Treatment wish of individuals with known and unknown restless legs syndrome in the community - Journal of Neurology

Study objectives

Restless legs syndrome (RLS) is a frequent sleep disorder with a prevalence of 5 % to 15 % in Caucasion populations. Dopaminergic treatment is known to reduce sensorimotor RLS symptoms and is approved for RLS, but not all patients ask for treatment. About 2 % to 3 % of patients presenting to a primary care physician require RLS-specific treatment. The overall treatment preference of RLS sufferers, however, is still unknown. The aim of this study was to assess the prevalence and treatment preference in patients with previously diagnosed and those with yet undiagnosed RLS in a population-based survey in Germany.

Design and setting

Cross-sectional health survey with face-to-face interviews with 1312 participants in the Dortmund Health Study. RLS was assessed with standardized, validated questions addressing the four minimal diagnostic criteria for RLS defined by the International Restless Legs Syndrome Study Group.

Participants

Participants were aged 25 to 75 years and were randomly selected from the city register.

Results

The overall prevalence of individuals with a known doctor diagnosis of RLS was 2.3 %. In addition, 6.5 % fulfilled the four minimal criteria but did not know about this diagnosis yielding an overall prevalence of 8.8 %. Prevalence was higher in women (10.2 %) and German descendents (9.2 %) compared to men (7.1 %) and migrants (6.7 %). Almost 60 % of all RLS cases reported symptoms at least once a week. 33.3 % of cases with a known RLS diagnosis and 14.1 % with an unknown diagnosis had an RLS treatment wish. The latter is determined by knowledge of the diagnosis, daily symptoms, diabetes and sleep disturbance.

Conclusion

About every fourth RLS case knows about the diagnosis and overall every fifth RLS case wishes medication to effectively reduce symptoms, corresponding to 1.6 % of the whole study population.

1. Allen R, Picchietti D, Hening W, Trenkwalder C, Walters A, Montplaisir J (2003) Restless legs syndrome: diagnostic criteria, special considerations, and epidemiology. A report from the restless legs syndrome diagnosis and epidemiology workshop at the National Institute of Health. Sleep Med 4:101–119

   Article  PubMed  Google Scholar 

2. Berger K, Lüdemann J, Trenkwalder C, John U, Kessler C (2004) Sex and the risk of restless legs syndrome in the general population. Arch Intern Med 164:196–202

   Article  PubMed  Google Scholar 

3. Berger K, von Eckardstein A, Trenkwalder C, Rothdach A, Junker R, Weiland SK (2002) Iron metabolism and the risk of restless legs syndrome in an elderly general population: the MEMO study. J Neurol 249:1195–1199

   Article  PubMed  CAS  Google Scholar 

4. Buysse DJ, Reynolds CF 3rd, Monks TH, et al. (1989) The Pittsburgh Sleep Quality Index: A new instrument for psychiatric practice and research. Psychiatry Res 28:193–213

   Article  PubMed  CAS  Google Scholar 

5. Garcia-Borreguero D, Egatz R, Winkelmann J, Berger K (2006) Epidemiology of restless legs syndrome: the current status. Sleep Med Rev 10:153–167

   Article  PubMed  Google Scholar 

6. 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 5:237–246

   Article  PubMed  Google Scholar 

7. Högl B, Kiechl S, Willeit J, et al. (2005) Restless legs syndrome. A communitybased study of prevalence, severity, and risk factors. Neurology 64:1920–1924

   Article  PubMed  Google Scholar 

8. Paulus W, Trenkwalder C (2006) Less is more: Pathophysiology of dopaminergic- therapy-related augmentation in restless legs syndrome. Lancet Neurol 5:878–886

   Article  PubMed  CAS  Google Scholar 

9. Rothdach AJ, Trenkwalder C, Haberstock J, Keil U, Berger K (2000) Prevalence and risk factors of RLS in an elderly population. The MEMO study. Neurology 54:1064–1068

   PubMed  CAS  Google Scholar 

10. Sevim S, Dogu O, Camdeviren H, et al. (2003) Unexpectedly low prevalence and unusual characteristics of RLS in Mersin, Turkey. Neurology 61:1562–1569

    PubMed  CAS  Google Scholar 

11. Walters AS (1995) Toward a better definition of restless legs syndrome. The International Restless Legs Syndrome Study Group. Mov Disord 10:634–642

    Article  PubMed  CAS  Google Scholar 

12. Willis T (1685) The London Practice of Physick. London, England: Bassett & Crooke, 404

13. Youakun R (1996) Nightwalkers: Do your legs seem to have a life of their own – your torment has a name. Modern maturity 35:82–83

    Google Scholar 

Download references

Authors and Affiliations

1. Dept. of Clinical Neurophysiology, Klinikum Bremen-Ost/University of Göttingen, Züricher Strasse 40, 28325, Bremen, Germany

   S. Happe MD

2. Dept. of Epidemiology and Social Medicine, University of Münster, Münster, Germany

   M. Vennemann MD, MPH & K. Berger MD, MPH

3. Dept. of Neurology, University of Münster, Münster, Germany

   S. Evers MD, PhD

Corresponding author

Correspondence to S. Happe MD.

Open Access This is an open access article distributed under the terms of the Creative Commons Attribution Noncommercial License ( https://creativecommons.org/licenses/by-nc/2.0 ), which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.

Reprints and permissions

Cite this article

Happe, S., Vennemann, M., Evers, S. et al. Treatment wish of individuals with known and unknown restless legs syndrome in the community. J Neurol 255, 1365–1371 (2008). https://doi.org/10.1007/s00415-008-0922-7

Download citation

• Received: 03 August 2007

• Revised: 18 January 2008

• Accepted: 15 February 2008

• Published: 27 June 2008

• Issue Date: September 2008

• DOI: https://doi.org/10.1007/s00415-008-0922-7

Key words