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01-09-2020 | Anemia | Neurology • Original Article

Prevalence and predictors of restless legs syndrome in non-pregnant Saudi women of childbearing age

Authors: Aljohara S. Almeneessier, Maha Alzahrani, Aisha Alsafi, Raneem Alotaibi, Awad H. Olaish, Ahmed S. BaHammam

Published in: Sleep and Breathing | Issue 3/2020

Abstract

Purpose

This study assessed the prevalence of restless legs syndrome (RLS) and its correlates and severity among non-pregnant Saudi women of childbearing age.

Methods

Consecutive non-pregnant female visitors (age 15–44 years) of the primary care centers of the female University campus at King Saud University (n = 1,136) were interviewed face-to-face to determine the presence and severity of RLS using the International Restless Legs Syndrome (IRLS) Study Group criteria and IRLS severity scale.

Results

A total of 271 participants (24%) were diagnosed with RLS. Of these cases, severe/very severe RLS was diagnosed in 13% and mild/moderate in 87%. None of these participants had been diagnosed or treated for RLS before. Subjects with RLS were older, had a higher body mass index, and a higher prevalence of vitamin D deficiency and diabetes mellitus than those without RLS. Multivariate binary logistic regression analysis identified the following independent predictors of RLS: age (OR 1.03 [1.009–1.051], p = 0.004), vitamin D deficiency (OR 2.147 [1.612–2.86], p < 0.001), and diabetes mellitus (OR 4.408 [1.946–9.982], p < 0.001).

Conclusions

Our results indicate that RLS is very common and underdiagnosed among non-pregnant Saudi women of a childbearing age–attending primary care cents. RLS was linked to age, vitamin D deficiency, and diabetes mellitus.

Guo S, Huang J, Jiang H, Han C, Li J, Xu X, Zhang G, Lin Z, Xiong N, Wang T (2017) Restless legs syndrome: from pathophysiology to clinical diagnosis and management. Front Aging Neurosci 9:171. https://doi.org/10.3389/fnagi.2017.00171CrossRefPubMedPubMedCentral

Cho SJ, Hong JP, Hahm BJ, Jeon HJ, Chang SM, Cho MJ, Lee HB (2009) Restless legs syndrome in a community sample of Korean adults: prevalence, impact on quality of life, and association with DSM-IV psychiatric disorders. Sleep 32(8):1069–1076PubMedPubMedCentral

Picchietti D, Allen RP, Walters AS, Davidson JE, Myers A, Ferini-Strambi L (2007) Restless legs syndrome: prevalence and impact in children and adolescents--the Peds REST study. Pediatrics 120(2):253–266. https://doi.org/10.1542/peds.2006-2767CrossRefPubMed

Allen RP, Walters AS, Montplaisir J, Hening W, Myers A, Bell TJ, Ferini-Strambi L (2005) Restless legs syndrome prevalence and impact: REST general population study. Arch Intern Med 165(11):1286–1292. https://doi.org/10.1001/archinte.165.11.1286CrossRefPubMed

Hening W, Walters AS, Allen RP, Montplaisir J, Myers A, Ferini-Strambi L (2004) Impact, diagnosis and treatment of restless legs syndrome (RLS) in a primary care population: the REST (RLS epidemiology, symptoms, and treatment) primary care study. Sleep Med 5(3):237–246. https://doi.org/10.1016/j.sleep.2004.03.006CrossRefPubMed

Gupta R, Dhyani M, Kendzerska T, Pandi-Perumal SR, BaHammam AS, Srivanitchapoom P, Pandey S, Hallett M (2016) Restless legs syndrome and pregnancy: prevalence, possible pathophysiological mechanisms and treatment. Acta Neurol Scand 133(5):320–329. https://doi.org/10.1111/ane.12520CrossRefPubMed

Berger K, Luedemann J, Trenkwalder C, John U, Kessler C (2004) Sex and the risk of restless legs syndrome in the general population. Arch Intern Med 164(2):196–202. https://doi.org/10.1001/archinte.164.2.196CrossRefPubMed

Montplaisir J, Boucher S, Poirier G, Lavigne G, Lapierre O, Lesperance P (1997) Clinical, polysomnographic, and genetic characteristics of restless legs syndrome: a study of 133 patients diagnosed with new standard criteria. Mov Disord 12(1):61–65. https://doi.org/10.1002/mds.870120111CrossRefPubMed

Walters AS, Hickey K, Maltzman J, Verrico T, Joseph D, Hening W, Wilson V, Chokroverty S (1996) A questionnaire study of 138 patients with restless legs syndrome: the ‘Night-Walkers’ survey. Neurology 46(1):92–95. https://doi.org/10.1212/wnl.46.1.92CrossRefPubMed

10.

