High rate of restless legs syndrome in fibromyalgia

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A study in the October 15 issue of the    Journal of Clinical Sleep Medicine  found that  adults with   fibromyalgia had a prevalence and   risk much higher than restless leg syndrome   the  controls   healthy. The study suggests that the treatment of RLS can improve sleep and quality of life in people with fibromyalgia.

The results show that the prevalence of restless leg syndrome is approximately 10 times higher in the fibromyalgia group (33 percent) than in the controls (3.1 percent). After statistical adjustments for possible confounding factors, such as age, sex and ethnicity, participants with fibromyalgia were 11 times more likely than controls to have RLS (odds ratio = 11.2). As expected, participants with fibromyalgia reported considerable sleep disruption with the Pittsburgh Sleep Quality Index, insomnia and the Epworth severity index of sleepiness. In the fibromyalgia group, these sleep problems were more severe in people who also had RLS.

“Sleep disorders are common in fibromyalgia and often difficult to treat,” said lead author Dr. Nathaniel F. Watson, an associate professor of neurology at the University of Washington in Seattle, Washington. “From our study, it appears that an important part of sleep disturbances in fibromyalgia is due to restless legs syndrome.”

The research team led by Dr. Watson and lead author Dr. Mari Viola-Saltzman of Loyola University Medical Center in Maywood, Illinois, studied 172 people with fibromyalgia who had a mean age of 50 years; 93 percent were women. They were compared with 63 healthy controls with an average age of 41 years.

Fibromyalgia was identified by self-report or review of clinical history, and was confirmed in the review according to published guidelines regarding the presence of chronic and widespread pain. The pain was assessed by the subjective relationship and objective measurement with a pain meter, a spring meter that is used to apply standardized pressure points that offer points on the arms and legs.

According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, fibromyalgia can cause significant pain and fatigue. It is estimated that it affects 5 million Americans 18 years of age or older, and between 80 and 90 percent of people with fibromyalgia are women. The causes of fibromyalgia remain unknown ..

The restless legs syndrome was diagnosed using a self-administered and validated questionnaire. SPI is a movement disorder related to sleep that involves a desire to move the legs that is usually accompanied or caused by unpleasant and unpleasant sensations in the legs. This desire begins or deteriorates during periods of rest or inactivity, is partially or totally resolved by movement and deteriorates or occurs only at night. SPI occurs 1.5 to twice more in women than in men.

Watson noted that the treatment of restless legs syndrome can be one of the keys to reduce fatigue and improve the quality of life of people with fibromyalgia. SPI can often be treated successfully with a medication such as pramipexole or ropinirole.

“Since restless legs syndrome is a treatable disease, the diagnosis and treatment of RLS in patients with fibromyalgia has the potential to improve their sleep,” Watson said.

According to the authors, the cross-sectional nature of the study did not allow an examination of causality. However, several aspects of the two syndromes suggest a logical superposition. Both disorders involve sensory abnormalities and a similar pathophysiology of the system that regulates dopamine for both syndromes has been proposed. In addition, restless legs syndrome can be induced by antidepressants, which are a common treatment for pain and depression in fibromyalgia. In addition, it has been shown that exercise improves the symptoms of both syndromes.

The study was supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institute of Health and by the National Fibromyalgia Research Association.

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