Restless Leg Syndrome in Patients Referred for Obstructive Sleep Apnea

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    • Abstract:
      BackgroundRestless leg syndrome (RLS) or Willis-Ekbom disease is a common disorder. It may present with excessive daytime sleepiness (EDS). EDS is seen often in obstructive sleep apnea (OSA) as well. Obesity and diabetes mellitus (DM) can be associated with both RLS and OSA. AimTo study the prevalence of RLS among patients with suspected OSA. Material and MethodA retrospective evaluation of data was performed from proforma of patients referred for polysomnographic evaluation of OSA from January 2015 to December 2015 at a tertiary care post-graduate teaching institute. The sleep proforma through which the datawas collected also had RLS diagnostic criteria. ResultOut of 69 patients who underwent the sleep study for suspected OSA, 9 (13%) patients fulfilled the diagnostic criteria of RLS. The majority of the patients i.e. 7/9 (78%) were women while 2/9 (22%) were men. The mean age was 50 ±3.5 years. History of excessive daytime sleepiness (EDS) was positive in 8 cases with the Epworth sleepiness score (ESS) of > 8. History of snoring was present in all 9 cases. Six out of 9 cases had a history of insomnia. The mean body mass index (BMI) was 34.5± 4.2 kg/m2. On polysomnography, three patients were diagnosed to have OSA with anapnea-hypopnea index of 5.2, 15 and 42 per hour. Periodic limb movement in sleep (PLMS) was documented in 7/9 (78%) patients. Eight out of 9 cases had secondary RLS, 4 due to diabetes, 2 had iron deficiency and the remaining 2 patients had RLS because of chronic obstructive pulmonary disease. ConclusionRLS is common among patients suspected with OSA. Screening of RLS should be done in all OSA suspect cases to prevent misdiagnosis and mismanagement of RLS in patients.