Restless Legs Syndrome and Sleep-Wake Disturbances in Pregnancy.

STUDY OBJECTIVES To estimate the association of restless legs syndrome (RLS) and its frequency with sleep-wake disturbances in pregnancy. METHODS 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. RESULTS 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. CONCLUSIONS 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. COMMENTARY A commentary on this article appears in this issue on page 857.

[1]  R. A. Sáenz,et al.  Problems , 2017 .

[2]  E. Svanborg,et al.  Postpartum depressive symptoms and its association to daytime sleepiness and restless legs during pregnancy , 2016, BMC Pregnancy and Childbirth.

[3]  M. Hallett,et al.  Restless legs syndrome and pregnancy: prevalence, possible pathophysiological mechanisms and treatment , 2016, Acta neurologica Scandinavica.

[4]  K. Innes,et al.  The Relationship of Restless Legs Syndrome to History of Pregnancy-Induced Hypertension. , 2016, Journal of women's health.

[5]  G. Bourjeily,et al.  Restless Legs Symptoms and Pregnancy and Neonatal Outcomes. , 2016, Clinical therapeutics.

[6]  Yunzhe Wang,et al.  Restless legs syndrome and pregnancy or delivery complications in China: a representative survey. , 2016, Sleep medicine.

[7]  V. Sreenivas,et al.  Sleep disorders in pregnancy and their association with pregnancy outcomes: a prospective observational study , 2016, Sleep and Breathing.

[8]  Zahra Meharaban,et al.  Restless Legs Syndrome During Pregnancy and Preterm Birth in Women Referred to Health Centers of Ardabil , 2015, Iranian Red Crescent medical journal.

[9]  P. Gander,et al.  Self-reported sleep in late pregnancy in relation to birth size and fetal distress: the E Moe, Māmā prospective cohort study , 2015, BMJ Open.

[10]  Kathryn A. Lee,et al.  Consensus clinical practice guidelines for the diagnosis and treatment of restless legs syndrome/Willis-Ekbom disease during pregnancy and lactation. , 2015, Sleep medicine reviews.

[11]  Jinjian Yang,et al.  Restless legs syndrome and hypertension in Chinese pregnant women , 2015, Neurological Sciences.

[12]  M. Hallett,et al.  Restless legs syndrome and pregnancy: a review. , 2014, Parkinsonism & related disorders.

[13]  H. Völzke,et al.  Multimorbidity and the risk of restless legs syndrome in 2 prospective cohort studies , 2014, Neurology.

[14]  M. Dolatian,et al.  The effect of impaired sleep on preterm labour. , 2014, The West Indian medical journal.

[15]  M. Rohani,et al.  Prevalence and associated features of restless legs syndrome in a population of Iranian women during pregnancy , 2013, International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics.

[16]  C. Bassetti,et al.  Is preeclampsia associated with restless legs syndrome? , 2013, Sleep medicine.

[17]  H. Völzke,et al.  A time sequence analysis of the relationship between cardiovascular risk factors, vascular diseases and restless legs syndrome in the general population , 2013, Journal of sleep research.

[18]  P. Valkovič,et al.  Prevalence and impact of restless legs syndrome in pregnancy. , 2013, Neuro endocrinology letters.

[19]  Chie-Pein Chen,et al.  Risk factors and prevalence rate of restless legs syndrome among pregnant women in Taiwan. , 2012, Sleep medicine.

[20]  R. O'Hara,et al.  Epidemiology of restless legs syndrome: a synthesis of the literature. , 2012, Sleep medicine reviews.

[21]  K. Innes,et al.  Restless legs syndrome and conditions associated with metabolic dysregulation, sympathoadrenal dysfunction, and cardiovascular disease risk: a systematic review. , 2012, Sleep medicine reviews.

[22]  E. Svanborg,et al.  Restless legs syndrome during and after pregnancy and its relation to snoring , 2012, Acta obstetricia et gynecologica Scandinavica.

