Restless legs syndrome and conditions associated with metabolic dysregulation, sympathoadrenal dysfunction, and cardiovascular disease risk: A systematic review

Kim E. Innesa, b, , , Terry Kit Selfea, b, c, , Parul Agarwala, d, a Department of Community Medicine, West Virginia University School of Medicine, PO Box 9190, Morgantown, WV 26506-9190, USAb Center for the Study of Complementary and Alternative Therapies, University of Virginia Health System, PO Box 800782, McLeod Hall, Charlottesville, VA 22908-0782, USAReceived 1 February 2011. Revised 7 April 2011. Accepted 11 April 2011. Available online 5 July 2011.View full text Restless legs syndrome (RLS) is a distressing sleep and sensorimotor disorder that affects a large percentage of adults in the western industrialized world and is associated with profound reductions in quality of life. However, the etiology of RLS remains incompletely understood. Enhanced understanding regarding both the antecedents and sequelae of RLS could shed new light on the pathogenesis of RLS. Evidence from an emerging body of literature suggests associations between RLS and diabetes, hypertension, obesity, and related conditions linked to sympathetic activation and metabolic dysregulation, raising the possibility that these factors may likewise play a significant role in the development and progression of RLS, and could help explain the recently documented associations between RLS and subsequent cardiovascular disease. However, the relation between RLS and these chronic conditions has received relatively little attention to date, although potential implications for the pathogenesis and treatment of RLS could be considerable. In this paper, we systematically review the recently published literature regarding the association of RLS to cardiovascular disease and related risk factors characterized by sympathoadrenal and metabolic dysregulation, discuss potential underlying mechanisms, and outline some possible directions for future research.

prs.rt("abs_end");Restless legs syndrome; RLS; Ekbom disease; Cardiovascular disease; Hypertension; Diabetes; Impaired glucose tolerance; Obesity; Weight gain; Dyslipidemia; Autonomic dysfunction; HPA axis dysfunction

Figures and tables from this article:

Table 1. Summary table of study characteristics. N = 30 studies (1995-2010).

Abbreviations: CVD = cardiovascular disease; DM = diabetes; DM2 = type 2 diabetes; dx = diagnosis; IGT = impaired glucose tolerance: IRLSSG = international restless legs syndrome study group; Min freq/sev = minimum frequency and/or severity; pts = patients; pts = patients; VA = veterans administration; w/ = with.

View Within ArticleTable 2. Relation of RLS to cardiovascular disease. Summary of study characteristics and findings (N = 15 studies published between 1995 and 2010).

Abbreviations: appt = appointment; ARIC = atherosclerosis risk in communities; BOLD = the burden of obstructive lung diseases study; BP = blood pressure; btwn = between; CAD = Coronary artery disease; CHF = congestive heart failure; CHS = cardiovascular health study; condn = condition; CVD = cardiovascular disease; DM = diabetes mellitus; DM2 = type 2 diabetes; dx = diagnosis; ECA = epidemiologic catchment area; F=female; FBG = fasting blood glucose; FHS = framingham heart study; Freq = frequency; Hgb = hemoglobin; HPFS = health professionals follow-up study; HTN = hypertension; hx = history; ICD = International Classification of Diseases; ICSD = international classification of sleep disorders; IRLS = international RLS study group rating scale; IRLSSG = international restless legs syndrome study group; M = male; MEMO = the memory and morbidity in augsburg elderly study; MI = myocardial infraction; MONICA = monitoring trends and determinants in CVD survey-Augsburg; n’s = numbers; NC-FP-RN = north carolina family practice research network; NHS II = nurses health study II; NSF = national sleep foundation poll; NY cohorts = new york hypertension cohorts; OR = odds ratio (95% Confidence Interval); pt = patient; RLS = restless legs syndrome; SDB = sleep disordered breathing; SHHS = sleep heart health study; SHS = strong heart study; SPAR = the official database covering the total population of Sweden; Sx = symptoms; TG = triglycerides; Tucson cohorts = tucson epidemiologic study of airways obstructive diseases and the health and environment study; tx = treatment; VA = veterans administration; w/ = with; w/o = without.*Calculated from data provided in paper.

View Within ArticleTable 3. Relation of RLS to hypertension: Summary of study characteristics and findings (N = 17 studies published between 1995 and 2010).

Abbreviations: appt = appointment; ARIC = atherosclerosis risk in communities; BOLD = the burden of obstructive lung diseases study; BP = blood pressure; btwn = between; CHF = congestive heart failure; CHS = cardiovascular health study; condn = condition; CVD = cardiovascular disease; DBP = diastolic blood pressure; DM = diabetes mellitus; DM2 = type 2 diabetes; DM1 = type 1 diabetes; dx = diagnosis; ECA = epidemiologic catchment area; F=female; FBG = fasting blood glucose; FHS = framingham heart study; Freq = frequency; Hgb = hemoglobin; HPFS = health professionals follow-up study; HTN = hypertension; hx = history; ICD9CM = international classification of diseases, 9th revision, clinical modification; ICSD = international classification of sleep disorders; IRLS = international RLS study group rating scale; IRLSSG = international restless legs syndrome study group; M = male; MEMO = the memory and morbidity in augsburg elderly study; MI = myocardial infarction; MONICA = monitoring trends and determinants in CVD survey-Augsburg; n’s = numbers; NC-FP-RN = north carolina family practice research network; NHS II = nurses health study II; NSF = national sleep foundation poll; NY cohorts = new york hypertension cohorts; OR = odds ratio (95% Confidence Interval); Pt = patient; RLS = restless legs syndrome; SBP = systolic blood pressure; SDB = Sleep disordered breathing; SHHS = sleep heart health study; SHS = strong heart study; SPAR = the official database covering the total population of Sweden; Sx = symptoms; TG = triglycerides; Tucson cohorts = tucson epidemiologic study of airways obstructive diseases and the health and environment study; tx = treatment; VA = veterans administration; w/ = with; w/in = within; w/o = without.* Calculated from data provided in paper.

View Within ArticleTable 4. Relation of RLS to diabetes and impaired glucose tolerance: Summary of study characteristics and findings (N=26 studies (1995-2010)).

