectiveThe lack of nocturnal decline in blood pressure (BP) is associated with an increase in cardiovascular events. Restless leg syndrome (RLS) is an uncomfortable feeling in which the patient wants to budge the legs with ache in the legs. RLS also increases the hypertension and cardiovascular risk. In this study, we aimed to evaluate the relationship between dipping and non-dipping blood pressure patterns with RLS and its severity.MethodsTwo hundred patients who had 24-hour ambulatory blood pressure monitoring (ABPM) were enrolled into this cross-sectional study. They were classified by bl

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… Legs Syndrome Study Group Validation of the International Restless Legs Syndrome Study Group rating scale for restless legs syndrome Sleep Med 2003 4 121 32 [CrossRef] 14592342 10.1016/s1389-9457(02)00258-7 6 Phillips B Young T Finn L Asher K Hening WA Purvis C Epidemiology of restless legs symptoms … legs syndrome (Willis-Ekbom Disease), hypertension, cardiovascular disease, and cerebrovascular disease J Neurol 2013 [Epub ahead of print] [CrossRef] 10.1007/s00415-013-7065-1 PMC4057632 23963470 12 Winkelman JW Shahar E Sharief I Gottlieb DJ Association of restless legs syndrome and cardiovascular …

Other clinical uses for apomorphine: Sedation and sleep disorders, withdrawal of oral dopaminergic medication, palliative care, restless legs syndrome, traumatic brain injury, sexual dysfunction.

Apomorphine is now recognised as the oldest antiparkinsonian drug on the market. Though still underused, it is increasingly prescribed for p … vidence: sedation and sleep disorders, withdrawal of oral dopaminergic medication, palliative care, restless legs syndrome, traumatic brain injury and sexual dysfunction.

The long-term effect of work schedule, shift work disorder, insomnia and restless legs syndrome on headache among nurses: A prospective longitudinal cohort study.

BACKGROUND: The preset study aimed to explore whether work schedules and sleep disorders predict the onset of headache. METHODS: A longitudinal study was conducted with questionnaire data from 2014 (baseline) and 2017 (follow-up) on work schedule, number of night shifts, number of quick returns, insomnia, shift work disorder (SWD), restless legs syndrome (RLS) and validated headache diagnoses among 1560 Norwegian nurses. Associations were explored by multivariate regression analyses. RESULTS: Work related factors at baseline did not predict onset of headache three years later. In the adjuste…

Comparison of the Effect of Reflexology and Swedish Massage on Restless Legs Syndrome and Sleep Quality in Patients Undergoing Hemodialysis: a Randomized Clinical Trial.

BACKGROUND: Patients undergoing hemodialysis experience painful complications such as restless leg syndrome and poor sleep quality, which negatively affect their quality of life. PURPOSE: This study aimed to compare the effect of reflexology and Swedish massage on restless leg syndrome and sleep quality in patients undergoing hemodialysis. METHOD: This is a randomized clinical trial conducted on 90 patients undergoing hemodialysis. The two intervention groups received either foot reflexology (n = 30) or Swedish massage (n = 30) for four weeks. In the sham group (n = 30), a simple touch of th

An Exploratory Randomized Controlled Trial of a 12-Week Yoga Versus Educational Film Program for the Management of Restless Legs Syndrome: Feasibility and Acceptability.

Objectives: The primary objectives of this pilot trial were to assess the study feasibility and acceptability of the 12-week yoga and educational film programs for the management of restless legs syndrome (RLS) in preparation for a future randomized controlled trial (RCT). Materials and Methods: This pilot, parallel-arm, randomized feasibility trial was conducted at two sites, Morgantown, WV and Columbus, OH. Yoga group participants attended 75-min Iyengar yoga classes, twice weekly for 4 weeks, then once a week for 8 weeks (16 total classes), and completed a 30-min homework routine on nonclas…

Mapping intrinsic functional brain changes and repetitive transcranial magnetic stimulation neuromodulation in idiopathic restless legs syndrome: a resting-state functional magnetic resonance imaging study.

OBJECTIVE: The objectives of this study were, first, to explore differences in brain activity between normal people and idiopathic restless legs syndrome (RLS) patients during asymptomatic periods; and, second, to determine whether administering repetitive transcranial magnetic stimulation (rTMS) to specific cortical regions would reverse any observed differences in brain activity and alleviate patient symptoms. METHODS: Fifteen idiopathic RLS patients (nine drug-naive patients) and 14 gender- and age-matched healthy controls were enrolled. Resting-state functional magnetic resonance imaging …

Uremic restless legs syndrome (RLS) and sleep quality in patients with end-stage renal disease on hemodialysis: potential role of homocysteine and parathyroid hormone.

BACKGROUND: The aetiology of uremic restless legs syndrome (RLS) remains unclear. Our research investigated whether an elevated plasma concentration of the excitatory amino acid homocysteine might be associated with RLS occurrence in patients with chronic renal insufficiency on hemodialysis. METHODS: Total plasma homocysteine as well as creatinine, urea, folate, parathyroid hormone, hemoglobin, iron, ferritin, phosphate, calcium, magnesium, and albumin levels were compared between 26 RLS-affected (RLSpos) and 26 non-affected (RLSneg) patients on chronic hemodialysis. We further compared subje…

The variation of motor-related brain structure and its relation to abnormal motor behaviors in end-stage renal disease patients with restless legs syndrome.

