Skip to main content
Top
Published in: Sleep and Breathing 1/2021

01-03-2021 | Angiography | Sleep Breathing Physiology and Disorders • Original Article

The prevalence of restless legs syndrome in patients undergoing coronary angiography and its relationship with the severity of coronary artery stenosis

Authors: Dürdane Aksoy, Ataç Çelik, Volkan Solmaz, Betül Çevik, Orhan Sümbül, Semiha Kurt

Published in: Sleep and Breathing | Issue 1/2021

Login to get access

Abstract

Purpose

Results from studies on the relationship between restless legs syndrome (RLS) and coronary artery disease (CAD) are conflicting. Some studies associate RLS with CAD by heart rate variability, blood pressure variability, and other autonomic, neuronal reasons, while other studies do not support these observations. The aim of this study was to investigate the prevalence of RLS in patients undergoing coronary angiography for CAD and to assess RLS prevalence with severity of CAD.

Methods

After inclusion and exclusion criteria were applied, enrolled patients with less than 50% coronary artery stenosis by angiography (0–49%) were assigned to group 1, and patients with 50% or more coronary artery stenosis were assigned to group 2. Patients were diagnosed with RLS if they met all five essential criteria of the International RLS study group. RLS prevalence and other comorbidities were compared between the two groups.

Results

Of 126 patients, 74 men (59%), mean age 64.0 ± 8.7 years, mean BMI 29.6 kg/m2, 47 (37%) were assigned to group 1 (no or nonobstructive CAD) and 79 (63%) were assigned to group 2 (obstructive CAD). No significant differences were found between the groups in terms of mean age, BMI, gender, or prevalence of hypertension, hypercholesterolemia, and DM. The prevalence of RLS in group 2 (29%) was significantly higher than in group 1 (15%), p = 0.013.

