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April 08, 2014; 82 (14) Article

Restless legs syndrome status as a predictor for lower physical function

Chunbai Zhang, Yanping Li, Atul Malhotra, Yi Ning, Xiang Gao
First published March 5, 2014, DOI: https://doi.org/10.1212/WNL.0000000000000284
Chunbai Zhang
From The Channing Division of Network Medicine (C.Z., Y.L., X.G.) and Division of Sleep Medicine (C.Z., A.M.), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; the Department of Epidemiology and Community Health (Y.N.), Virginia Commonwealth University, Richmond; the Department of Nutrition (X.G.), Harvard School of Public Health, Boston, MA; and School of Public Health (XG), Peking Union Medical College, Beijing, China.
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Yanping Li
From The Channing Division of Network Medicine (C.Z., Y.L., X.G.) and Division of Sleep Medicine (C.Z., A.M.), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; the Department of Epidemiology and Community Health (Y.N.), Virginia Commonwealth University, Richmond; the Department of Nutrition (X.G.), Harvard School of Public Health, Boston, MA; and School of Public Health (XG), Peking Union Medical College, Beijing, China.
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Atul Malhotra
From The Channing Division of Network Medicine (C.Z., Y.L., X.G.) and Division of Sleep Medicine (C.Z., A.M.), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; the Department of Epidemiology and Community Health (Y.N.), Virginia Commonwealth University, Richmond; the Department of Nutrition (X.G.), Harvard School of Public Health, Boston, MA; and School of Public Health (XG), Peking Union Medical College, Beijing, China.
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Yi Ning
From The Channing Division of Network Medicine (C.Z., Y.L., X.G.) and Division of Sleep Medicine (C.Z., A.M.), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; the Department of Epidemiology and Community Health (Y.N.), Virginia Commonwealth University, Richmond; the Department of Nutrition (X.G.), Harvard School of Public Health, Boston, MA; and School of Public Health (XG), Peking Union Medical College, Beijing, China.
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Xiang Gao
From The Channing Division of Network Medicine (C.Z., Y.L., X.G.) and Division of Sleep Medicine (C.Z., A.M.), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; the Department of Epidemiology and Community Health (Y.N.), Virginia Commonwealth University, Richmond; the Department of Nutrition (X.G.), Harvard School of Public Health, Boston, MA; and School of Public Health (XG), Peking Union Medical College, Beijing, China.
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Citation
Restless legs syndrome status as a predictor for lower physical function
Chunbai Zhang, Yanping Li, Atul Malhotra, Yi Ning, Xiang Gao
Neurology Apr 2014, 82 (14) 1212-1218; DOI: 10.1212/WNL.0000000000000284

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Abstract

Objective: To examine the potential long-term impact of restless legs syndrome (RLS) and other common sleep complaints on subsequent physical function (PF), we conducted a longitudinal analysis of 12,556 men in the Health Professionals Follow-up Study.

Methods: We used a set of questions recommended by the International RLS Study Group to assess RLS in 2002. We asked questions regarding other sleep complaints—insomnia, sleep fragmentation, and excessive daytime sleepiness—in 2004. We used the Physical Function (PF-10) survey of the Short Form–36 Health Survey to characterize PF in 1996 and 2008. We examined the 2008 PF-10 scores across categories of baseline RLS (2002), adjusted for age, 1996 PF-10 score, and other potential confounders.

Results: The participants with RLS at baseline had significantly lower PF-10 score 6 years later than those without RLS (mean difference = −2.32, p = 0.01), after adjusting for potential confounders. The magnitude of difference in PF-10 score for RLS symptoms ≥15 times/month vs no RLS was more than that of a 5-year increase of age or moderate amount of smoking. Having daily daytime sleepiness and sleep duration ≥9 hours/day were associated with lower mean PF value than not having these symptoms (p < 0.05 for both).

Conclusions: RLS and other sleep complaints are associated with lower PF. Our findings need to be replicated by more longitudinal studies including women and populations of other social and cultural backgrounds. It is important to understand whether RLS is an independent risk factor or a marker for other unknown risk factors for disability.

GLOSSARY

ADL=
activities of daily living;
BMI=
body mass index;
ESRD=
end-stage renal disease;
HPFS=
Health Professionals Follow-up Study;
HRQOL=
health-related quality of life;
MI=
myocardial infarction;
NSAID=
nonsteroidal anti-inflammatory drug;
OSA=
obstructive sleep apnea;
PD=
Parkinson disease;
PF=
physical function;
PF-10=
Physical Function survey of the Short Form–36 Health Survey;
QOL=
quality of life;
RLS=
restless legs syndrome;
SF-36=
Short Form–36 Health Survey

Footnotes

  • Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

  • Editorial, page 1198

  • Supplemental data at Neurology.org

  • Received July 31, 2013.
  • Accepted in final form November 5, 2013.
  • © 2014 American Academy of Neurology
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