Abbreviations: appt = appointment; ARIC = atherosclerosis risk in communities; BG = blood glucose; BMI = body mass index; BOLD = the burden of obstructive lung diseases study; BP = blood pressure; btwn = between; CHF = congestive heart failure; CHS = cardiovascular health study; condn = condition; CVD = cardiovascular disease; DM = diabetes mellitus; DM1 = type 1 diabetes; DM2 = type 2 diabetes; dx = diagnosis; ECA = epidemiologic catchment area; F=female; FBG = fasting blood glucose; FHS = framingham heart study; Freq = frequency; Hgb = hemoglobin; HOMA = homeostasis model assessment; HPFS = health professionals follow-up study; HTN = hypertension; hx = history; ICD9CM = international classification of diseases, 9th revision, clinical modification; IGT = impaired glucose tolerance; ICSD = international classification of sleep disorders; IGR = impaired glucose regulation; IGT = impaired glucose tolerance; IRLS = international RLS study group rating scale; IRLSSG = international restless legs syndrome study group; M = male; MEMO = the memory and morbidity in augsburg elderly study; MONICA = monitoring trends and determinants in CVD survey-Augsburg; NC-FP-RN = north carolina family practice research network; NHS II = nurses health study II; NSF = national sleep foundation poll; NY cohorts = new york hypertension cohorts; OGTT = oral glucose tolerance test; OR = odds ratio (95% Confidence Interval); pts = patients; RLS = restless legs syndrome; SDB = sleep disordered breathing; SHHS = sleep heart health study; SHS = Strong heart study; SPAR = the official database covering the total population of Sweden; Sx = symptoms; TG = triglycerides; Tucson cohorts = tucson epidemiologic study of airways obstructive diseases and the health and environment study; tx = treatment; VA = veterans administration; w/ = with; w/in = within; w/o = without.*Calculated from data provided in table.

View Within ArticleTable 5. Relation of RLS to obesity, weight gain, and dyslipidemia: Summary of study characteristics and findings (N=18 studies with data on the association of RLS to obesity/weight gain, 7 studies with data on the association of RLS to lipid profiles).

Abbreviations: appt = appointment; ARIC = atherosclerosis risk in communities; BMI = body mass index; BOLD = the burden of obstructive lung diseases study; BP = blood pressure; btwn = between; CHF = congestive heart failure; CHS = cardiovascular health study; condn = condition; CVD = cardiovascular disease; DM = diabetes mellitus; DM1 = type 1 diabetes; DM2 = type 2 diabetes; dx = diagnosis; ECA = epidemiologic catchment area; F=female; FBG = fasting blood glucose; FHS = framingham heart study; Freq = frequency; Hgb = hemoglobin; HPFS = health professionals follow-up study; HTN = hypertension; hx = history; ICSD = international classification of sleep disorders; IRLS = intl RLS study group rating scale; IRLSSG = international restless legs syndrome study group; M = male; MEMO = the memory and morbidity in augsburg elderly study; MI = myocardial infarction; MONICA = Monitoring trends and determinants in CVD survey-Augsburg; NC-FP-RN = north carolina family practice research network; NHS II = nurses health study II; NSF = national sleep foundation poll; NY cohorts = new york hypertension cohorts; OGTT = oral glucose tolerance test; OR = odds ratio (95% confidence interval); RLS = restless legs syndrome; SDB = sleep disordered breathing; SHHS = sleep heart health study; SHS = strong heart study; SPAR = the official database covering the total population of Sweden; Sx = symptoms; TG = triglycerides; Tucson cohorts = tucson epidemiologic study of airways obstructive diseases and the health and environment study; tx = treatment; VA = veterans administration; w/ = with; w/o = without.*Calculated from data provided in paper.

View Within ArticleCopyright © 2011 Elsevier Ltd. All rights reserved.

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Restless legs syndrome and conditions associated with metabolic dysregulation, sympathoadrenal dysfunction, and cardiovascular disease risk: A systematic review

Kim E. Innesa, b, , , Terry Kit Selfea, b, c, , Parul Agarwala, d, a Department of Community Medicine, West Virginia University School of Medicine, PO Box 9190, Morgantown, WV 26506-9190, USAb Center for the Study of Complementary and Alternative Therapies, University of Virginia Health System, PO Box 800782, McLeod Hall, Charlottesville, VA 22908-0782, USAReceived 1 February 2011. Revised 7 April 2011. Accepted 11 April 2011. Available online 5 July 2011.View full text Restless legs syndrome (RLS) is a distressing sleep and sensorimotor disorder that affects a large percentage of adults in the western industrialized world and is associated with profound reductions in quality of life. However, the etiology of RLS remains incompletely understood. Enhanced understanding regarding both the antecedents and sequelae of RLS could shed new light on the pathogenesis of RLS. Evidence from an emerging body of literature suggests associations between RLS and diabetes, hypertension, obesity, and related conditions linked to sympathetic activation and metabolic dysregulation, raising the possibility that these factors may likewise play a significant role in the development and progression of RLS, and could help explain the recently documented associations between RLS and subsequent cardiovascular disease. However, the relation between RLS and these chronic conditions has received relatively little attention to date, although potential implications for the pathogenesis and treatment of RLS could be considerable. In this paper, we systematically review the recently published literature regarding the association of RLS to cardiovascular disease and related risk factors characterized by sympathoadrenal and metabolic dysregulation, discuss potential underlying mechanisms, and outline some possible directions for future research.

prs.rt("abs_end");Restless legs syndrome; RLS; Ekbom disease; Cardiovascular disease; Hypertension; Diabetes; Impaired glucose tolerance; Obesity; Weight gain; Dyslipidemia; Autonomic dysfunction; HPA axis dysfunction

Figures and tables from this article:

Table 1. Summary table of study characteristics. N = 30 studies (1995-2010).

Abbreviations: CVD = cardiovascular disease; DM = diabetes; DM2 = type 2 diabetes; dx = diagnosis; IGT = impaired glucose tolerance: IRLSSG = international restless legs syndrome study group; Min freq/sev = minimum frequency and/or severity; pts = patients; pts = patients; VA = veterans administration; w/ = with.

