Restless Legs Syndrome and fatigue in multiple sclerosis: A cross-sectional clinical study

Mult Scler Relat Disord. 2023 Nov:79:104946. doi: 10.1016/j.msard.2023.104946. Epub 2023 Aug 19.

Abstract

Background: Restless Legs Syndrome is a sleep-related sensorimotor disorder with a higher prevalence in Multiple Sclerosis (MS) patients than in the general population. Our aim was to determine the prevalence of RLS in a group of relapsing-remittent multiple sclerosis (RRMS) patients, and to investigate whether RLS is associated with MS-related disability, sleep quality, mood disorders and fatigue.

Methods: In this retrospective, mono-centric, observational study, 92 RRMS patients were recruited (median age 46.5 years, 68.5% female patients). Data on MS clinical and radiological variables were collected. Patients underwent a subjective evaluation with standardized questionnaires on sleep fatigue and mood, which were evaluated by an expert neurologists specialized in sleep disorders about the occurrence of RLS.

Results: Prevalence of RLS in our sample was of 47.8%. Patients with RLS had a significantly higher rate of worse sleep quality and fatigue, compared to non RLS subjects (respectively 56.8% vs. 35.4%, p=0.04 and 54.4% vs 22.7%, p=0.002). Univariate analysis showed that RLS was significantly more frequent in fatigued patients (66.7% vs 38.5% RLS- patients, p=0.009). Multivariate analysis showed that fatigue correlated with MS-related disability (OR 1.556, p=0.011), poor sleep quality (OR 1.192, p 0.036), and mood disorders (OR 1.096, p 0.046). RLS appears to independently increase the risk of fatigue of 50%, without reaching clear statistical significance (OR 1.572, p 0,0079).

Conclusion: Our study confirms the high prevalence of RLS in patients with multiple sclerosis and highlights the potential impact of RLS on fatigue and its strict interaction with sleep quality.

Keywords: Fatigue; Multiple sclerosis; Restless Legs Syndrome; Sleep disorders; Sleep quality.

Publication types

  • Observational Study

MeSH terms

  • Cross-Sectional Studies
  • Fatigue / complications
  • Fatigue / etiology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Multiple Sclerosis* / complications
  • Multiple Sclerosis* / epidemiology
  • Prevalence
  • Restless Legs Syndrome* / epidemiology
  • Retrospective Studies
  • Sleep Wake Disorders* / complications
  • Sleep Wake Disorders* / etiology
  • Surveys and Questionnaires