OBJECTIVE: To observe the clinical therapeutic effect of acupuncture (acupuncture for regulating the spirit) on restless leg syndrome and its concomitance symptoms of sleep disorder and anxiety, and to provide theoretical basis for the clinical application of acupuncture. METHODS: A total of 60 patients were randomized into an observation group and a control group, 30 cases in each one. Conventional acupuncture at lower limbs' acupoints such as Zusanli (ST 36), Yanglingquan (GB 34) and Xuanzhong (GB 39) was applied in the control group. On the basis of the control group, acupuncture at Baihui (GV 20), Shenting (GV 24) and Benshen (GB 13) was added in the observation group. In both groups, the treatment was given once a day, 6 times a week, one week as a course and totally 3 courses were required. Scores of international restless leg syndrome rating scale (IRLS), Pittsburgh sleep quality index (PSQI) and Hamilton anxiety scale (HAMA) were observed before and after treatment in the two groups. RESULTS: Compared before treatment, scores of IRLS, PSQI and HAMA after treatment were decreased in both groups (<0.05), and the improvement in the observation group was superior to the control group (<0.05). CONCLUSION On the basis of conventional acupuncture, acupuncture can effectively relieve the discomforts of the lower limbs in patients with restless leg syndrome, improve the sleep disorder and anxiety, which is better than conventional acupuncture.
Acupuncture Points ; Acupuncture Therapy ; Anxiety ; etiology ; therapy ; Humans ; Restless Legs Syndrome ; complications ; therapy ; Sleep Wake Disorders ; etiology ; therapy ; Treatment Outcome

Sleep disorders are one of the main symptoms of menopause. Symptoms of sleep disorders that menopausal women complain about include falling asleep, frequent awakening and/or early morning awakening. There are many possible causes of sleep disorders in postmenopausal women, including vasomotor symptoms, ovarian hormone changes, restless legs syndrome, periodic leg movement syndrome, and obstructive sleep apnea. In this review, we discuss the relationship between menopause and sleep disorders.
Accidental Falls ; Female ; Humans ; Leg ; Menopause ; Postmenopause ; Restless Legs Syndrome ; Sleep Apnea, Obstructive ; Sleep Wake Disorders

OBJECTIVE: To investigate the clinical features and implication of restless legs syndrome (RLS) in ischemic stroke patients. METHODS: A total of 199 ischemic stroke patients were enrolled and assessed by polysomnography (PSG). RLS was identified according to criteria of International Restless Legs Syndrome Study Group. Epworth Sleepiness Scale (ESS), Mini-mental State Examination (MMSE) and Patient Health Questionnaire (PHQ-9) were used to evaluate the sleep quality, cognitive function and post-stroke depression, respectively. The National Institute of Health Stroke Scale (NIHSS) was used to evaluate the neurological function 3 months after stroke onset. Gender-and age-matched non-ischemic stroke patients with RLS (primary PLS) were selected as controls. RESULTS: Twenty-two cases of RLS were identified among 199 ischemic stroke patients (11.1%). Generalized linear model and logistic regression showed that low serum ferritin level (=-133.3 mg/L, 95%:-200.4--0.1, <0.01), subcortical infarction (=4.05, 95%:1.15-14.18, <0.05) and female (=2.54, 95%:1.04-6.23, <0.05) were identified as the risk factors of RLS in ischemic stroke patients. Compared with ischemic stroke patients without RLS, ESS increased by 4.37 (95%:2.33-6.41, <0.01), PHQ-9 increased by 2.17 (95%:0.39--3.94, <0.05), and reduced NIHSS from the baseline deceased by 0.97 (95%:-1.79--0.15, <0.05) in ischemic stroke patients with RLS. In addition, the incidence of moderate-severe depression increased (=4.27, 95%:1.40-13.10, <0.05) in ischemic stroke patients with RLS. The index of periodic leg movements of sleep (PLMS) with arousal in ischemic stroke patients with RLS was significantly higher than that in patients with primary RLS (=12.85, 95%:2.04-23.67, <0.05). CONCLUSIONS RLS is common in ischemic stroke patients and has adverse influences on patients.
Brain Ischemia ; complications ; pathology ; Depression ; complications ; Female ; Humans ; Male ; Polysomnography ; Restless Legs Syndrome ; complications ; pathology ; Stroke ; complications ; pathology