View Within ArticleTable 2. Relation of RLS to cardiovascular disease. Summary of study characteristics and findings (N = 15 studies published between 1995 and 2010).

Abbreviations: appt = appointment; ARIC = atherosclerosis risk in communities; BOLD = the burden of obstructive lung diseases study; BP = blood pressure; btwn = between; CAD = Coronary artery disease; CHF = congestive heart failure; CHS = cardiovascular health study; condn = condition; CVD = cardiovascular disease; DM = diabetes mellitus; DM2 = type 2 diabetes; dx = diagnosis; ECA = epidemiologic catchment area; F=female; FBG = fasting blood glucose; FHS = framingham heart study; Freq = frequency; Hgb = hemoglobin; HPFS = health professionals follow-up study; HTN = hypertension; hx = history; ICD = International Classification of Diseases; ICSD = international classification of sleep disorders; IRLS = international RLS study group rating scale; IRLSSG = international restless legs syndrome study group; M = male; MEMO = the memory and morbidity in augsburg elderly study; MI = myocardial infraction; MONICA = monitoring trends and determinants in CVD survey-Augsburg; n’s = numbers; NC-FP-RN = north carolina family practice research network; NHS II = nurses health study II; NSF = national sleep foundation poll; NY cohorts = new york hypertension cohorts; OR = odds ratio (95% Confidence Interval); pt = patient; RLS = restless legs syndrome; SDB = sleep disordered breathing; SHHS = sleep heart health study; SHS = strong heart study; SPAR = the official database covering the total population of Sweden; Sx = symptoms; TG = triglycerides; Tucson cohorts = tucson epidemiologic study of airways obstructive diseases and the health and environment study; tx = treatment; VA = veterans administration; w/ = with; w/o = without.*Calculated from data provided in paper.

View Within ArticleTable 3. Relation of RLS to hypertension: Summary of study characteristics and findings (N = 17 studies published between 1995 and 2010).

Abbreviations: appt = appointment; ARIC = atherosclerosis risk in communities; BOLD = the burden of obstructive lung diseases study; BP = blood pressure; btwn = between; CHF = congestive heart failure; CHS = cardiovascular health study; condn = condition; CVD = cardiovascular disease; DBP = diastolic blood pressure; DM = diabetes mellitus; DM2 = type 2 diabetes; DM1 = type 1 diabetes; dx = diagnosis; ECA = epidemiologic catchment area; F=female; FBG = fasting blood glucose; FHS = framingham heart study; Freq = frequency; Hgb = hemoglobin; HPFS = health professionals follow-up study; HTN = hypertension; hx = history; ICD9CM = international classification of diseases, 9th revision, clinical modification; ICSD = international classification of sleep disorders; IRLS = international RLS study group rating scale; IRLSSG = international restless legs syndrome study group; M = male; MEMO = the memory and morbidity in augsburg elderly study; MI = myocardial infarction; MONICA = monitoring trends and determinants in CVD survey-Augsburg; n’s = numbers; NC-FP-RN = north carolina family practice research network; NHS II = nurses health study II; NSF = national sleep foundation poll; NY cohorts = new york hypertension cohorts; OR = odds ratio (95% Confidence Interval); Pt = patient; RLS = restless legs syndrome; SBP = systolic blood pressure; SDB = Sleep disordered breathing; SHHS = sleep heart health study; SHS = strong heart study; SPAR = the official database covering the total population of Sweden; Sx = symptoms; TG = triglycerides; Tucson cohorts = tucson epidemiologic study of airways obstructive diseases and the health and environment study; tx = treatment; VA = veterans administration; w/ = with; w/in = within; w/o = without.* Calculated from data provided in paper.

View Within ArticleTable 4. Relation of RLS to diabetes and impaired glucose tolerance: Summary of study characteristics and findings (N=26 studies (1995-2010)).

Abbreviations: appt = appointment; ARIC = atherosclerosis risk in communities; BG = blood glucose; BMI = body mass index; BOLD = the burden of obstructive lung diseases study; BP = blood pressure; btwn = between; CHF = congestive heart failure; CHS = cardiovascular health study; condn = condition; CVD = cardiovascular disease; DM = diabetes mellitus; DM1 = type 1 diabetes; DM2 = type 2 diabetes; dx = diagnosis; ECA = epidemiologic catchment area; F=female; FBG = fasting blood glucose; FHS = framingham heart study; Freq = frequency; Hgb = hemoglobin; HOMA = homeostasis model assessment; HPFS = health professionals follow-up study; HTN = hypertension; hx = history; ICD9CM = international classification of diseases, 9th revision, clinical modification; IGT = impaired glucose tolerance; ICSD = international classification of sleep disorders; IGR = impaired glucose regulation; IGT = impaired glucose tolerance; IRLS = international RLS study group rating scale; IRLSSG = international restless legs syndrome study group; M = male; MEMO = the memory and morbidity in augsburg elderly study; MONICA = monitoring trends and determinants in CVD survey-Augsburg; NC-FP-RN = north carolina family practice research network; NHS II = nurses health study II; NSF = national sleep foundation poll; NY cohorts = new york hypertension cohorts; OGTT = oral glucose tolerance test; OR = odds ratio (95% Confidence Interval); pts = patients; RLS = restless legs syndrome; SDB = sleep disordered breathing; SHHS = sleep heart health study; SHS = Strong heart study; SPAR = the official database covering the total population of Sweden; Sx = symptoms; TG = triglycerides; Tucson cohorts = tucson epidemiologic study of airways obstructive diseases and the health and environment study; tx = treatment; VA = veterans administration; w/ = with; w/in = within; w/o = without.*Calculated from data provided in table.

View Within ArticleTable 5. Relation of RLS to obesity, weight gain, and dyslipidemia: Summary of study characteristics and findings (N=18 studies with data on the association of RLS to obesity/weight gain, 7 studies with data on the association of RLS to lipid profiles).

