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Digestive Diseases and Sciences
Published in: Digestive Diseases and Sciences 3/2017

01-03-2017 | Original Article

Prevalence of Restless Legs Syndrome in Patients with Inflammatory Bowel Disease

Authors: Ikuko Takahara, Fuminao Takeshima, Tatsuki Ichikawa, Toshihisa Matsuzaki, Hidetaka Shibata, Satoshi Miuma, Yuko Akazawa, Hisamitsu Miyaaki, Naota Taura, Kazuhiko Nakao

Published in: Digestive Diseases and Sciences | Issue 3/2017

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Abstract

Background and Aim

There has been increased interest in sleep disorders in patients with inflammatory bowel disease (IBD). Studies in North America and Europe reported that the prevalence of restless legs syndrome (RLS) is much higher in patients with Crohn’s disease (CD) than in the general population. The aim of this study was to reveal the prevalence and clinical features of RLS in Japanese patients with IBD and investigate the influence of RLS on sleep quality and quality of life (QOL).

Methods

The study included 80 outpatients with IBD who visited Nagasaki University Hospital between December 2012 and July 2014. All patients completed the international RLS study group rating scale, a validated measure of the presence of RLS. Sleep quality was assessed using the Japanese version of the Pittsburgh Sleep Quality Index (PSQI), and health-related QOL was assessed using the Japanese version of the 36-item short form healthy profile (SF-36) version 2.

Results

The prevalence of RLS in patients with IBD was 20%, including rates of 21.7% in patients with ulcerative colitis (UC) and 17.6% in patients with CD. Among patients with CD, the proportion of women and serum level of CRP were higher in the RLS group than in the non-RLS group. Among those with UC, there were no differences in clinical characteristics between the RLS and non-RLS groups. Patients in the RLS group slept significantly less well than those in the non-RLS group (PSQI > 5; 62.5 vs. 34.4%, P < 0.05). No significant relationships were observed between QOL indices and the presence of RLS (SF-36 physical score, 46.8 vs. 50.1; mental score, 43.8 vs. 45.7; role/social score, 48.1 vs. 49.2).

