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The urge to move and breathe - the impact of obstructive sleep apnea syndrome treatment in patients with previously diagnosed, clinically significant restless legs syndrome.
Sleep Med 2017; 38:17-20SM

Abstract

OBJECTIVE

The association between restless legs syndrome (RLS) and obstructive sleep apnea syndrome (OSAS) has seldom been reported. There is one study reporting improvement of RLS symptoms severity in patients naive of treatment after initiation of continuous positive airway pressure (CPAP) for OSAS. The aim of this study was to evaluate the impact of the OSAS treatment in patients with previously diagnosed, clinically significant RLS in a usual clinical setting.

METHODS

This was a retrospective study of RLS patients from a sleep clinic with a concomitant or subsequent diagnosis of OSAS. All patients who started treatment for OSAS and had a follow-up of ≥3 months were selected. Exclusion criteria included noncompliance, absence of sufficient information on clinical records, and RLS improvement following treatment of secondary causes. The primary outcome variable was clinical status of RLS symptoms following OSA treatment. Other variables included demographics, RLS treatment and outcome, OSA diagnosis, treatment, compliance, outcome, and PSG characteristics.

RESULTS

From a database of 97 RLS patients, 56 patients had both OSA and RLS. Of these patients, 28 met the criteria for the study. In all, 17 patients (60.9%) were female, with a mean age 60 years. A total of 16 patients (57.1%) were diagnosed with idiopathic RLS. OSAS was diagnosed, on average, 21 months after the RLS diagnosis. A total of 19 (70.4%) patients were overweight or obese, 26 (92.9%) reported snoring, and 10 (35.7%) witnessed apneas. A total of 16 patients (57.1%) had excessive daytime sleepiness and 23 (84.1%) had insomnia. The mean apnea-hypopnea index was 19. Patients were mostly treated with dopamine agonists (19 patients, 67.9%) for the RLS, and nine patients were treated with more than two drugs for RLS. A total of 20 patients (71.4%) had improvement of symptoms of RLS after therapy for OSAS, of whom nine stopped drug therapy and eight reduced the dose.

CONCLUSIONS

In patients with clinically significant RLS, treatment of concomitant OSAS significantly improved RLS symptoms, enabling drug therapy reduction in more than half of the patients. These data reinforce the need to actively diagnose OSAS in RLS patients.

Authors+Show Affiliations

Department of Neurosciences, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon, Portugal. Electronic address: cristianafhsilva@gmail.com.Department of Neurosciences, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon, Portugal; EEG/Sleep Laboratory, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon, Portugal; Faculty of Medicine, Lisbon University, Lisbon, Portugal.Department of Neurosciences, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon, Portugal; EEG/Sleep Laboratory, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon, Portugal; Faculty of Medicine, Lisbon University, Lisbon, Portugal.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29031750

Citation

Silva, Cristiana, et al. "The Urge to Move and Breathe - the Impact of Obstructive Sleep Apnea Syndrome Treatment in Patients With Previously Diagnosed, Clinically Significant Restless Legs Syndrome." Sleep Medicine, vol. 38, 2017, pp. 17-20.
Silva C, Peralta AR, Bentes C. The urge to move and breathe - the impact of obstructive sleep apnea syndrome treatment in patients with previously diagnosed, clinically significant restless legs syndrome. Sleep Med. 2017;38:17-20.
Silva, C., Peralta, A. R., & Bentes, C. (2017). The urge to move and breathe - the impact of obstructive sleep apnea syndrome treatment in patients with previously diagnosed, clinically significant restless legs syndrome. Sleep Medicine, 38, pp. 17-20. doi:10.1016/j.sleep.2017.06.023.
Silva C, Peralta AR, Bentes C. The Urge to Move and Breathe - the Impact of Obstructive Sleep Apnea Syndrome Treatment in Patients With Previously Diagnosed, Clinically Significant Restless Legs Syndrome. Sleep Med. 2017;38:17-20. PubMed PMID: 29031750.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The urge to move and breathe - the impact of obstructive sleep apnea syndrome treatment in patients with previously diagnosed, clinically significant restless legs syndrome. AU - Silva,Cristiana, AU - Peralta,Ana Rita, AU - Bentes,Carla, Y1 - 2017/07/22/ PY - 2017/03/07/received PY - 2017/05/06/revised PY - 2017/06/12/accepted PY - 2017/10/17/entrez PY - 2017/10/17/pubmed PY - 2018/3/9/medline KW - Obstructive sleep apnea KW - Restless legs syndrome SP - 17 EP - 20 JF - Sleep medicine JO - Sleep Med. VL - 38 N2 - OBJECTIVE: The association between restless legs syndrome (RLS) and obstructive sleep apnea syndrome (OSAS) has seldom been reported. There is one study reporting improvement of RLS symptoms severity in patients naive of treatment after initiation of continuous positive airway pressure (CPAP) for OSAS. The aim of this study was to evaluate the impact of the OSAS treatment in patients with previously diagnosed, clinically significant RLS in a usual clinical setting. METHODS: This was a retrospective study of RLS patients from a sleep clinic with a concomitant or subsequent diagnosis of OSAS. All patients who started treatment for OSAS and had a follow-up of ≥3 months were selected. Exclusion criteria included noncompliance, absence of sufficient information on clinical records, and RLS improvement following treatment of secondary causes. The primary outcome variable was clinical status of RLS symptoms following OSA treatment. Other variables included demographics, RLS treatment and outcome, OSA diagnosis, treatment, compliance, outcome, and PSG characteristics. RESULTS: From a database of 97 RLS patients, 56 patients had both OSA and RLS. Of these patients, 28 met the criteria for the study. In all, 17 patients (60.9%) were female, with a mean age 60 years. A total of 16 patients (57.1%) were diagnosed with idiopathic RLS. OSAS was diagnosed, on average, 21 months after the RLS diagnosis. A total of 19 (70.4%) patients were overweight or obese, 26 (92.9%) reported snoring, and 10 (35.7%) witnessed apneas. A total of 16 patients (57.1%) had excessive daytime sleepiness and 23 (84.1%) had insomnia. The mean apnea-hypopnea index was 19. Patients were mostly treated with dopamine agonists (19 patients, 67.9%) for the RLS, and nine patients were treated with more than two drugs for RLS. A total of 20 patients (71.4%) had improvement of symptoms of RLS after therapy for OSAS, of whom nine stopped drug therapy and eight reduced the dose. CONCLUSIONS: In patients with clinically significant RLS, treatment of concomitant OSAS significantly improved RLS symptoms, enabling drug therapy reduction in more than half of the patients. These data reinforce the need to actively diagnose OSAS in RLS patients. SN - 1878-5506 UR - https://www.unboundmedicine.com/medline/citation/29031750/The_urge_to_move_and_breathe___the_impact_of_obstructive_sleep_apnea_syndrome_treatment_in_patients_with_previously_diagnosed_clinically_significant_restless_legs_syndrome_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1389-9457(17)30290-3 DB - PRIME DP - Unbound Medicine ER -