Good sleep is necessary for good health. Sleep health is increasingly recognized as important for physical and mental health by both the medical profession and the general public, and there is great interest in how to avoid and treat sleep disorders and problems. Recent research indicates that insufficient sleep, disrupted sleep, and sleep disorders affect many aspects of human health including sexual function. In fact, patients with urological disorders or erectile dysfunction (ED) may have a sleep disorder that contributes to their urological or sexual dysfunction. Obstructive sleep apnea, insomnia, shift work disorder, and restless legs syndrome are all common sleep disorders and are associated with ED and/or other urological disorders. Therefore, careful attention should be paid to the diagnosis and treatment of concomitant sleep disorders in patients with sexual dysfunction. In this review, we provide an overview of what sleep is and how it is assessed in the clinic or laboratory; our current understanding of the functions of sleep and sleep health; a description of common sleep disorders, as well as how they are diagnosed and treated; and how sleep and its disorders are associated with male sexual dysfunction. Sleep is considered to be a ‘third pillar of health’, along with diet and exercise. With an understanding of common sleep disorders and how they can impact male sexual function, the urologist can ensure that sleep disorders are considered as a contributor to sexual dysfunction in their patients in order to provide them with the optimal treatment for overall health.
Diagnosis ; Diet ; Erectile Dysfunction ; Humans ; Male ; Mental Health ; Restless Legs Syndrome ; Sexual Dysfunctions, Psychological ; Sleep Apnea, Obstructive ; Sleep Initiation and Maintenance Disorders ; Sleep Wake Disorders ; Testosterone

BACKGROUND AND PURPOSE: We investigated the frequency and clinical features of restless legs syndrome (RLS) in patients with Parkinson's disease (PD). METHODS: This study included 74 PD patients. RLS was diagnosed in face-to-face assessments of all of the subjects based on diagnostic criteria of the International Restless Legs Syndrome Study Group revised in 2003. We analyzed the clinical features of PD patients with and without RLS and compared the data to idiopathic RLS. RESULTS: The frequency of RLS in the cohort was 21.6% (n=16). Two (12.5%) of the patients with RLS were not treated with dopaminergic drugs, while 14 (24.1%) of the 58 patients without RLS received treatment with dopaminergic drugs. Anxiety, depression, and quality of life (QoL) were significantly worst in patients with RLS. PD patients with RLS had significantly worse sleep quality (p=0.003) and worse scores on the cardiovascular subscale of the Scales for Outcomes in Parkinson's Disease for Autonomic Symptoms (p=0.031) compared to those without RLS. In the group of PD patients with RLS, RLS preceding PD onset was related to a lower Hoehn and Yahr stage. CONCLUSIONS: We found that the frequency of RLS in the present patients with PD was higher than that in our previous study of a general population of RLS subjects. Compared to the PD patients without RLS, the present PD patients with RLS suffered from worse sleep quality and QoL, depression, anxiety, and autonomic disturbances, especially those with cardiovascular problems.
Anxiety ; Cohort Studies ; Depression ; Dopamine Agents ; Humans ; Parkinson Disease ; Prevalence ; Primary Dysautonomias ; Quality of Life ; Restless Legs Syndrome ; Weights and Measures