Conclusions

RLS occurs frequently in Japanese patients with UC as well as CD. RLS affects sleep quality but not QOL, and it should be considered one of the causes of sleep disturbance in patients with IBD.
Literature
1.
Drossman DA, Patrick DL, Mitchell CM, et al. Health-related quality of life in inflammatory bowel disease. Functional status and patient worries and concerns. Dig Dis Sci. 1989;34:1379–1386.CrossRefPubMed
2.
Papadakis KA, Targan SR. Current theories on the causes of inflammatory bowel disease. Gastroenterol Clin North Am. 1999;28:283–296.CrossRefPubMed
3.
Farhadi A, Banan A, Fields J, Keshavarzian A. Intestinal barrier: an interface between health and disease. J Gastroenterol Hepatol. 2003;18:479–497.CrossRefPubMed
4.
Farhadi A, Keshavarzian A, Van de Kar LD, et al. Heightened responses to stressors in patients with inflammatory bowel disease. Am J Gastroenterol. 2005;100:1796–1804.CrossRefPubMed
5.
Legaki E, Gazouli M. Influence of environmental factors in the development of inflammatory bowel diseases. World J Gastrointest Pharmacol Ther. 2016;7:112–125.CrossRefPubMedPubMedCentral
6.
Ananthakrishnan AN, Long MD, Martin CF, Sandler RS, Kappelman MD. Sleep disturbance and risk of active disease in patients with Crohn’s disease and ulcerative colitis. Clin Gastroenterol Hepatol. 2013;11:965–971.CrossRefPubMedPubMedCentral
7.
Ananthakrishnan AN, Khalili H, Konijeti GG, et al. Sleep duration affects risk for ulcerative colitis: a prospective cohort study. Clin Gastroenterol Hepatol. 2014;12:1879–1886.CrossRefPubMedPubMedCentral
8.
Gingold-Belfer R, Peled N, Levy S, et al. Impaired sleep quality in Crohn’s disease depends on disease activity. Dig Dis Sci. 2014;59:146–151.CrossRefPubMed
9.
Parekh PJ, Oldfield Iv EC, Challapallisri V, Ware JC, Johnson DA. Sleep disorders and inflammatory disease activity: chicken or the egg? Am J Gastroenterol. 2015;110:484–488.CrossRefPubMed
10.
Sobolewska-Wlodarczyk A, Wlodarczyk M, Szemraj J, Stec-Michalska K, Fichna J, Wisniewska-Jarosinska M. Circadian rhythm abnormalities—association with the course of inflammatory bowel disease. Pharmacol Rep. 2016;68:847–851.CrossRefPubMed
11.
Allen RP, Picchietti D, Hening WA, et al. Restless legs syndrome: diagnostic criteria, special considerations, and epidemiology. A report from the restless legs syndrome diagnosis and epidemiology workshop at the National Institutes of Health. Sleep Med. 2003;4:101–119.CrossRefPubMed
12.
Rijsman R, Neven AK, Graffelman W, Kemp B, de Weerd A. Epidemiology of restless legs in The Netherlands. Eur J Neurol. 2004;11:607–611.CrossRefPubMed
13.
Van De Vijver DA, Walley T, Petri H. Epidemiology of restless legs syndrome as diagnosed in UK primary care. Sleep Med. 2004;5:435–440.CrossRef
14.
Hogl B, Kiechl S, Willeit J, et al. Restless legs syndrome: a community-based study of prevalence, severity, and risk factors. Neurology. 2005;64:1920–1924.CrossRefPubMed
15.
Nichols DA, Allen RP, Grauke JH, et al. Restless legs syndrome symptoms in primary care: a prevalence study. Arch Intern Med. 2003;163:2323–2329.CrossRefPubMed
16.
Suzuki K, Ohida T, Sone T, et al. The prevalence of restless legs syndrome among pregnant women in Japan and the relationship between restless legs syndrome and sleep problems. Sleep. 2003;26:673–677.PubMed
17.
Franco RA, Ashwathnarayan R, Deshpandee A, et al. The high prevalence of restless legs syndrome symptoms in liver disease in an academic-based hepatology practice. J Clin Sleep Med. 2008;4:45–49.PubMedPubMedCentral
18.
Matsuzaki T, Ichikawa T, Kondo H, et al. Prevalence of restless legs syndrome in Japanese patients with chronic liver disease. Hepatol Res. 2012;42:1221–1226.CrossRefPubMed
19.
Kawauchi A, Inoue Y, Hashimoto T, et al. Restless legs syndrome in hemodialysis patients: health-related quality of life and laboratory data analysis. Clin Nephrol. 2006;66:440–446.CrossRefPubMed
20.
Nomura T, Inoue Y, Miyake M, Yasui K, Nakashima K. Prevalence and clinical characteristics of restless legs syndrome in Japanese patients with Parkinson’s disease. Mov Disord. 2006;21:380–384.CrossRefPubMed
21.
Weinstock LB, Bosworth BP, Scherl EJ, et al. Crohn’s disease is associated with restless legs syndrome. Inflamm Bowel Dis. 2010;16:275–279.CrossRefPubMed
22.
Hoek PD, Smits MG, de Roos NM, Rijsman RM, Witteman BJ. Increased prevalence of restless legs syndrome in patients with Crohn’s disease. Eur J Gastroenterol Hepatol. 2015;27:951–955.CrossRefPubMed
23.
Tan EK, Seah A, See SJ, Lim E, Wong MC, Koh KK. Restless legs syndrome in an Asian population: A study in Singapore. Mov Disord. 2001;16:577–579.CrossRefPubMed