[23]  B. Backe,et al.  Restless legs syndrome in pregnancy is a frequent disorder with a good prognosis , 2011, Acta obstetricia et gynecologica Scandinavica.

[24]  Richard P Allen,et al.  Prevalence and disease burden of primary restless legs syndrome: Results of a general population survey in the United States , 2011, Movement disorders : official journal of the Movement Disorder Society.

[25]  P. Ingrand,et al.  Restless Legs Syndrome and Pregnancy: Follow-Up of Pregnant Women before and after Delivery , 2010, European Neurology.

[26]  G. Bouche,et al.  Restless Legs Syndrome and Pregnancy: A Questionnaire Study in the Poitiers District, France , 2010, European Neurology.

[27]  M. Gultekin,et al.  Restless legs syndrome and pregnancy in Kayseri, Turkey: A hospital based survey , 2010 .

[28]  S. Duntley,et al.  Sleep deprivation during pregnancy and maternal and fetal outcomes: is there a relationship? , 2010, Sleep medicine reviews.

[29]  E. Yokoyama,et al.  Prevalence of restless legs syndrome with pregnancy and the relationship with sleep disorders in the Japanese large population , 2008 .

[30]  J. Ulfberg,et al.  Restless legs syndrome among women: prevalence, co-morbidity and possible relationship to menopause , 2008, Climacteric : the journal of the International Menopause Society.

[31]  Y. Karadag,et al.  Predisposing factors of restless legs syndrome in pregnancy , 2007, Movement disorders : official journal of the Movement Disorder Society.

[32]  L. Regeur,et al.  Prevalence, severity and risk factors of restless legs syndrome in the general adult population in two Scandinavian countries. , 2005, Sleep medicine.

[33]  Richard P Allen,et al.  Restless legs syndrome prevalence and impact: REST general population study. , 2005, Archives of internal medicine.

[34]  Kathryn A. Lee,et al.  Sleep in late pregnancy predicts length of labor and type of delivery. , 2004, American journal of obstetrics and gynecology.

[35]  L Ferini-Strambi,et al.  Restless legs syndrome and pregnancy , 2004, Neurology.

[36]  W. Hening.  Restless legs syndrome: the most common and least diagnosed sleep disorder. , 2004, Sleep medicine.

[37]  R. Allen,et al.  Evaluating the quality of life of patients with restless legs syndrome. , 2004, Clinical therapeutics.

[38]  E. Granieri,et al.  Pregnancy as a risk factor for restless legs syndrome. , 2004, Sleep medicine.

[39]  Kathryn A. Lee,et al.  Sleep Patterns and Fatigue in New Mothers and Fathers , 2004, Biological research for nursing.

[40]  U. John,et al.  Sex and the risk of restless legs syndrome in the general population. , 2004, Archives of internal medicine.

[41]  E. Yokoyama,et al.  The prevalence of restless legs syndrome among pregnant women in Japan and the relationship between restless legs syndrome and sleep problems. , 2003, Sleep.

[42]  Richard P Allen,et al.  Restless legs syndrome: diagnostic criteria, special considerations, and epidemiology. A report from the restless legs syndrome diagnosis and epidemiology workshop at the National Institutes of Health. , 2003, Sleep medicine.

[43]  T. Young,et al.  Epidemiology of restless legs symptoms in adults. , 2000, Archives of internal medicine.

[44]  G. Lavigne,et al.  Restless legs syndrome and sleep bruxism: prevalence and association among Canadians. , 1994, Sleep.

[45]  M. Johns.  Daytime sleepiness, snoring, and obstructive sleep apnea. The Epworth Sleepiness Scale. , 1993, Chest.

[46]  Kathryn A. Lee,et al.  Sleep disturbances, vitality, and fatigue among a select group of employed childbearing women. , 1992, Birth.

[47]  Kathryn A. Lee,et al.  Self-reported sleep disturbances in employed women. , 1992, Sleep.