BACKGROUND: The association between restless legs syndrome (RLS) and hypertension remains controversial. We investigated the relationship between RLS and hypertension in a nationwide sample of the Korean adult population. METHODS: This was a cross-sectional questionnaire-based study including 2,740 adults aged 19 years or more. Subjects who met the four essential International RLS Study Group criteria and reported symptoms occurring at least once a week were defined as the RLS group. The presence of hypertension was defined as a self-reported history of physician-diagnosed hypertension. We conducted multiple logistic regression analysis to determine the independent association between RLS symptoms and self-reported hypertension after adjusting for potential confounding factors. RESULTS: Among the 2,740 subjects, 68 (2.5%; 95% confidence interval [CI], 1.9%–3.1%) were found to have RLS with a symptom frequency of at least once a week. The prevalence of self-reported hypertension was 30.9% (95% CI, 20.5%–42.0%) in the RLS group, which was significantly higher than that in controls (12.4%; 95% CI, 11.2%–13.6%; P < 0.001). Multiple logistic regression analysis showed that the adjusted odds ratio for self-reported hypertension in the RLS group was 2.10 (95% CI, 1.12–3.93) compared to controls. In addition to RLS symptoms, old age, being overweight, low education level, diabetes mellitus, and short sleep duration were significantly associated with self-reported hypertension. CONCLUSION: RLS symptoms occurring at least once a week is independently associated with a higher prevalence of self-reported hypertension in the adult Korean population. Further research will confirm the clinical implication of the present results and the causal relationship between RLS and hypertension.
Adult ; Diabetes Mellitus ; Education ; Humans ; Hypertension ; Korea ; Logistic Models ; Odds Ratio ; Overweight ; Prevalence ; Restless Legs Syndrome

BACKGROUND AND PURPOSE: Restless legs syndrome (RLS) is a common sleep-related neurological disorder that affects the quality of sleep. This study aimed to estimate the prevalence, predictive factors, and natural course of RLS, and its effect on sleep quality in pregnant Thai women. METHODS: A cross-sectional study that included 214 pregnant women was performed. RLS was diagnosed according to the revised criteria of the International RLS Study Group (IRLSSG). General demographic and antenatal-care data were reviewed. Scores on the Thai versions of the Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index, and the IRLSSG Rating Scale were determined. RESULTS: RLS was diagnosed in 24 of the pregnant women (11.2%): 4.2%, 25.0%, and 70.8% in the first, second, and third trimesters, respectively. Multiple logistic regression analysis revealed that a hemoglobin level (Hb) less than 11 g/dL [odds ratio (OR)=3.21, 95% CI=1.27–8.13] and a history of RLS (OR=16.62, 95% CI=1.52–181.32) were associated with RLS during pregnancy. Subjects with RLS significantly had higher Thai-ESS scores (p < 0.01). All subjects with RLS had severe symptoms that subsided within 1 week after delivery. No immediate labor complication was associated with RLS. CONCLUSIONS: Our study has confirmed a high prevalence of RLS and its impacts on sleep in pregnant women. An Hb of less than 11 g/dL and a history of RLS are predictive factors for RLS developing during pregnancy. Pregnancy-related RLS has a benign course and usually disappears within 1 week after delivery.
Anemia ; Asian Continental Ancestry Group* ; Cross-Sectional Studies ; Female ; Humans ; Logistic Models ; Nervous System Diseases ; Obstetric Labor Complications ; Pregnancy ; Pregnancy Trimester, Third ; Pregnant Women ; Prevalence* ; Restless Legs Syndrome* ; Sleep Wake Disorders

Restless legs syndrome,as a common sleep disorder,has nowadays long been diagnosed by self-rating scale and polysomnography.In this paper,a domestic diagnosis system for early restless legs syndrome based on deep learning is proposed,which is suitable for early patients with unstable symptoms in routine diagnosis.The hardware system is installed in the bed.And the non-contact sleeping dynamic signal acquisition is realized based on the acceleration sensors.The software system uses deep learning to classify and recognize the signals.A Fully Connected Feedforward Network based on Keras framework is constructed to recognize seven kinds of activities during sleeping.The accuracy of comprehensive classification is 97.83%.Based on former results,the periodic limb movement index and awakening index were evaluated to make the diagnosis of restless legs syndrome.
Deep Learning ; Humans ; Movement ; Polysomnography ; Restless Legs Syndrome ; diagnosis ; Sleep