Abbreviations: appt = appointment; ARIC = atherosclerosis risk in communities; BMI = body mass index; BOLD = the burden of obstructive lung diseases study; BP = blood pressure; btwn = between; CHF = congestive heart failure; CHS = cardiovascular health study; condn = condition; CVD = cardiovascular disease; DM = diabetes mellitus; DM1 = type 1 diabetes; DM2 = type 2 diabetes; dx = diagnosis; ECA = epidemiologic catchment area; F=female; FBG = fasting blood glucose; FHS = framingham heart study; Freq = frequency; Hgb = hemoglobin; HPFS = health professionals follow-up study; HTN = hypertension; hx = history; ICSD = international classification of sleep disorders; IRLS = intl RLS study group rating scale; IRLSSG = international restless legs syndrome study group; M = male; MEMO = the memory and morbidity in augsburg elderly study; MI = myocardial infarction; MONICA = Monitoring trends and determinants in CVD survey-Augsburg; NC-FP-RN = north carolina family practice research network; NHS II = nurses health study II; NSF = national sleep foundation poll; NY cohorts = new york hypertension cohorts; OGTT = oral glucose tolerance test; OR = odds ratio (95% confidence interval); RLS = restless legs syndrome; SDB = sleep disordered breathing; SHHS = sleep heart health study; SHS = strong heart study; SPAR = the official database covering the total population of Sweden; Sx = symptoms; TG = triglycerides; Tucson cohorts = tucson epidemiologic study of airways obstructive diseases and the health and environment study; tx = treatment; VA = veterans administration; w/ = with; w/o = without.*Calculated from data provided in paper.

View Within ArticleCopyright © 2011 Elsevier Ltd. All rights reserved.

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Restless legs syndrome and conditions associated with metabolic dysregulation, sympathoadrenal dysfunction, and cardiovascular disease risk: A systematic review

Kim E. Innesa, b, , , Terry Kit Selfea, b, c, , Parul Agarwala, d, a Department of Community Medicine, West Virginia University School of Medicine, PO Box 9190, Morgantown, WV 26506-9190, USAb Center for the Study of Complementary and Alternative Therapies, University of Virginia Health System, PO Box 800782, McLeod Hall, Charlottesville, VA 22908-0782, USAReceived 1 February 2011. Revised 7 April 2011. Accepted 11 April 2011. Available online 5 July 2011.View full text Restless legs syndrome (RLS) is a distressing sleep and sensorimotor disorder that affects a large percentage of adults in the western industrialized world and is associated with profound reductions in quality of life. However, the etiology of RLS remains incompletely understood. Enhanced understanding regarding both the antecedents and sequelae of RLS could shed new light on the pathogenesis of RLS. Evidence from an emerging body of literature suggests associations between RLS and diabetes, hypertension, obesity, and related conditions linked to sympathetic activation and metabolic dysregulation, raising the possibility that these factors may likewise play a significant role in the development and progression of RLS, and could help explain the recently documented associations between RLS and subsequent cardiovascular disease. However, the relation between RLS and these chronic conditions has received relatively little attention to date, although potential implications for the pathogenesis and treatment of RLS could be considerable. In this paper, we systematically review the recently published literature regarding the association of RLS to cardiovascular disease and related risk factors characterized by sympathoadrenal and metabolic dysregulation, discuss potential underlying mechanisms, and outline some possible directions for future research.

prs.rt("abs_end");Restless legs syndrome; RLS; Ekbom disease; Cardiovascular disease; Hypertension; Diabetes; Impaired glucose tolerance; Obesity; Weight gain; Dyslipidemia; Autonomic dysfunction; HPA axis dysfunction

Figures and tables from this article:

Table 1. Summary table of study characteristics. N = 30 studies (1995-2010).

Abbreviations: CVD = cardiovascular disease; DM = diabetes; DM2 = type 2 diabetes; dx = diagnosis; IGT = impaired glucose tolerance: IRLSSG = international restless legs syndrome study group; Min freq/sev = minimum frequency and/or severity; pts = patients; pts = patients; VA = veterans administration; w/ = with.

View Within ArticleTable 2. Relation of RLS to cardiovascular disease. Summary of study characteristics and findings (N = 15 studies published between 1995 and 2010).

Abbreviations: appt = appointment; ARIC = atherosclerosis risk in communities; BOLD = the burden of obstructive lung diseases study; BP = blood pressure; btwn = between; CAD = Coronary artery disease; CHF = congestive heart failure; CHS = cardiovascular health study; condn = condition; CVD = cardiovascular disease; DM = diabetes mellitus; DM2 = type 2 diabetes; dx = diagnosis; ECA = epidemiologic catchment area; F=female; FBG = fasting blood glucose; FHS = framingham heart study; Freq = frequency; Hgb = hemoglobin; HPFS = health professionals follow-up study; HTN = hypertension; hx = history; ICD = International Classification of Diseases; ICSD = international classification of sleep disorders; IRLS = international RLS study group rating scale; IRLSSG = international restless legs syndrome study group; M = male; MEMO = the memory and morbidity in augsburg elderly study; MI = myocardial infraction; MONICA = monitoring trends and determinants in CVD survey-Augsburg; n’s = numbers; NC-FP-RN = north carolina family practice research network; NHS II = nurses health study II; NSF = national sleep foundation poll; NY cohorts = new york hypertension cohorts; OR = odds ratio (95% Confidence Interval); pt = patient; RLS = restless legs syndrome; SDB = sleep disordered breathing; SHHS = sleep heart health study; SHS = strong heart study; SPAR = the official database covering the total population of Sweden; Sx = symptoms; TG = triglycerides; Tucson cohorts = tucson epidemiologic study of airways obstructive diseases and the health and environment study; tx = treatment; VA = veterans administration; w/ = with; w/o = without.*Calculated from data provided in paper.

View Within ArticleTable 3. Relation of RLS to hypertension: Summary of study characteristics and findings (N = 17 studies published between 1995 and 2010).

