Effects of Depression on Sleep Quality, Fatigue, and Sleepiness in Persons With Restless Legs Syndrome

BACKGROUND: Restless legs syndrome is a sleep disorder that is associated with depression and poor sleep quality; it possibly affects sleepiness and fatigue, thereby affecting quality of life. OBJECTIVE: To determine the effect of depression on sleep quality, sleepiness, and fatigue in persons with restless legs syndrome. STUDY DESIGN: Descriptive, comparative study. Data was collected on demographics, depression, sleep quality, sleepiness, and fatigue. Participants were grouped based on depression scores. RESULTS: 40% of the sample reported depressive symptomology. Depressed participants had significantly worse sleep quality (t=4.12, df=40, p<.001) and fatigue (t=3.69, df=46, p=.001). Depression did not affect sleepiness (p=.733). CONCLUSIONS: Persons with restless legs syndrome who are depressed have poorer sleep quality and higher fatigue than nondepressed persons with restless legs syndrome. Few participants are being treated for depression. Health care providers must recognize the impact that depression has on persons with restless legs syndrome and develop innovative nonpharmacological strategies to help with depression.

[1]  J. Aldenhoff,et al.  Case management for the treatment of patients with major depression in general practices – rationale, design and conduct of a cluster randomized controlled trial – PRoMPT (Primary care Monitoring for depressive Patient's Trial) [ISRCTN66386086] – Study protocol , 2005, BMC public health.

[2]  U. Keil,et al.  Prevalence and risk factors of RLS in an elderly population , 2000, Neurology.

[3]  Richard P Allen,et al.  Impact, diagnosis and treatment of restless legs syndrome (RLS) in a primary care population: the REST (RLS epidemiology, symptoms, and treatment) primary care study. , 2004, Sleep medicine.

[4]  P. Anderer,et al.  EEG mapping in patients with restless legs syndrome as compared with normal controls , 2002, Psychiatry Research: Neuroimaging.

[5]  F. Goodwin,et al.  The de facto US mental and addictive disorders service system. Epidemiologic catchment area prospective 1-year prevalence rates of disorders and services. , 1993, Archives of general psychiatry.

[6]  Olga V. Demler,et al.  Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. , 2005, Archives of general psychiatry.

[7]  R A Haslam,et al.  Anxiety and depression in the workplace: effects on the individual and organisation (a focus group investigation). , 2005, Journal of affective disorders.

[8]  M. Kryger,et al.  Sleep complaints are common in a dialysis unit. , 1995, American journal of kidney diseases : the official journal of the National Kidney Foundation.

[9]  A. Leon,et al.  Role of antidepressants in murder and suicide. , 2002, The American journal of psychiatry.

[10]  P. Janicak Principles and Practice of Psychopharmacotherapy , 1993 .

[11]  T. Roth,et al.  Sleep and Pain: Interaction of Two Vital Functions , 2005, Seminars in neurology.

[12]  Sung-Wan Kim,et al.  Bupropion may improve restless legs syndrome: a report of three cases. , 2005, Clinical neuropharmacology.

[13]  A. Badawy Alcohol and violence and the possible role of serotonin. , 2003, Criminal behaviour and mental health : CBMH.

[14]  M. Atkinson,et al.  Validation of the Restless Legs Syndrome Quality of Life Instrument (RLS-QLI): Findings of a Consortium of National Experts and the RLS Foundation , 2004, Quality of Life Research.

[15]  Amar K. Das,et al.  Depression in African Americans: breaking barriers to detection and treatment. , 2006, The Journal of family practice.

[16]  W. Katon,et al.  Outcomes of “Inadequate” antidepressant treatment , 1995, Journal of General Internal Medicine.

[17]  J E Schwartz,et al.  The measurement of fatigue: a new instrument. , 1993, Journal of psychosomatic research.

[18]  B. Sen Adolescent propensity for depressed mood and help seeking: race and gender differences. , 2004, The journal of mental health policy and economics.

[19]  D. Hui,et al.  Prevalence of sleep disturbances in Chinese patients with end stage renal failure on maintenance hemodialysis. , 2002, Medical science monitor : international medical journal of experimental and clinical research.

[20]  B. Pollock,et al.  Late‐onset major depression: clinical and treatment‐response variability , 2005, International journal of geriatric psychiatry.

[21]  E. Álvarez,et al.  [Knowledge and perception about depression in the Spanish population]. , 2004, Actas espanolas de psiquiatria.

[22]  N. Carter,et al.  Prevalence of restless legs syndrome among men aged 18 to 64 years: An association with somatic disease and neuropsychiatric symptoms , 2001, Movement disorders : official journal of the Movement Disorder Society.