Alswailem AM, Alahmad SM, Alshehri MA (2017) The prevalence of iron deficiency anemia and its associated risk factors among a sample of females in Riyadh, Saudi Arabia. Egypt J Hosp Med 72:4625–4629

11.

Alquaiz AM, Gad Mohamed A, Khoja TA, Alsharif A, Shaikh SA, Al Mane H, Aldiris A, Kazi A, Hammad D (2013) Prevalence of anemia and associated factors in child bearing age women in Riyadh, Saudi Arabia. J Nutr Metab 2013:636585. https://doi.org/10.1155/2013/636585CrossRefPubMedPubMedCentral

12.

Al-Alyani H, Al-Turki HA, Al-Essa ON, Alani FM, Sadat-Ali M (2018) Vitamin D deficiency in Saudi Arabians: a reality or simply hype: a meta-analysis (2008-2015). J Fam Community Med 25(1):1–4. https://doi.org/10.4103/jfcm.JFCM_73_17CrossRef

13.

Alzaheb RA (2018) The prevalence of hypovitaminosis D and its associated risk factors among women of reproductive age in Saudi Arabia: a systematic review and meta-analysis. Clin Med Insights Womens Health 11:1179562X18767884. https://doi.org/10.1177/1179562X18767884CrossRefPubMedPubMedCentral

14.

Al-Daghri NM (2018) Vitamin D in Saudi Arabia: prevalence, distribution and disease associations. J Steroid Biochem Mol Biol 175:102–107. https://doi.org/10.1016/j.jsbmb.2016.12.017CrossRefPubMed

15.

Al-Mogbel ES (2012) Vitamin D status among adult Saudi females visiting primary health care clinics. Int J Health Sci (Qassim) 6(2):116–126CrossRef

16.

Almeneessier AS, Alyousefi N, Alzahrani M, Alsafi AA, Alotaibi R, Olaish AH, Sabr Y, BaHammam AS (2019) Prevalence of restless legs syndrome among pregnant women: a case–control study. Ann Thoracic Med 15:9–14. https://doi.org/10.4103/atm.ATM_206_19

17.

Crocetti AF, Mushak P, Schwartz J (1990) Determination of numbers of lead-exposed women of childbearing age and pregnant women: an integrated summary of a report to the U.S. Congress on childhood lead poisoning. Environ Health Perspect 89:121–124. https://doi.org/10.1289/ehp.9089121CrossRefPubMedPubMedCentral

18.

Martinez GM, Daniels K, Febo-Vazquez I (2018) Fertility of men and women aged 15-44 in the United States: National Survey of Family Growth, 2011-2015. Natl Health Stat Rep 113:1–17

19.

Goonewardene M, Shehata M, Hamad A (2012) Anaemia in pregnancy. Best Pract Res Clin Obstet Gynaecol 26(1):3–24. https://doi.org/10.1016/j.bpobgyn.2011.10.010CrossRefPubMed

20.

Kidney disease: improving global outcomes (KDIGO) (2013) Chapter 1: definition and classification of CKD. Kidney Int Suppl (2011) 3(1):19–62. https://doi.org/10.1038/kisup.2012.64CrossRef

21.

BaHammam A, Al-shahrani K, Al-zahrani S, Al-shammari A, Al-amri N, Sharif M (2011) The prevalence of restless legs syndrome in adult Saudis attending primary health care. Gen Hosp Psychiatry 33(2):102–106. https://doi.org/10.1016/j.genhosppsych.2011.01.005CrossRefPubMed

22.

Allen RP, Kushida CA, Atkinson MJ, Consortium RLSQ (2003) Factor analysis of the International Restless Legs Syndrome Study Group’s scale for restless legs severity. Sleep Med 4(2):133–135CrossRef

23.