Abbreviations: appt = appointment; ARIC = atherosclerosis risk in communities; BOLD = the burden of obstructive lung diseases study; BP = blood pressure; btwn = between; CHF = congestive heart failure; CHS = cardiovascular health study; condn = condition; CVD = cardiovascular disease; DBP = diastolic blood pressure; DM = diabetes mellitus; DM2 = type 2 diabetes; DM1 = type 1 diabetes; dx = diagnosis; ECA = epidemiologic catchment area; F=female; FBG = fasting blood glucose; FHS = framingham heart study; Freq = frequency; Hgb = hemoglobin; HPFS = health professionals follow-up study; HTN = hypertension; hx = history; ICD9CM = international classification of diseases, 9th revision, clinical modification; ICSD = international classification of sleep disorders; IRLS = international RLS study group rating scale; IRLSSG = international restless legs syndrome study group; M = male; MEMO = the memory and morbidity in augsburg elderly study; MI = myocardial infarction; MONICA = monitoring trends and determinants in CVD survey-Augsburg; n’s = numbers; NC-FP-RN = north carolina family practice research network; NHS II = nurses health study II; NSF = national sleep foundation poll; NY cohorts = new york hypertension cohorts; OR = odds ratio (95% Confidence Interval); Pt = patient; RLS = restless legs syndrome; SBP = systolic blood pressure; SDB = Sleep disordered breathing; SHHS = sleep heart health study; SHS = strong heart study; SPAR = the official database covering the total population of Sweden; Sx = symptoms; TG = triglycerides; Tucson cohorts = tucson epidemiologic study of airways obstructive diseases and the health and environment study; tx = treatment; VA = veterans administration; w/ = with; w/in = within; w/o = without.* Calculated from data provided in paper.

View Within ArticleTable 4. Relation of RLS to diabetes and impaired glucose tolerance: Summary of study characteristics and findings (N=26 studies (1995-2010)).

Abbreviations: appt = appointment; ARIC = atherosclerosis risk in communities; BG = blood glucose; BMI = body mass index; BOLD = the burden of obstructive lung diseases study; BP = blood pressure; btwn = between; CHF = congestive heart failure; CHS = cardiovascular health study; condn = condition; CVD = cardiovascular disease; DM = diabetes mellitus; DM1 = type 1 diabetes; DM2 = type 2 diabetes; dx = diagnosis; ECA = epidemiologic catchment area; F=female; FBG = fasting blood glucose; FHS = framingham heart study; Freq = frequency; Hgb = hemoglobin; HOMA = homeostasis model assessment; HPFS = health professionals follow-up study; HTN = hypertension; hx = history; ICD9CM = international classification of diseases, 9th revision, clinical modification; IGT = impaired glucose tolerance; ICSD = international classification of sleep disorders; IGR = impaired glucose regulation; IGT = impaired glucose tolerance; IRLS = international RLS study group rating scale; IRLSSG = international restless legs syndrome study group; M = male; MEMO = the memory and morbidity in augsburg elderly study; MONICA = monitoring trends and determinants in CVD survey-Augsburg; NC-FP-RN = north carolina family practice research network; NHS II = nurses health study II; NSF = national sleep foundation poll; NY cohorts = new york hypertension cohorts; OGTT = oral glucose tolerance test; OR = odds ratio (95% Confidence Interval); pts = patients; RLS = restless legs syndrome; SDB = sleep disordered breathing; SHHS = sleep heart health study; SHS = Strong heart study; SPAR = the official database covering the total population of Sweden; Sx = symptoms; TG = triglycerides; Tucson cohorts = tucson epidemiologic study of airways obstructive diseases and the health and environment study; tx = treatment; VA = veterans administration; w/ = with; w/in = within; w/o = without.*Calculated from data provided in table.

View Within ArticleTable 5. Relation of RLS to obesity, weight gain, and dyslipidemia: Summary of study characteristics and findings (N=18 studies with data on the association of RLS to obesity/weight gain, 7 studies with data on the association of RLS to lipid profiles).

Abbreviations: appt = appointment; ARIC = atherosclerosis risk in communities; BMI = body mass index; BOLD = the burden of obstructive lung diseases study; BP = blood pressure; btwn = between; CHF = congestive heart failure; CHS = cardiovascular health study; condn = condition; CVD = cardiovascular disease; DM = diabetes mellitus; DM1 = type 1 diabetes; DM2 = type 2 diabetes; dx = diagnosis; ECA = epidemiologic catchment area; F=female; FBG = fasting blood glucose; FHS = framingham heart study; Freq = frequency; Hgb = hemoglobin; HPFS = health professionals follow-up study; HTN = hypertension; hx = history; ICSD = international classification of sleep disorders; IRLS = intl RLS study group rating scale; IRLSSG = international restless legs syndrome study group; M = male; MEMO = the memory and morbidity in augsburg elderly study; MI = myocardial infarction; MONICA = Monitoring trends and determinants in CVD survey-Augsburg; NC-FP-RN = north carolina family practice research network; NHS II = nurses health study II; NSF = national sleep foundation poll; NY cohorts = new york hypertension cohorts; OGTT = oral glucose tolerance test; OR = odds ratio (95% confidence interval); RLS = restless legs syndrome; SDB = sleep disordered breathing; SHHS = sleep heart health study; SHS = strong heart study; SPAR = the official database covering the total population of Sweden; Sx = symptoms; TG = triglycerides; Tucson cohorts = tucson epidemiologic study of airways obstructive diseases and the health and environment study; tx = treatment; VA = veterans administration; w/ = with; w/o = without.*Calculated from data provided in paper.

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Does abnormal non-rapid eye movement sleep impair declarative memory consolidation? Disturbed thalamic functions in sleep and memory processing

a Yeshiva University: Ferkauf Graduate School of Psychology, Rousso Building, 1165 Morris Park Avenue, Bronx, NY 10461, United Statesb Department of Psychiatry and Psychotherapy, University Hospital Schleswig-Holstein, University of Kiel, GermanyReceived 10 July 2010. Revised 30 July 2011. Accepted 1 August 2011. Available online 1 September 2011.View full text Non-rapid eye movement (NREM) sleep has recently garnered support for its role in consolidating hippocampus-based declarative memories in humans. We provide a brief review of the latest research on NREM sleep activity and its association with declarative memory consolidation. Utilizing empirical findings from sleep studies on schizophrenia, Alzheimer’s disease, and fibromyalgia, we argue that a significant reduction of slow-wave sleep and sleep spindle activity contribute to the development of deficits in declarative memory consolidation along with concomitant sleep disturbances commonly experienced in the aforementioned disorders. A tentative model is introduced to describe the mediating role of the thalamocortical network in disruptions of both declarative memory consolidation and NREM sleep. The hope is to stimulate new research in further investigating the intimate link between these two very important functions.