[23]  K. Tanaka,et al.  The features of psychological problems and their significance in patients on hemodialysis--with reference to social and somatic factors. , 1999, Clinical nephrology.

[24]  M. Johns,et al.  A new method for measuring daytime sleepiness: the Epworth sleepiness scale. , 1991, Sleep.

[25]  S. Chokroverty,et al.  A questionnaire study of 138 patients with restless legs syndrome , 1996, Neurology.

[26]  L. Radloff The CES-D Scale , 1977 .

[27]  W. Blättler,et al.  [Restless legs and nocturnal leg spasms--forgotten facts in diagnosis--new facts for therapy]. , 1982, Schweizerische medizinische Wochenschrift.

[28]  M. Johns,et al.  Reliability and factor analysis of the Epworth Sleepiness Scale. , 1992, Sleep.

[29]  A. Mitchell,et al.  Prognosis of depression in old age compared to middle age: a systematic review of comparative studies. , 2005, The American journal of psychiatry.

[30]  Maurice M Ohayon,et al.  The effects of breathing-related sleep disorders on mood disturbances in the general population. , 2003, The Journal of clinical psychiatry.

[31]  Kathleen M Griffiths,et al.  Stigma about Depression and its Impact on Help-Seeking Intentions , 2006, The Australian and New Zealand journal of psychiatry.

[32]  J. Savarino,et al.  Suicide risk during antidepressant treatment. , 2006, The American journal of psychiatry.

[33]  C. Ko,et al.  Self-stigma and its correlates among outpatients with depressive disorders. , 2005, Psychiatric services.

[34]  T. Miyaoka,et al.  CSF iron, ferritin and transferrin levels in restless legs syndrome , 2005, Journal of sleep research.

[35]  B. Ehrenberg,et al.  An algorithm for the management of restless legs syndrome. , 2004, Mayo Clinic proceedings.

[36]  Christopher Earley,et al.  Toward a better definition of the restless legs syndrome , 1995, Movement disorders : official journal of the Movement Disorder Society.

[37]  W. Hening,et al.  The clinical neurophysiology of the restless legs syndrome and periodic limb movements. Part I: diagnosis, assessment, and characterization , 2004, Clinical Neurophysiology.

[38]  D. Dinges,et al.  Neurocognitive Consequences of Sleep Deprivation , 2005, Seminars in neurology.

[39]  M. Ohayon,et al.  Prevalence of restless legs syndrome and periodic limb movement disorder in the general population. , 2002, Journal of psychosomatic research.

[40]  J. Montplaisir,et al.  The influence of sex, age and sleep/wake state on characteristics of periodic leg movements in restless legs syndrome patients , 1999, Clinical Neurophysiology.

[41]  M. Thase Correlates and consequences of chronic insomnia. , 2005, General hospital psychiatry.

[42]  N. Larocca,et al.  The fatigue severity scale. Application to patients with multiple sclerosis and systemic lupus erythematosus. , 1989, Archives of neurology.

[43]  S. Rogus Restless Legs Syndrome: Detection and Management in Primary Care , 2000 .

[44]  G Klösch,et al.  Normal IPT and IBZM SPECT in drug naive and levodopa-treated idiopathic restless legs syndrome. , 2001, Neurology.

[45]  A. Desautels,et al.  Identification of a major susceptibility locus for restless legs syndrome on chromosome 12q. , 2001, American journal of human genetics.

[46]  Á. Comas,et al.  Conocimiento y percepción de la depresión entre la población española , 2004 .

[47]  G. Simon,et al.  Recognition, management, and outcomes of depression in primary care. , 1995, Archives of family medicine.

[48]  Olga V. Demler,et al.  The epidemiology of major depressive disorder: results from the National Comorbidity Survey Replication (NCS-R). , 2003, JAMA.

[49]  L. Krupp,et al.  Fatigue and declines in cognitive functioning in multiple sclerosis , 2000, Neurology.

[50]  P. Andersen,et al.  Do antidepressants prevent suicide? , 2006, International clinical psychopharmacology.

[51]  R. Post Adjunctive strategies in the treatment of refractory bipolar depression: clinician options in the absence of a systematic database , 2005, Expert opinion on pharmacotherapy.

[52]  W. Hall How have the SSRI antidepressants affected suicide risk? , 2006, The Lancet.

[53]  L. Egede Beliefs and Attitudes of African Americans With Type 2 Diabetes Toward Depression , 2002, The Diabetes educator.