24.
Nomura T, Inoue Y, Kusumi M, Uemura Y, Nakashima K. Prevalence of restless legs syndrome in a rural community in Japan. Mov Disord. 2008;23:2363–2369.CrossRefPubMed
25.
Tsuboi Y, Imamura A, Sugimura M, Nakano S, Shirakawa S, Yamada T. Prevalence of restless legs syndrome in a Japanese elderly population.  Parkinsonism Relat Disord. 2009;15:598–601.CrossRefPubMed
26.
Ng SC. Emerging leadership lecture: inflammatory bowel disease in Asia: emergence of a “Western” disease. J Gastroenterol Hepatol. 2015;30:440–445.CrossRefPubMed
27.
Buysse DJ, Reynolds CF 3rd, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989;28:193–213.CrossRefPubMed
28.
McHorney CA, Ware JE Jr, Raczek AE. The MOS 36-Item Short-Form Health Survey (SF-36): II. Psychometric and clinical tests of validity in measuring physical and mental health constructs. Med Care. 1993;31:247–263.CrossRefPubMed
29.
Fukuhara S, Ware JE Jr, Kosinski M, Wada S, Gandek B. Psychometric and clinical tests of validity of the Japanese SF-36 Health Survey. J Clin Epidemiol. 1998;51:1045–1053.CrossRefPubMed
30.
Harbord M, Annese V, Vavricka SR, et al. The first European evidence-based consensus on extra-intestinal manifestations in inflammatory bowel disease. J Crohns Colitis. 2016;10:239–254.CrossRefPubMed
31.
Mizuno S, Mihara T, Iyaoka T, Inagaki T, Horiguchi J. CSF iron, ferritin and transferrin levels in restless legs syndrome. J Sleep Res. 2005;14:43–47.CrossRefPubMed
32.
Weinstock LB, Walters AS, Paueksakon P. Restless legs syndrome-Theoretical roles of inflammatory and immune mechanisms. Sleep Med Rev. 2012;16:341–354.CrossRefPubMed
33.
Kim KW, Yoon IY, Chung S, et al. Prevalence, comorbidities and risk factors of restless legs syndrome in th Korean elderly population-results from the Korean Longitudinal Study on Health and Aging. J Sleep Res. 2010;19:87–92.CrossRefPubMed
34.
Higuchi T, Abe M, Mizuno M, et al. Association of restless legs syndrome with oxidative stress and inflammation in patients undergoing hemodialysis. Sleep Med. 2015;16:941–948.CrossRefPubMed
35.
Patel SS, Molnar MZ, Tayek JA, et al. Serum creatinine as a marker of muscle mass in chronic kidney disease: results of a cross-sectional study and review of literature. J Cachexia Sarcopenia Muscle. 2013;4:19–29.CrossRefPubMed
36.
Schneider SM, Al-Jaouni R, Filippi J, et al. Sarcopenia is prevalent in patients with Crohn’s disease in clinical remission. Inflamm Bowel Dis. 2008;14:1562–1568.CrossRefPubMed
37.
Zimmerman J. Extraintestinal symptoms in irritable bowel syndrome and inflammatory bowel diseases: nature, severity, and relationship to gastrointestinal symptoms. Dig Dis Sci. 2003;48:743–749.CrossRefPubMed
38.
Ranjbaran Z, Keefer L, Farhadi A, Stepanski E, Sedghi S, Keshavarzian A. Impact of sleep disturbances in inflammatory bowel disease. J Gastroenterol Hepatol. 2007;22:1748–1753.CrossRefPubMed
39.
Graff LA, Walker JR, Bernstein CN. Depression and anxiety in inflammatory bowel disease: a review of comorbidity and management. Inflamm Bowel Dis. 2009;15:1105–1118.CrossRefPubMed
40.
Ali T, Madhoun MF, Orr WC, Rubin DT. Assessment of the relationship between quality of sleep and disease activity in inflammatory bowel disease patients. Inflamm Bowel Dis. 2013;19:2440–2443.CrossRefPubMed
41.
Ranjbaran Z, Keefer L, Stepanski E, Farhadi A, Keshavarzian A. The relevance of sleep abnormalities to chronic inflammatory conditions. Inflamm Res. 2007;56:51–57.CrossRefPubMed
42.
Rohleder N, Aringer M, Boentert M. Role of interleukin-6 in stress, sleep, and fatigue. Ann N Y Acad Sci. 2012;1261:88–96.CrossRefPubMed
43.
Tang Y, Preuss F, Turek FW, Jakate S, Keshavarzian A. Sleep deprivation worsens inflammation and delays recovery in a mouse model of colitis. Sleep Med. 2009;10:597–603.CrossRefPubMedPubMedCentral
44.
Silber MH, Becker PM, Earley C, et al. Willis-Ekbom Disease Foundation Revised Consensus Statement on the Management of Restless Legs Syndrome. Mayo Clin Proc. 2013;88:977–986.CrossRefPubMed
Metadata
Title
Prevalence of Restless Legs Syndrome in Patients with Inflammatory Bowel Disease
Authors
Ikuko Takahara
Fuminao Takeshima
Tatsuki Ichikawa
Toshihisa Matsuzaki
Hidetaka Shibata
Satoshi Miuma
Yuko Akazawa
Hisamitsu Miyaaki
Naota Taura
Kazuhiko Nakao
Publication date
01-03-2017
Publisher
Springer US
Published in
Digestive Diseases and Sciences / Issue 3/2017
Print ISSN: 0163-2116
Electronic ISSN: 1573-2568
DOI
https://doi.org/10.1007/s10620-016-4420-y

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