prs.rt("abs_end");NREM sleep; Sleep spindles; Slow-wave sleep; Declarative memory consolidation; Hippocampus; Thalamocortical network; Schizophrenia; Alzheimer’s disease; Fibromyalgia syndrome

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Fig. 1. During NREM sleep, abnormal thalamocortical structures may be unable to generate sufficient slow oscillations to drive the reactivation of hippocampal memory traces. These same structures may also be unable to facilitate normal spindle activity, preventing efficient declarative memory consolidation due to an absence in cortical plastic changes. Decreases in spindle activity lead to failure in inhibiting sensory information from reaching the neocortex. Thus, the individual is awakened and kept awake by sensory information, consequently experiencing disturbed NREM sleep.

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Does abnormal non-rapid eye movement sleep impair declarative memory consolidation? Disturbed thalamic functions in sleep and memory processing

a Yeshiva University: Ferkauf Graduate School of Psychology, Rousso Building, 1165 Morris Park Avenue, Bronx, NY 10461, United Statesb Department of Psychiatry and Psychotherapy, University Hospital Schleswig-Holstein, University of Kiel, GermanyReceived 10 July 2010. Revised 30 July 2011. Accepted 1 August 2011. Available online 1 September 2011.View full text Non-rapid eye movement (NREM) sleep has recently garnered support for its role in consolidating hippocampus-based declarative memories in humans. We provide a brief review of the latest research on NREM sleep activity and its association with declarative memory consolidation. Utilizing empirical findings from sleep studies on schizophrenia, Alzheimer’s disease, and fibromyalgia, we argue that a significant reduction of slow-wave sleep and sleep spindle activity contribute to the development of deficits in declarative memory consolidation along with concomitant sleep disturbances commonly experienced in the aforementioned disorders. A tentative model is introduced to describe the mediating role of the thalamocortical network in disruptions of both declarative memory consolidation and NREM sleep. The hope is to stimulate new research in further investigating the intimate link between these two very important functions.

prs.rt("abs_end");NREM sleep; Sleep spindles; Slow-wave sleep; Declarative memory consolidation; Hippocampus; Thalamocortical network; Schizophrenia; Alzheimer’s disease; Fibromyalgia syndrome

Figures and tables from this article:

Fig. 1. During NREM sleep, abnormal thalamocortical structures may be unable to generate sufficient slow oscillations to drive the reactivation of hippocampal memory traces. These same structures may also be unable to facilitate normal spindle activity, preventing efficient declarative memory consolidation due to an absence in cortical plastic changes. Decreases in spindle activity lead to failure in inhibiting sensory information from reaching the neocortex. Thus, the individual is awakened and kept awake by sensory information, consequently experiencing disturbed NREM sleep.

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Does abnormal non-rapid eye movement sleep impair declarative memory consolidation? Disturbed thalamic functions in sleep and memory processing

a Yeshiva University: Ferkauf Graduate School of Psychology, Rousso Building, 1165 Morris Park Avenue, Bronx, NY 10461, United Statesb Department of Psychiatry and Psychotherapy, University Hospital Schleswig-Holstein, University of Kiel, GermanyReceived 10 July 2010. Revised 30 July 2011. Accepted 1 August 2011. Available online 1 September 2011.View full text Non-rapid eye movement (NREM) sleep has recently garnered support for its role in consolidating hippocampus-based declarative memories in humans. We provide a brief review of the latest research on NREM sleep activity and its association with declarative memory consolidation. Utilizing empirical findings from sleep studies on schizophrenia, Alzheimer’s disease, and fibromyalgia, we argue that a significant reduction of slow-wave sleep and sleep spindle activity contribute to the development of deficits in declarative memory consolidation along with concomitant sleep disturbances commonly experienced in the aforementioned disorders. A tentative model is introduced to describe the mediating role of the thalamocortical network in disruptions of both declarative memory consolidation and NREM sleep. The hope is to stimulate new research in further investigating the intimate link between these two very important functions.

prs.rt("abs_end");NREM sleep; Sleep spindles; Slow-wave sleep; Declarative memory consolidation; Hippocampus; Thalamocortical network; Schizophrenia; Alzheimer’s disease; Fibromyalgia syndrome

Figures and tables from this article:

Fig. 1. During NREM sleep, abnormal thalamocortical structures may be unable to generate sufficient slow oscillations to drive the reactivation of hippocampal memory traces. These same structures may also be unable to facilitate normal spindle activity, preventing efficient declarative memory consolidation due to an absence in cortical plastic changes. Decreases in spindle activity lead to failure in inhibiting sensory information from reaching the neocortex. Thus, the individual is awakened and kept awake by sensory information, consequently experiencing disturbed NREM sleep.

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Sleep in attention-deficit/hyperactivity disorder in children and adults: Past, present, and future

Sun Young Rosalia Yoona, b, , , , Umesh Jainb, e, , Colin Shapiroa, c, d, f, a Institute of Medical Sciences, University of Toronto, Canadab Child, Youth and Family Service, Centre for Addiction and Mental Health, 352-250 College Street, Toronto, ON, M5T 1R8, Canadac Division of Patient Based Clinical Research, Toronto Western Research Institute, Canadad Youthdale Child and Adolescent Sleep Centre, CanadaReceived 5 April 2011. Revised 1 July 2011. Accepted 5 July 2011. Available online 26 October 2011.View full text The understanding that sleep can give rise to, or exacerbate symptoms of attention-deficit/hyperactivity disorder (ADHD), and that good sleep hygiene improves attention and concentration tasks has sparked interest in the investigation of possible etiological relationships between sleep disorders and ADHD.

Studies indicate that 30% of children and 60–80% of adults with ADHD have symptoms of sleep disorders such as daytime sleepiness, insomnia, delayed sleep phase syndrome, fractured sleep, restless legs syndrome, and sleep disordered breathing. The range and diversity of findings by different researchers have posed challenges in establishing whether sleep disturbances are intrinsic to ADHD or whether disturbances occur due to co-morbid sleep disorders. As a result, understanding of the nature of the relationship between sleep disturbances/disorders and ADHD remains unclear.

