Clinical reviewEpidemiology of restless legs syndrome: A synthesis of the literature
Introduction
Restless legs syndrome (RLS) was first depicted in 1685 by Sir Thomas Willis, an English physician, in a sharp description of patients who cannot fall asleep because of «leapings and contractions» of the arms and legs. Sir Willis wrote that «restlessness and tossing» could be so severe that the patients «are no more able to sleep than if they were in a place of a greatest torture».1 In the nineteen century, RLS was termed as «anxietas tibiarum» in Germany by Wittmaack.2 It was in 1945, while studying a group of eight patients, that the Swedish neurologist Karl-Axel Ekbom coined the term “restless-legs syndrome,” apparently unaware of Willis’ previous description indicating the syndrome could also involve the upper extremities.3
RLS is a sleep disorder affecting a significant portion of the general population. The syndrome has a strong family component, and several co-morbid conditions may be associated with RLS. Research over the past 10 years has highlighted its heritability and has shed some interesting light to this disorder.
Clinically, RLS is characterized by disagreeable leg sensations occurring most often at sleep onset that provoke an irresistible urge to move the legs. Patients with RLS typically complain of itching, creeping, tingling in their legs, usually between the ankle and the knee. These unpleasant sensations occur when the individual is at rest and are more pronounced in the evening or at night. The unpleasant sensations are relieved temporarily with leg movements.
Here we review the data-based publications on the epidemiology of RLS in the general population and in primary care settings including RLS’s impact as a disorder or co-morbid condition and provide a synthesis of the available literature.
Section snippets
Methodology
The articles utilized in this review included only peer-reviewed original studies published between 1994 and 2010 and written in English, French or Spanish. Databases searched were PubMed, PsycInfo, and PsycArticles. Search terms were “Restless leg” with “community” or “epidemiology,” or “primary care.” The search returned a total of 653 peer-reviewed articles. In addition, references cited in retrieved articles were screened for additional reports.
The inclusion criteria were
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Articles had to
Results
In the last 10 years, there has been a surge in the evaluation of RLS in the general population. 47 studies of the general population were utilized in this review. Before 2000, there was only one epidemiological study published on RLS. Nine were published between 2000 and 2004. The number increased to 27 articles between 2005 and 2009 with a further 10 articles appearing in 2010 alone. In primary care practice, 9 studies were retained. Three were done between 2000 and 2004; 4 between 2005 and
Conclusions
Epidemiologic knowledge of RLS has increased considerably recently, in fact, since 2005 epidemiological research on RLS has effectively blossomed.
This synthesis of the literature reveals that RLS prevalence rates are linked to:
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The way RLS is evaluated. Single-item studies have provided the highest RLS prevalence followed by studies having limited the assessment to the 4 minimal criteria described by the IRLSSG. In this last case, prevalence of RLS in the adult general population ranges between
Acknowledgment
M.M. Ohayon was supported by National Institutes of Health grant R01NS044199.
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