OBJECTIVES: Significant benefit of intravenous ferric carboxymaltose (FCM) for restless legs syndrome (RLS) has been demonstrated. However, clinical indicators to expect treatment response of RLS are not clarified. The aim of this study is to find out determinant factors to predict treatment outcome of FCM. METHODS: We enrolled consecutive 108 patients with RLS who visited sleep clinic and received FCM from April 2016 to November 2017. Obtained data were detailed history including international restless legs scale (IRLS) and questionnaires, comorbid diseases, medication. Complete blood cell count, serum iron, ferritin, and total iron-binding capacity were sampled before and after treatment. Treatment response was assessed about four weeks after FCM administration. Patients with more than 40% decrease on IRLS were classified into the responders. RESULTS: 99 patients (mean 54.5 y and 79 females) were included. 58 patients (58.6%) were classified to be responders. There were substantial differences in post-treatment IRLS and symptom reduction rate between responders (7.4±6.4, 77.5±18.6%) and non-responders (29.7±8.7, 7.4±10.3%). No significant differences were found in demographics, baseline IRLS, sleep, and mood status between two groups. Serum ferritin and transferrin saturation was significantly lower in responders (37.6 ng/mL, 25.0%) than non-responders (55.1 ng/mL, p=0.014 and 36.5%, p=0.001). Patients with a history of gastrectomy (n=8) showed an excellent response to FCM (83.8% of symptom reduction). Comorbid lumbosacral radiculopathy had lower response rate (29.4%). CONCLUSIONS: Peripheral iron compromised state and gastrectomy history may indicate good response to intravenous FCM in patients with RLS. Patients with lumbosacral radiculopathy tend to be poor responders to intravenous FCM.
Blood Cell Count ; Demography ; Ferritins ; Gastrectomy ; Humans ; Iron ; Radiculopathy ; Restless Legs Syndrome ; Transferrin ; Treatment Outcome

OBJECTIVES: Periodic leg movements in sleep (PLMS) are associated with arousals and autonomic activation, which may contribute to higher cardiovascular disease risk in patients with restless legs syndrome (RLS). Non-periodic leg movements in sleep (NPLM) are leg jerks in sleep that does not satisfy standard criteria of PLMS. The aim of this study was to evaluate impact of short-interval leg movements in sleep (SILMS) and isolated leg movements in sleep (ILMS) in comparison to PLMS on heart rate in both patients with RLS and healthy controls. METHODS: Seven idiopathic RLS patients and 9 controls were enrolled in this study. Polysomnographic studies were analyzed and leg movements (LM) were automatically detected. NPLM can be classified as SILMS and ILMS. SILMS are LM separated by an inter-movement interval (IMI) shorter than 10 s, and ILMS are LM with IMI longer than 90 s. Frequency and heart rate associated with SILMS, ILMS, and PLMS in RLS patients were compared to those in controls. Heart rate change associated with LM were determined for a fixed time window. RESULTS: Frequencies of SILMS and ILMS of patients with RLS were not significantly different to those of controls. RLS patients presented higher heart rate change associated with SILMS than PLMS before movement onset, while heart rate change associated with SILMS, ILMS, and PLMS were not different in the controls. CONCLUSIONS: Although the number of SILMS is not higher than PLMS, SILMS may have closely associated with higher cardiac activation of RLS than PLMS. Therefore, SILMS might be an important treatment target for patients with RLS to reduce long-term cardiovascular risk. Long-term prospective studies are needed to evaluate the relationship between NPLM and cardiovascular disease in patients with RLS.
Arousal ; Cardiovascular Diseases ; Healthy Volunteers ; Heart Rate ; Humans ; Leg ; Prospective Studies ; Restless Legs Syndrome