Summary: A new study links restless leg syndrome to poor quality sleep and poor daytime function in pregnant women. RLS is common in pregnant women, especially in the third trimester. It is estimated up to 36% of women suffer RLS at some point during pregnancy. Researchers say identifying and treating RLS could help alleviate some of the burden of the symptoms.
New study shows relationship between RLS and sleep-wake disturbances.
A new study of pregnant women shows that restless legs syndrome (RLS) is common and is strongly associated with poor sleep quality, excessive daytime sleepiness, and poor daytime function, which are frequent complaints during pregnancy.
Results show that 36 percent of women in their third trimester had RLS, and half of the women with RLS had moderate to severe symptoms. Compared with pregnant women without RLS, those with RLS were twice as likely to report poor sleep quality and poor daytime function, and they were also more likely to have excessive daytime sleepiness. Additionally, the study found a positive dose-response relationship between RLS severity and the sleep-wake disturbances.
“While we expected that RLS would be relatively common in pregnant women, we were surprised to observe just how many had a severe form,” said lead author Galit Levi Dunietz, PhD, a T32 post-doctoral research fellow at the University of Michigan Sleep Disorders Center in Ann Arbor. “These women experienced RLS symptoms at least four times per week.”
Study results are published in the July 15 issue of the Journal of Clinical Sleep Medicine.
The study involved 1,563 pregnant women with an average age of 30 years, each of whom was in her third trimester. RLS was diagnosed using the standardized criteria of self-reported symptoms and frequency. Demographic and pregnancy data were extracted from medical records, and sleep information was collected with questionnaires. The study found no evidence for any association between RLS and delivery outcomes.
According to the authors, health care providers often dismiss patient complaints of poor sleep and daytime sleepiness during pregnancy.
“These sleep-wake disturbances are considered common symptoms in pregnancy and are frequently attributed to physiological changes that occur in normal pregnancy, but our data suggest that RLS is an additional contributor to these symptoms,” said Dunietz.
The authors suggest that the identification and treatment of RLS in pregnancy – using non-pharmacological approaches – may alleviate the burden of these symptoms for many women.
Funding: This study was partially supported by a T32 Grant from the National Institute of Neurological Disorders and Stroke (NIH/NINDS T32 NS007222) and by the Gene and Tubie Gilmore Fund for Sleep Research, the University of Michigan Institute for Clinical and Health Research (MICHR) grant UL1TR000433, MICHR seed pilot grant F021024, and the National Heart, Lung, and Blood Institute (R21 HL089918).
Source: Corinne Lederhouse – AASM
Image Source: NeuroscienceNews.com image is credited to Dunietz GL, et al. J Clin Sleep Med. 2017;13(7):863-870. American Academy of Sleep Medicine.
Original Research: Full open access research for “Restless Legs Syndrome and Sleep-Wake Disturbances in Pregnancy” by Galit Levi Dunietz, PhD; Lynda D. Lisabeth, PhD; Kerby Shedden, PhD; Q. Afifa Shamim-Uzzaman, MD; Alexandra S. Bullough, MBChB; Mark C. Chames, MD; Marc F. Bowden; and Louise M. O’Brien, PhD in Journal of Clinical Sleep Medicine. Published online July 13 2017 doi:10.5664/jcsm.6654
Restless Legs Syndrome and Sleep-Wake Disturbances in Pregnancy
To estimate the association of restless legs syndrome (RLS) and its frequency with sleep-wake disturbances in pregnancy.
A cohort of 1,563 women in their third trimester of pregnancy were recruited from prenatal clinics between March 2007 and December 2010. Demographic, pregnancy, and delivery data were extracted from medical records and sleep information was collected with questionnaires. To diagnose RLS, we used standardized criteria of RLS symptoms and frequency that were developed by the International Restless Legs Study Group. Logistic regression models were constructed to investigate the association of RLS and its frequency with sleep-wake disturbances (poor sleep quality, daytime sleepiness, poor daytime function) and delivery outcomes.
Overall 36% of the pregnant women had RLS, and half had moderate to severe symptoms. Compared to women without RLS, those with RLS were more likely to have poor sleep quality (odds ratio [OR] 2.2, 95% confidence interval [CI] 1.7–2.9), poor daytime function (OR 1.9, 95% CI 1.4–2.4), and excessive daytime sleepiness (OR 1.6, 95% CI 1.3–2.0). A dose-response relationship also was evident between RLS frequency and each of the sleep-wake disturbances. There was no evidence for any association between RLS and delivery outcomes.
RLS is a significant contributor to poor sleep quality, daytime sleepiness, and poor daytime function, all common and often debilitating conditions in pregnancy. Obstetric health care providers should be aware of these associations and screen women for RLS.
“Restless Legs Syndrome and Sleep-Wake Disturbances in Pregnancy” by Galit Levi Dunietz, PhD; Lynda D. Lisabeth, PhD; Kerby Shedden, PhD; Q. Afifa Shamim-Uzzaman, MD; Alexandra S. Bullough, MBChB; Mark C. Chames, MD; Marc F. Bowden; and Louise M. O’Brien, PhD in Journal of Clinical Sleep Medicine. Published online July 13 2017 doi:10.5664/jcsm.6654