Epidemiology of restless legs syndrome: A synthesis of the literature

a Stanford Sleep Epidemiology Research Center, Stanford University, School of Medicine, 3430 West Bayshore Road, Palo Alto, CA 94303, United Statesb Stanford University, School of Medicine, Stanford, CA 94305, United Statesc Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA 98195, United StatesReceived 12 January 2011. Revised 8 May 2011. Accepted 9 May 2011. Available online 26 July 2011.View full text Restless legs syndrome (RLS) has gained considerable attention in the recent years: nearly 50 community-based studies have been published in the last decade around the world. The development of strict diagnostic criteria in 1995 and their revision in 2003 helped to stimulate research interest on this syndrome. In community-based surveys, RLS has been studied as: 1) a symptom only, 2) a set of symptoms meeting minimal diagnostic criteria of the international restless legs syndrome study group (IRLSSG), 3) meeting minimal criteria accompanied with a specific frequency and/or severity, and 4) a differential diagnosis. In the first case, prevalence estimates in the general adult population ranged from 9.4% to 15%. In the second case, prevalence ranged from 3.9% to 14.3%. When frequency/severity is added, prevalence ranged from 2.2% to 7.9% and when differential diagnosis is applied prevalence estimates are between 1.9% and 4.6%. In all instances, RLS prevalence is higher in women than in men. It also increases with age in European and North American countries but not in Asian countries. Symptoms of anxiety and depression have been consistently associated with RLS. Overall, individuals with RLS have a poorer health than non-RLS but evidence for specific disease associations is mixed. Future epidemiological studies should focus on systematically adding frequency and severity in the definition of the syndrome in order to minimize the inclusion of cases mimicking RLS.

prs.rt("abs_end");Epidemiology; Restless legs syndrome; Community; Primary Care; Mental disorders; IllnessRLS, Restless legs syndrome; IRLSSG, International Restless Legs Syndrome Study Group; DIS, Difficulty initiating sleep; DMS, Difficulty maintaining sleep; NRS, non-restorative sleep; ESS, Epworth Sleepiness Scale

Figures and tables from this article:

Fig. 1. Changes in RLS prevalence rates in North America and Europe general population according to used definitions. *Prevalence rates for differential diagnosis came from primary care samples. Prevalence estimates are based on samples including participants from 18 to =65 years.

View Within ArticleFig. 2. a. Prevalence of RLS in men – North America and Europe. Included 12 studies that had provided prevalence by age groups for men. These studies are based on minimal IRLSSG criteria. A total of 23,282 men aged =18 are included in the scatter plot. b. Prevalence of RLS in men – Asia. Included 5 studies that had provided prevalence by age groups for men. These studies are based on minimal IRLSSG criteria. A total of 8081 men aged =18 are included in the scatter plot. c. Prevalence of RLS in women – North America and Europe. Included 12 studies that had provided prevalence by age groups for women. These studies are based on minimal IRLSSG criteria. A total of 26,150 women aged =18 are included in the scatter plot. d. Prevalence of RLS in women – Asia. Included 6 studies that had provided prevalence by age groups for women. These studies are based on minimal IRLSSG criteria. A total of 11,253 women aged =18 are included in the scatter plot.

View Within ArticleTable 1. Prevalence for restless leg syndrome or symptoms in the general population.

ECA = Epidemiologic Catchment Area; HPFS = Health Professionals Follow-up Study; ICSD = International classification of sleep disorders; IRLSSG = International restless legs syndrome study group; M = Men; NHANES = National Health and Nutrition Examination Survey; NHS II = Nurses' Health Study II; NIH = National Institutes of Health; RLS = Restless legs syndrome; t/mo = times per month; t/wk = times per week; unkn = unknown; W = Women.

View Within ArticleTable 2. Prevalence for restless legs syndrome or symptoms in clinical settings.

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