In this review, we present a comprehensive and critical account of the research that has been carried out to investigate the association between sleep and ADHD, as well as discuss mechanisms that have been proposed to account for the elusive relationship between sleep disturbances, sleep disorders, and ADHD.

prs.rt("abs_end");Sleep architecture; Sleep disturbances; Sleep disordered breathing; Restless legs; Periodic limb movements; ADHD; Circadian cycle

Figures and tables from this article:

Table 1. Studies of sleep disturbances in children with ADHD with subjective methods.

ADHD = Attention-deficit/hyperactivity disorder, ADHD-C = ADHD of the combined subtype, ADHD-H/I = ADHD of the hyperactive/impulsive subtype, ADHD-I = ADHD of the inattentive subtype, BD = bipolar disorder, CD = conduct disorder, DEP = major depressive episode, C(P/T)RS-R:S = Conner’s (parent/teacher) rating scale-revised: short forms, GAD = generalized anxiety disorder, IQ = intelligence quotient, LD = learning disability, MPH = methylphenidate, OCD = obsessive compulsive disorder, ODD = oppositional defiant disorder, PTSD = post-traumatic stress disorder, SAD = separation anxiety disorder, SD = standard deviation.

View Within ArticleTable 2. Studies of sleep disturbances in children with ADHD with objective methods.

AHI = Apnea hypopnea index, BD = bipolar disorder, CD = conduct disorder, DEX = dextro-amphetamine, DLMO = dim light melatonin onset, GAD = generalized anxiety disorder, LD = learning disability, MD = major depression, MPH = methylphenidate, MSLT = multiple sleep latency test, ODD = oppositional defiant disorder, PLMI = periodic limb movement index, RDI = respiratory disturbance index, REM = rapid eye movement, S1 = stage 1 sleep, SAD = separation anxiety disorder, SDB = sleep disordered breathing, SE = sleep efficiency, SOL = sleep onset latency, SOT = sleep onset time,TSP = total sleep period.

View Within ArticleTable 3. Studies of sleep disturbances in adults with ADHD with subjective methods.

ADHD = attention-deficit/hyperactivity disorder, ADHD-C = ADHD of the combined subtype, ADHD-H/I = ADHD of the hyperactive/impulsive subtype, ADHD-I = ADHD of the inattentive subtype, ASRS = adult self report scale, CSM = composite scale of morningness, EDS = excessive daytime sleepiness, ESS - Epworth sleepiness scale, IH = idiopathic hypersomnia, GAD = generalized anxiety disorder, MDD = major depressive disorder, MPH = methylphenidate, OCD = obsessive compulsive disorder, PTSD = post-traumatic stress disorder.

View Within ArticleTable 4. Studies of sleep disturbances in adults with ADHD with objective methods.

DEX = dextro-amphetamine, BRD = brief recurrent depression, MDD = major depressive disorder, MPH = methylphenidate, PSG = polysomnography, REM = rapid eye movement, SE = sleep efficiency, SOL = sleep onset latency.

View Within ArticleCopyright © 2011 Elsevier Ltd. Published by Elsevier Ltd. All rights reserved.

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Sleep in attention-deficit/hyperactivity disorder in children and adults: Past, present, and future

Sun Young Rosalia Yoona, b, , , , Umesh Jainb, e, , Colin Shapiroa, c, d, f, a Institute of Medical Sciences, University of Toronto, Canadab Child, Youth and Family Service, Centre for Addiction and Mental Health, 352-250 College Street, Toronto, ON, M5T 1R8, Canadac Division of Patient Based Clinical Research, Toronto Western Research Institute, Canadad Youthdale Child and Adolescent Sleep Centre, CanadaReceived 5 April 2011. Revised 1 July 2011. Accepted 5 July 2011. Available online 26 October 2011.View full text The understanding that sleep can give rise to, or exacerbate symptoms of attention-deficit/hyperactivity disorder (ADHD), and that good sleep hygiene improves attention and concentration tasks has sparked interest in the investigation of possible etiological relationships between sleep disorders and ADHD.

Studies indicate that 30% of children and 60–80% of adults with ADHD have symptoms of sleep disorders such as daytime sleepiness, insomnia, delayed sleep phase syndrome, fractured sleep, restless legs syndrome, and sleep disordered breathing. The range and diversity of findings by different researchers have posed challenges in establishing whether sleep disturbances are intrinsic to ADHD or whether disturbances occur due to co-morbid sleep disorders. As a result, understanding of the nature of the relationship between sleep disturbances/disorders and ADHD remains unclear.

In this review, we present a comprehensive and critical account of the research that has been carried out to investigate the association between sleep and ADHD, as well as discuss mechanisms that have been proposed to account for the elusive relationship between sleep disturbances, sleep disorders, and ADHD.

prs.rt("abs_end");Sleep architecture; Sleep disturbances; Sleep disordered breathing; Restless legs; Periodic limb movements; ADHD; Circadian cycle

Figures and tables from this article:

Table 1. Studies of sleep disturbances in children with ADHD with subjective methods.

ADHD = Attention-deficit/hyperactivity disorder, ADHD-C = ADHD of the combined subtype, ADHD-H/I = ADHD of the hyperactive/impulsive subtype, ADHD-I = ADHD of the inattentive subtype, BD = bipolar disorder, CD = conduct disorder, DEP = major depressive episode, C(P/T)RS-R:S = Conner’s (parent/teacher) rating scale-revised: short forms, GAD = generalized anxiety disorder, IQ = intelligence quotient, LD = learning disability, MPH = methylphenidate, OCD = obsessive compulsive disorder, ODD = oppositional defiant disorder, PTSD = post-traumatic stress disorder, SAD = separation anxiety disorder, SD = standard deviation.

View Within ArticleTable 2. Studies of sleep disturbances in children with ADHD with objective methods.

