@article {1004, title = {Association of restless legs syndrome and cardiovascular disease in the Sleep Heart Health Study.}, journal = {Neurology}, volume = {70}, year = {2008}, month = {2008 Jan 01}, pages = {35-42}, abstract = {

OBJECTIVE: We evaluated the cross-sectional association between restless legs syndrome (RLS) and prevalent cardiovascular disease (CVD) in a large community-based sample of middle-aged and elderly subjects.

METHODS: This is a cross-sectional observational study of 1,559 men and 1,874 women (mean age of 67.9 years) who were enrolled in the Sleep Heart Health Study, a community-based study of the cardiovascular consequences of sleep-disordered breathing. RLS was defined by positive responses on a self-administered questionnaire to the four diagnostic criteria, with symptoms occurring at least five times per month and associated with at least moderate distress. Coronary artery disease (CAD) was determined by self-report of doctor-diagnosed angina, myocardial infarction, or coronary revascularization procedure. Total CVD included CAD or history of physician-diagnosed stroke or heart failure. The relation of RLS to prevalent CAD and CVD was examined by multivariable logistic regression models

RESULTS: RLS was present in 6.8\% of women (n = 128) and 3.3\% of men (n = 51). After adjustment for age, sex, race, body mass index, diabetes mellitus, systolic blood pressure, antihypertensive medication use, total:high-density lipoprotein cholesterol ratio, and smoking history, the ORs for CAD were 2.05 (95\% CI 1.38 to 3.04) and for CVD were 2.07 (1.43 to 3.00) for subjects with RLS compared to those without RLS. The associations of RLS with CAD and CVD were stronger in those with RLS symptoms at least 16 times per month and were stronger in those with severe than in those with moderately bothersome symptoms.

CONCLUSIONS: Restless legs syndrome (RLS) is associated with prevalent coronary artery disease and cardiovascular disease. This association appears stronger in those with greater frequency or severity of RLS symptoms.

}, keywords = {Aged, Body Mass Index, Cardiovascular Diseases, Cross-Sectional Studies, Evaluation Studies as Topic, Female, Health Surveys, Humans, Logistic Models, Male, Middle Aged, Odds Ratio, Prevalence, Restless Legs Syndrome, Surveys and Questionnaires}, issn = {1526-632X}, doi = {10.1212/01.wnl.0000287072.93277.c9}, author = {Winkelman, John W and Shahar, Eyal and Sharief, Imran and Gottlieb, Daniel J} } @article {1105, title = {Polysomnographic and health-related quality of life correlates of restless legs syndrome in the Sleep Heart Health Study.}, journal = {Sleep}, volume = {32}, year = {2009}, month = {2009 Jun}, pages = {772-8}, abstract = {

STUDY OBJECTIVES: Sleep disturbance is the primary clinical morbidity of restless legs syndrome (RLS). To date, sleep disturbance in RLS has been measured in (1) clinical samples with polysomnography (PSG) or (2) population-based samples by self-report. The objective of this study was to analyze sleep by PSG in a population-based sample with symptoms of RLS.

DESIGN: Cross-sectional observational study.

SETTING: Community-based.

PARTICIPANTS: 3433 older men and women.

INTERVENTIONS: None.

MEASUREMENTS AND RESULTS: RLS was evaluated using an 8-item self-administered questionnaire based on NIH diagnostic criteria and required symptoms occurring > or = five times per month and associated with at least moderate distress. Health-related quality of life (HRQOL) was determined using the SF-36. Unattended, in-home PSG was performed. Data were assessed using general linear models with adjustment for demographic, health-related variables, and apnea-hypopnea index (AHI). Subjects with RLS had longer adjusted mean sleep latency (39.8 vs 26.4 min, P < 0.0001) and higher arousal index (20.1 vs 18.0, P = 0.0145) than those without RLS. Sleep latency increased progressively as the frequency of RLS symptoms increased from 5-15 days per month to 6-7 days per week. No differences in sleep stage percentages were observed between participants with and without RLS. Subjects with RLS also reported poorer HRQOL in all physical domains as well as in the Mental Health and Vitality domains.

CONCLUSIONS: These novel PSG data from a nonclinical, community-based sample of individuals with RLS document sleep disturbance in the home even in individuals with intermittent symptoms.

}, keywords = {Adult, Aged, Cohort Studies, Comorbidity, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Polysomnography, Prospective Studies, Quality of Life, Restless Legs Syndrome, Sleep Initiation and Maintenance Disorders, Statistics as Topic}, issn = {0161-8105}, author = {Winkelman, John W and Redline, Susan and Baldwin, Carol M and Resnick, Helaine E and Newman, Anne B and Gottlieb, Daniel J} }