Allen RP, Picchietti DL, Garcia-Borreguero D, Ondo WG, Walters AS, Winkelman JW, Zucconi M, Ferri R, Trenkwalder C, Lee HB, International Restless Legs Syndrome Study G (2014) Restless legs syndrome/Willis-Ekbom disease diagnostic criteria: updated International Restless Legs Syndrome Study Group (IRLSSG) consensus criteria--history, rationale, description, and significance. Sleep Med 15(8):860–873. https://doi.org/10.1016/j.sleep.2014.03.025CrossRef

24.

Chen PH, Liou KC, Chen CP, Cheng SJ (2012) Risk factors and prevalence rate of restless legs syndrome among pregnant women in Taiwan. Sleep Med 13(9):1153–1157. https://doi.org/10.1016/j.sleep.2012.06.008CrossRefPubMed

25.

Manconi M, Govoni V, De Vito A, Economou NT, Cesnik E, Casetta I, Mollica G, Ferini-Strambi L, Granieri E (2004) Restless legs syndrome and pregnancy. Neurology 63(6):1065–1069CrossRef

26.

Sikandar R, Khealani BA, Wasay M (2009) Predictors of restless legs syndrome in pregnancy: a hospital based cross sectional survey from Pakistan. Sleep Med 10(6):676–678. https://doi.org/10.1016/j.sleep.2008.06.011CrossRefPubMed

27.

Tunc T, Karadag YS, Dogulu F, Inan LE (2007) Predisposing factors of restless legs syndrome in pregnancy. Mov Disord 22(5):627–631. https://doi.org/10.1002/mds.21291CrossRefPubMed

28.

Al Hassan NN (2015) The prevalence of iron deficiency anemia in a Saudi University female students. J Microsc Ultrastruct 3(1):25–28. https://doi.org/10.1016/j.jmau.2014.11.003CrossRefPubMed

29.

Trenkwalder C, Allen R, Hogl B, Paulus W, Winkelmann J (2016) Restless legs syndrome associated with major diseases: a systematic review and new concept. Neurology 86(14):1336–1343. https://doi.org/10.1212/WNL.0000000000002542CrossRefPubMedPubMedCentral

30.

Connor JR, Patton SM, Oexle K, Allen RP (2017) Iron and restless legs syndrome: treatment, genetics and pathophysiology. Sleep Med 31:61–70. https://doi.org/10.1016/j.sleep.2016.07.028CrossRefPubMed

31.

Lin S, Zhang H, Gao T, Zhong F, Sun Y, Cai J, Ma A (2018) The association between obesity and restless legs syndrome: a systemic review and meta-analysis of observational studies. J Affect Disord 235:384–391. https://doi.org/10.1016/j.jad.2018.04.042CrossRefPubMed

32.

Gao Q, Kou T, Zhuang B, Ren Y, Dong X, Wang Q (2018) The association between vitamin D deficiency and sleep disorders: a systematic review and meta-analysis. Nutrients 10(10). https://doi.org/10.3390/nu10101395

33.

Archontogeorgis K, Nena E, Papanas N, Steiropoulos P (2018) The role of vitamin D in obstructive sleep apnoea syndrome. Breathe (Sheff) 14(3):206–215. https://doi.org/10.1183/20734735.000618CrossRef

34.

Balaban H, Yildiz OK, Cil G, Senturk IA, Erselcan T, Bolayir E, Topaktas S (2012) Serum 25-hydroxyvitamin D levels in restless legs syndrome patients. Sleep Med 13(7):953–957. https://doi.org/10.1016/j.sleep.2012.04.009CrossRefPubMed

35.

Wali S, Shukr A, Boudal A, Alsaiari A, Krayem A (2014) The effect of vitamin D supplements on the severity of restless legs syndrome. Sleep Breath 19:579–583. https://doi.org/10.1007/s11325-014-1049-yCrossRefPubMed

36.

Cui X, Pelekanos M, Liu PY, Burne TH, McGrath JJ, Eyles DW (2013) The vitamin D receptor in dopamine neurons; its presence in human substantia nigra and its ontogenesis in rat midbrain. Neuroscience 236:77–87. https://doi.org/10.1016/j.neuroscience.2013.01.035CrossRefPubMed

37.