AHI = Apnea hypopnea index, BD = bipolar disorder, CD = conduct disorder, DEX = dextro-amphetamine, DLMO = dim light melatonin onset, GAD = generalized anxiety disorder, LD = learning disability, MD = major depression, MPH = methylphenidate, MSLT = multiple sleep latency test, ODD = oppositional defiant disorder, PLMI = periodic limb movement index, RDI = respiratory disturbance index, REM = rapid eye movement, S1 = stage 1 sleep, SAD = separation anxiety disorder, SDB = sleep disordered breathing, SE = sleep efficiency, SOL = sleep onset latency, SOT = sleep onset time,TSP = total sleep period.

View Within ArticleTable 3. Studies of sleep disturbances in adults with ADHD with subjective methods.

ADHD = attention-deficit/hyperactivity disorder, ADHD-C = ADHD of the combined subtype, ADHD-H/I = ADHD of the hyperactive/impulsive subtype, ADHD-I = ADHD of the inattentive subtype, ASRS = adult self report scale, CSM = composite scale of morningness, EDS = excessive daytime sleepiness, ESS - Epworth sleepiness scale, IH = idiopathic hypersomnia, GAD = generalized anxiety disorder, MDD = major depressive disorder, MPH = methylphenidate, OCD = obsessive compulsive disorder, PTSD = post-traumatic stress disorder.

View Within ArticleTable 4. Studies of sleep disturbances in adults with ADHD with objective methods.

DEX = dextro-amphetamine, BRD = brief recurrent depression, MDD = major depressive disorder, MPH = methylphenidate, PSG = polysomnography, REM = rapid eye movement, SE = sleep efficiency, SOL = sleep onset latency.

View Within ArticleCopyright © 2011 Elsevier Ltd. Published by Elsevier Ltd. All rights reserved.

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Sleep in attention-deficit/hyperactivity disorder in children and adults: Past, present, and future

Sun Young Rosalia Yoona, b, , , , Umesh Jainb, e, , Colin Shapiroa, c, d, f, a Institute of Medical Sciences, University of Toronto, Canadab Child, Youth and Family Service, Centre for Addiction and Mental Health, 352-250 College Street, Toronto, ON, M5T 1R8, Canadac Division of Patient Based Clinical Research, Toronto Western Research Institute, Canadad Youthdale Child and Adolescent Sleep Centre, CanadaReceived 5 April 2011. Revised 1 July 2011. Accepted 5 July 2011. Available online 26 October 2011.View full text The understanding that sleep can give rise to, or exacerbate symptoms of attention-deficit/hyperactivity disorder (ADHD), and that good sleep hygiene improves attention and concentration tasks has sparked interest in the investigation of possible etiological relationships between sleep disorders and ADHD.

Studies indicate that 30% of children and 60–80% of adults with ADHD have symptoms of sleep disorders such as daytime sleepiness, insomnia, delayed sleep phase syndrome, fractured sleep, restless legs syndrome, and sleep disordered breathing. The range and diversity of findings by different researchers have posed challenges in establishing whether sleep disturbances are intrinsic to ADHD or whether disturbances occur due to co-morbid sleep disorders. As a result, understanding of the nature of the relationship between sleep disturbances/disorders and ADHD remains unclear.

In this review, we present a comprehensive and critical account of the research that has been carried out to investigate the association between sleep and ADHD, as well as discuss mechanisms that have been proposed to account for the elusive relationship between sleep disturbances, sleep disorders, and ADHD.

prs.rt("abs_end");Sleep architecture; Sleep disturbances; Sleep disordered breathing; Restless legs; Periodic limb movements; ADHD; Circadian cycle

Figures and tables from this article:

Table 1. Studies of sleep disturbances in children with ADHD with subjective methods.

ADHD = Attention-deficit/hyperactivity disorder, ADHD-C = ADHD of the combined subtype, ADHD-H/I = ADHD of the hyperactive/impulsive subtype, ADHD-I = ADHD of the inattentive subtype, BD = bipolar disorder, CD = conduct disorder, DEP = major depressive episode, C(P/T)RS-R:S = Conner’s (parent/teacher) rating scale-revised: short forms, GAD = generalized anxiety disorder, IQ = intelligence quotient, LD = learning disability, MPH = methylphenidate, OCD = obsessive compulsive disorder, ODD = oppositional defiant disorder, PTSD = post-traumatic stress disorder, SAD = separation anxiety disorder, SD = standard deviation.

View Within ArticleTable 2. Studies of sleep disturbances in children with ADHD with objective methods.

AHI = Apnea hypopnea index, BD = bipolar disorder, CD = conduct disorder, DEX = dextro-amphetamine, DLMO = dim light melatonin onset, GAD = generalized anxiety disorder, LD = learning disability, MD = major depression, MPH = methylphenidate, MSLT = multiple sleep latency test, ODD = oppositional defiant disorder, PLMI = periodic limb movement index, RDI = respiratory disturbance index, REM = rapid eye movement, S1 = stage 1 sleep, SAD = separation anxiety disorder, SDB = sleep disordered breathing, SE = sleep efficiency, SOL = sleep onset latency, SOT = sleep onset time,TSP = total sleep period.

View Within ArticleTable 3. Studies of sleep disturbances in adults with ADHD with subjective methods.

ADHD = attention-deficit/hyperactivity disorder, ADHD-C = ADHD of the combined subtype, ADHD-H/I = ADHD of the hyperactive/impulsive subtype, ADHD-I = ADHD of the inattentive subtype, ASRS = adult self report scale, CSM = composite scale of morningness, EDS = excessive daytime sleepiness, ESS - Epworth sleepiness scale, IH = idiopathic hypersomnia, GAD = generalized anxiety disorder, MDD = major depressive disorder, MPH = methylphenidate, OCD = obsessive compulsive disorder, PTSD = post-traumatic stress disorder.

View Within ArticleTable 4. Studies of sleep disturbances in adults with ADHD with objective methods.

DEX = dextro-amphetamine, BRD = brief recurrent depression, MDD = major depressive disorder, MPH = methylphenidate, PSG = polysomnography, REM = rapid eye movement, SE = sleep efficiency, SOL = sleep onset latency.

View Within ArticleCopyright © 2011 Elsevier Ltd. Published by Elsevier Ltd. All rights reserved.

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