Conclusion

These results suggest that prevalence of RLS is associated with CAD and with CAD severity. We conjecture that RLS may be related to vascular endothelial dysfunction in cardiovascular disease.
Literature
1.
go back to reference Allen RP, Picchietti D, Hening WA, Trenkwalder C, Walters AS, Montplaisi J (2003) Restless legs syndrome diagnosis and epidemiology workshop at the National Institutes of Health; international restless legs syndrome study group. Restless legs syndrome: diagnostic criteria, special considerations, and epidemiology. A report from the restless leg syndrome diagnosis and epidemiology workshop at the national Institutes of Health. Sleep Med 4:101–119CrossRef Allen RP, Picchietti D, Hening WA, Trenkwalder C, Walters AS, Montplaisi J (2003) Restless legs syndrome diagnosis and epidemiology workshop at the National Institutes of Health; international restless legs syndrome study group. Restless legs syndrome: diagnostic criteria, special considerations, and epidemiology. A report from the restless leg syndrome diagnosis and epidemiology workshop at the national Institutes of Health. Sleep Med 4:101–119CrossRef
2.
go back to reference Allen RP (2007) Controversies and challenges in defining the etiology and pathophysiology of restless legs syndrome. Am J Med 120(1 Suppl 1):S13–S21CrossRef Allen RP (2007) Controversies and challenges in defining the etiology and pathophysiology of restless legs syndrome. Am J Med 120(1 Suppl 1):S13–S21CrossRef
3.
go back to reference Earley CJ, Silber MH (2010) Restless legs syndrome: understanding its consequences and the need for better treatment. Sleep Med 11(9):807–815CrossRef Earley CJ, Silber MH (2010) Restless legs syndrome: understanding its consequences and the need for better treatment. Sleep Med 11(9):807–815CrossRef
4.
go back to reference Innes KE, Selfe TK, Agarwal P (2011) Prevalence of restless legs syndrome in North American and Western European populations: a systematic review. Sleep Med 12(7):623–634CrossRef Innes KE, Selfe TK, Agarwal P (2011) Prevalence of restless legs syndrome in North American and Western European populations: a systematic review. Sleep Med 12(7):623–634CrossRef
5.
go back to reference Ekbom K, Ulfberg J (2009) Restless legs syndrome. J Intern Med 266(5):419–431CrossRef Ekbom K, Ulfberg J (2009) Restless legs syndrome. J Intern Med 266(5):419–431CrossRef
6.
go back to reference Safak ED, Gocer S, Mucuk S, Ozturk A, Akin S, Arguvanli S, Mazicioglu MM (2016) The prevalence and related factors of restless leg syndrome in the community dwelling elderly; in Kayseri, Turkey: A cross-sectional study. Arch Gerontol Geriatr 65:29–35CrossRef Safak ED, Gocer S, Mucuk S, Ozturk A, Akin S, Arguvanli S, Mazicioglu MM (2016) The prevalence and related factors of restless leg syndrome in the community dwelling elderly; in Kayseri, Turkey: A cross-sectional study. Arch Gerontol Geriatr 65:29–35CrossRef
7.
go back to reference Demir AU, Ardıç S, Fırat H, Karadeniz D, Aksu M, Uçar ZZ, for the TAPES Investigation Committee et al (2015) Prevalence of sleep disorders in the Turkish adult population epidemiology of sleep study. Sleep Biol Rhythms 13:298–308CrossRef Demir AU, Ardıç S, Fırat H, Karadeniz D, Aksu M, Uçar ZZ, for the TAPES Investigation Committee et al (2015) Prevalence of sleep disorders in the Turkish adult population epidemiology of sleep study. Sleep Biol Rhythms 13:298–308CrossRef
8.
go back to reference Aboussouan LS, Lewis RA, Shy ME (1996) Restless legs syndrome in patients with neuropathy. Muscle Nerve 19:670–672CrossRef Aboussouan LS, Lewis RA, Shy ME (1996) Restless legs syndrome in patients with neuropathy. Muscle Nerve 19:670–672CrossRef
9.
go back to reference Högl B, Kiechl S, Willeit J, Saletu M, Frauscher B, Seppi K, Müller J, Rungger G, Gasperi A, Wenning G, Poewe W (2005) Restless legs syndrome: a community-based study of prevalence, severity and risk factors. Neurology 64:1920–1924CrossRef Högl B, Kiechl S, Willeit J, Saletu M, Frauscher B, Seppi K, Müller J, Rungger G, Gasperi A, Wenning G, Poewe W (2005) Restless legs syndrome: a community-based study of prevalence, severity and risk factors. Neurology 64:1920–1924CrossRef