Patton SM, Cho YW, Clardy TW, Allen RP, Earley CJ, Connor JR (2013) Proteomic analysis of the cerebrospinal fluid of patients with restless legs syndrome/Willis-Ekbom disease. Fluids Barriers CNS 10(1):20. https://doi.org/10.1186/2045-8118-10-20CrossRefPubMedPubMedCentral

38.

Wali SO, Abaalkhail B, Alhejaili F, Pandi-Perumal SR (2019) Efficacy of vitamin D replacement therapy in restless legs syndrome: a randomized control trial. Sleep Breath 23(2):595–601. https://doi.org/10.1007/s11325-018-1751-2CrossRefPubMed

39.

Moradi-Lakeh M, El Bcheraoui C, Afshin A, Daoud F, AlMazroa MA, Al Saeedi M, Basulaiman M, Memish ZA, Al Rabeeah AA, Mokdad AH (2017) Diet in Saudi Arabia: findings from a nationally representative survey. Public Health Nutr 20(6):1075–1081. https://doi.org/10.1017/S1368980016003141CrossRefPubMed

40.

Alsuwadia AO, Farag YM, Al Sayyari AA, Mousa DH, Alhejaili FF, Al-Harbi AS, Housawi AA, Mittal BV, Singh AK (2013) Prevalence of vitamin D deficiency in Saudi adults. Saudi Med J 34(8):814–818PubMed

41.

Innes KE, Selfe TK, Agarwal P (2012) Restless legs syndrome and conditions associated with metabolic dysregulation, sympathoadrenal dysfunction, and cardiovascular disease risk: a systematic review. Sleep Med Rev 16(4):309–339. https://doi.org/10.1016/j.smrv.2011.04.001CrossRefPubMed

42.

Keckeis M, Lattova Z, Maurovich-Horvat E, Beitinger PA, Birkmann S, Lauer CJ, Wetter TC, Wilde-Frenz J, Pollmacher T (2010) Impaired glucose tolerance in sleep disorders. PLoS One 5(3):e9444. https://doi.org/10.1371/journal.pone.0009444CrossRefPubMedPubMedCentral

43.

Bosco D, Plastino M, Fava A, Ettore M, Bosco F, Ermio C, Tallarigo F, Pirritano D, Consoli D (2009) Role of the Oral Glucose Tolerance Test (OGTT) in the idiopathic restless legs syndrome. J Neurol Sci 287(1–2):60–63. https://doi.org/10.1016/j.jns.2009.09.008CrossRefPubMed

44.

Mirghani OH, Amirthalingam P, Mohammed OS (2016) The effect of restless leg syndrome on diabetes control among type-2 diabetic patients in the Northwest region of Saudi Arabia. J Diabetol 7(3):1–5

45.

Phillips B, Young T, Finn L, Asher K, Hening WA, Purvis C (2000) Epidemiology of restless legs symptoms in adults. Arch Intern Med 160(14):2137–2141. https://doi.org/10.1001/archinte.160.14.2137CrossRefPubMed

46.

Ohayon MM, Roth T (2002) Prevalence of restless legs syndrome and periodic limb movement disorder in the general population. J Psychosom Res 53(1):547–554. https://doi.org/10.1016/s0022-3999(02)00443-9CrossRefPubMed

47.

Tison F, Crochard A, Leger D, Bouee S, Lainey E, El Hasnaoui A (2005) Epidemiology of restless legs syndrome in French adults: a nationwide survey: the INSTANT Study. Neurology 65(2):239–246. https://doi.org/10.1212/01.wnl.0000168910.48309.4aCrossRefPubMed

Title: Prevalence and predictors of restless legs syndrome in non-pregnant Saudi women of childbearing age
Authors: Aljohara S. Almeneessier
Maha Alzahrani
Aisha Alsafi
Raneem Alotaibi
Awad H. Olaish
Ahmed S. BaHammam
Publication date: 01-09-2020
Publisher: Springer International Publishing
Keywords: Anemia
Vitamin D Deficiency
Restless Legs Syndrome
Diabetes
Published in: Sleep and Breathing / Issue 3/2020
Print ISSN: 1520-9512
Electronic ISSN: 1522-1709
DOI: https://doi.org/10.1007/s11325-020-02054-9

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