Restless legs syndrome (RLS) is common in the end-stage renal disease (ESRD) population; however, their interrelationship remains largely unclear. In the current study, we aimed to investigate the brain structure variation in ESRD patients with RLS (ERSD-RLS) and its potential relation with the severity of RLS. Diffusion tensor imaging and T1-weighted imaging were obtained from 64 ERSD-RLS and 64 matched healthy controls. Voxel-based morphometry (VBM) analysis and tractography atlas-based analysis (TABS) were used to detect the alteration of gray matter (GM) volume and white matter (WM) micros…

Non-length-dependent somatosensory small fiber pathology presenting with restless legs syndrome in pre-motor Parkinson's disease. Evidence from skin biopsy in four patients.

BACKGROUND: The determinants of restless legs syndrome (RLS) occurring in co-morbid association with Parkinson's disease (PD) are currently unknown. METHODS: We performed a skin biopsy in proximal and distal sites of lower limbs in four PD patients, in which RLS had emerged in the pre-motor phase. RESULTS: A reduced somato-sensory intraepidermal nerve fiber (IENF) density mainly in the proximal sites, indicative of non-length-dependent small fiber pathology (SFP), was found in all patients, in absence of electroneurographic signs of large fiber neuropathy. DISCUSSION: The lack of known seco…

A prospective study of the cumulative incidence and course of restless legs syndrome in de novo patients with Parkinson's disease during chronic dopaminergic therapy.

The authors report the cumulative incidence of Restless Legs Syndrome (RLS) over a 3 years follow-up period in 92 de novo Parkinson's disease patients under chronic dopaminergic therapy and the clinical course of the sensory-motor disorder over 12 months as from its onset. The overall cumulative incidence of RLS was found by 15.3%, i.e. 14 incident cases, and by 11.9%, i.e. 11 incident cases, after the exclusion of possible "secondary" forms of the disorder. These figures are higher than those reported in general population in Germany (Study of Health in Pomerania), confirming our previous fin…

Prevalence, comorbidities and risk factors of restless legs syndrome in the Korean elderly population - results from the Korean Longitudinal Study on Health and Aging.

The aim of this study was to determine the prevalence, neuropsychiatric comorbidities, iron metabolism and potential risk factors of restless legs syndrome (RLS) in the elderly Korean population. As a community-based epidemiological study, a simple random sample of 1118 was drawn from a roster of 61 730 adult individuals aged 65 years and older and 714 participated. The diagnosis of RLS was established in face-to-face interviews using the four minimal diagnostic criteria for RLS recommended by National Institute of Health. Depressive symptoms, nocturnal sleep disturbances, daytime sleepiness a…

Night-to-night variability of periodic leg movements during sleep in restless legs syndrome and periodic limb movement disorder: comparison between the periodicity index and the PLMS index.

BACKGROUND: The number of periodic leg movements during sleep (PLMS index) shows high night-to-night variability, requiring multiple nights for its reliable estimation. It is currently not known if this is also the case for the degree of periodicity of leg movements, quantified by the Periodicity index. OBJECTIVE: To compare night-to-night variability of PLMS and Periodicity indices in patients with restless legs syndrome (RLS) or periodic limb movement disorder (PLMD). METHODS: Eighteen idiopathic RLS patients and 9 PLMD patients were recruited. Subjects underwent two consecutive full night…

Aripiprazole, a Novel Option in the Management of Restless Legs Syndrome (RLS) Patients with Augmentation and/or Severe RLS Symptoms: A Report of 4 Cases.

PURPOSE: Restless Legs Syndrome (RLS) is a sensorimotor disorder associated with an unpleasant urge to move the limbs, relieved with movement, occurring in the evenings and with prolonged rest/inactivity. Treatment with dopamine agonists is effective for up to 60-90% of affected individuals. However, augmentation, ie, the paradoxical worsening of RLS symptoms after prolonged RLS treatment, is frequently reported, typically after 3-10 years of treatment. Here, we present 4 patients with RLS who were successfully treated with dopamine agonists but later developed augmentation. A trial of aripipr…

A randomized, double-blind, placebo-controlled, dose-response study to assess the pharmacokinetics, efficacy, and safety of gabapentin enacarbil in subjects with restless legs syndrome.

OBJECTIVE: The objective of this study was to determine steady-state gabapentin exposures and corresponding relief of symptoms and safety profile produced by 4 dose levels of gabapentin enacarbil (GEn) in subjects with restless legs syndrome (RLS). METHODS: Subjects with RLS (n = 217) were randomized to receive once-daily, orally administered GEn 600 (n = 48), 1200 (n = 45), 1800 (n = 38), or 2400 mg (n = 45) or placebo (n = 41) in this 12-week, double-blind, multicenter study (NCT01332305). Clinic visits were at screening, baseline, and weeks 1, 2, 3, 4, 6, 8, 10, and 12; plasma gabapentin c…