10.
go back to reference Winkelman JW, Blackwell T, Stone K, Ancoli-Israel S, Redline S (2017) Associations of incident cardiovascular events with restless legs syndrome and periodic leg movements of sleep in older men, for the outcomes of sleep disorders in older men study (MrOS sleep study). Sleep 1:40(4). https://doi.org/10.1093/sleep/zsx023CrossRef Winkelman JW, Blackwell T, Stone K, Ancoli-Israel S, Redline S (2017) Associations of incident cardiovascular events with restless legs syndrome and periodic leg movements of sleep in older men, for the outcomes of sleep disorders in older men study (MrOS sleep study). Sleep 1:40(4). https://​doi.​org/​10.​1093/​sleep/​zsx023CrossRef
12.
go back to reference Liu Y, Liu G, Li L, Yang J, Ma S (2018) Evaluation of cardiovascular risk factors and restless legs syndrome in women and men: a preliminary population-based study in China. J Clin Sleep Med 14(3):445–450CrossRef Liu Y, Liu G, Li L, Yang J, Ma S (2018) Evaluation of cardiovascular risk factors and restless legs syndrome in women and men: a preliminary population-based study in China. J Clin Sleep Med 14(3):445–450CrossRef
13.
go back to reference Allen RP, Picchietti DL, Garcia-Borreguero D, Ondo WG, Walters AS, Winkelman JW, International Restless Legs Syndrome Study Group et al (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 15:860–873CrossRef Allen RP, Picchietti DL, Garcia-Borreguero D, Ondo WG, Walters AS, Winkelman JW, International Restless Legs Syndrome Study Group et al (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 15:860–873CrossRef
14.
go back to reference Lopes LA, Lins Cde M, Adeodato VG et al (2005) Restless legs syndrome and quality of sleep in type 2 diabetes. Diabetes Care 28(11):2633–2636CrossRef Lopes LA, Lins Cde M, Adeodato VG et al (2005) Restless legs syndrome and quality of sleep in type 2 diabetes. Diabetes Care 28(11):2633–2636CrossRef
15.
go back to reference Walters AS, Moussouttas M, Siddiqui F, Silveira DC, Fuentes K, Wang L, Berger K (2010) Prevalence of stroke in restless legs syndrome: initial results point to the need for more sophisticated studies. Open Neurol J 4:73–77CrossRef Walters AS, Moussouttas M, Siddiqui F, Silveira DC, Fuentes K, Wang L, Berger K (2010) Prevalence of stroke in restless legs syndrome: initial results point to the need for more sophisticated studies. Open Neurol J 4:73–77CrossRef
16.
go back to reference Katsanos AH, Kosmidou M, Konitsiotis S, Tsivgoulis G, Fiolaki A, Kyritsis AP, Giannopoulos S (2018) Restless legs syndrome and cerebrovascular/cardiovascular events: systematic review and meta-analysis. Acta Neurol Scand 137(1):142–148CrossRef Katsanos AH, Kosmidou M, Konitsiotis S, Tsivgoulis G, Fiolaki A, Kyritsis AP, Giannopoulos S (2018) Restless legs syndrome and cerebrovascular/cardiovascular events: systematic review and meta-analysis. Acta Neurol Scand 137(1):142–148CrossRef
17.
go back to reference Szentkirályi A, Völzke H, Hoffmann W, Trenkwalder C, Berger K (2014) Multimorbidity and the risk of restless legs syndrome in 2 prospective cohort studies. Neurology 82(22):2026–2033CrossRef Szentkirályi A, Völzke H, Hoffmann W, Trenkwalder C, Berger K (2014) Multimorbidity and the risk of restless legs syndrome in 2 prospective cohort studies. Neurology 82(22):2026–2033CrossRef
18.
go back to reference Winkelman JW, Shahar E, Sharief I, Gottlieb DJ (2008) Association of restless legs syndrome and cardiovascular disease in the sleep heart health study. Neurology 70(1):35–42CrossRef Winkelman JW, Shahar E, Sharief I, Gottlieb DJ (2008) Association of restless legs syndrome and cardiovascular disease in the sleep heart health study. Neurology 70(1):35–42CrossRef
19.
go back to reference Yatsu S, Kasai T, Suda S, Matsumoto H, Ishiwata S, Shiroshita N, Kato M, Kawana F, Murata A, Shimizu M, Shitara J, Kato T, Hiki M, Sai E, Miyauchi K, Daida H (2019) Prevalence and significance of restless legs syndrome in patients with coronary artery disease. Am J Cardiol 30222(19):S0002–S9149 Yatsu S, Kasai T, Suda S, Matsumoto H, Ishiwata S, Shiroshita N, Kato M, Kawana F, Murata A, Shimizu M, Shitara J, Kato T, Hiki M, Sai E, Miyauchi K, Daida H (2019) Prevalence and significance of restless legs syndrome in patients with coronary artery disease. Am J Cardiol 30222(19):S0002–S9149
20.
go back to reference Young T, Peppard P (2000) Sleep-disordered breathing and cardiovascular disease: epidemiologic evidence for a relationship. Sleep 23:S122–S126PubMed Young T, Peppard P (2000) Sleep-disordered breathing and cardiovascular disease: epidemiologic evidence for a relationship. Sleep 23:S122–S126PubMed
21.
go back to reference Walters AS, Rye DB (2009) Review of the relationship of restless legs syndrome and periodic limb movements in sleep to hypertension, heart disease, and stroke. Sleep 32(5):589–597CrossRef Walters AS, Rye DB (2009) Review of the relationship of restless legs syndrome and periodic limb movements in sleep to hypertension, heart disease, and stroke. Sleep 32(5):589–597CrossRef
22.
go back to reference Jiménez-Jiménez FJ, Alonso-Navarro H, García-Martín E, JAG A (2019) Neurochemical features of idiopathic restless legs syndrome. Sleep Med Rev 45:70–87CrossRef Jiménez-Jiménez FJ, Alonso-Navarro H, García-Martín E, JAG A (2019) Neurochemical features of idiopathic restless legs syndrome. Sleep Med Rev 45:70–87CrossRef
23.
go back to reference Schilling C, Schredl M, Strobl P, Deuschle M (2010) Restless legs syndrome: evidence for nocturnal hypothalamic-pituitaryadrenal system activation. Mov Disord 25:1047–1052CrossRef Schilling C, Schredl M, Strobl P, Deuschle M (2010) Restless legs syndrome: evidence for nocturnal hypothalamic-pituitaryadrenal system activation. Mov Disord 25:1047–1052CrossRef
24.
go back to reference Li Y, Walters AS, Chiuve SE, Rimm EB, Winkelman JW, Gao X (2012) Prospective study of restless legs syndrome and coronary heart disease among women. Circulation 126(14):1689–1694CrossRef Li Y, Walters AS, Chiuve SE, Rimm EB, Winkelman JW, Gao X (2012) Prospective study of restless legs syndrome and coronary heart disease among women. Circulation 126(14):1689–1694CrossRef
26.
go back to reference Koo DL, Nam H, Thomas RJ, Yun CH (2018) Sleep disturbances as a risk factor for stroke. J Stroke 20(1):12–32CrossRef Koo DL, Nam H, Thomas RJ, Yun CH (2018) Sleep disturbances as a risk factor for stroke. J Stroke 20(1):12–32CrossRef
28.
go back to reference Koh SY, Kim MS, Lee SM, Hong JM, Yoon JH (2015) Impaired vascular endothelial function in patients with restless legs syndrome: a new aspect of the vascular pathophysiology. J Neurol Sci 359(1-2):207–210CrossRef Koh SY, Kim MS, Lee SM, Hong JM, Yoon JH (2015) Impaired vascular endothelial function in patients with restless legs syndrome: a new aspect of the vascular pathophysiology. J Neurol Sci 359(1-2):207–210CrossRef
29.
go back to reference Erden İ, Çakcak Erden E, Durmuş H, Tıbıllı H, Tabakçı M, Kalkan ME, Türker Y, Akçakoyun M (2014) Anadolu Kardiyol Derg Nov;14(7): 612-6 Erden İ, Çakcak Erden E, Durmuş H, Tıbıllı H, Tabakçı M, Kalkan ME, Türker Y, Akçakoyun M (2014) Anadolu Kardiyol Derg Nov;14(7): 612-6
Metadata
Title
The prevalence of restless legs syndrome in patients undergoing coronary angiography and its relationship with the severity of coronary artery stenosis
Authors
Dürdane Aksoy
Ataç Çelik
Volkan Solmaz
Betül Çevik
Orhan Sümbül
Semiha Kurt
Publication date
01-03-2021
Publisher
Springer International Publishing
Published in
Sleep and Breathing / Issue 1/2021
Print ISSN: 1520-9512
Electronic ISSN: 1522-1709
DOI
https://doi.org/10.1007/s11325-020-02085-2

Other articles of this Issue 1/2021

Sleep and Breathing 1/2021 Go to the issue

Sleep Breathing Physiology and Disorders • Original ArticleSleep Breathing Physiology and Disorders • Original Article

Reducing cost and time to diagnosis and treatment of obstructive sleep apnea using ambulatory sleep study: a Singapore sleep centre experience

Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.