Lo Coco Daniele, Mattaliano Alfredo, Lo Coco Albino, Randisi Biagio
U.O. Neurologia, Dipartimento di Neuroscienze, Ospedale Civico ARNAS, 2-90129 Palermo, Italy.
Sleep Med. 2009 May;10(5):572-6. doi: 10.1016/j.sleep.2008.04.014. Epub 2008 Nov 8.
Despite complaints of poor sleep being very common in people with chronic obstructive pulmonary disease (COPD), restless legs syndrome (RLS) symptoms have not been extensively investigated in these patients.
To assess the prevalence and severity of RLS in patients with COPD and to investigate the factors potentially associated with RLS.
A total of 87 patients with COPD and 110 controls, matched for age and sex, were evaluated regarding the presence and severity of RLS symptoms. A diagnosis of RLS was made according to the criteria of the International RLS Study Group (IRSLSSG), and severity was assessed by the IRLSSG severity scale. Excessive daytime somnolence was assessed using the Epworth sleepiness scale (ESS).
RLS was significantly more frequent in COPD patients than in controls (36.8% vs. 11%; p < 0.001). Compared to controls, COPD patients with RLS showed higher disease severity (mean IRLSSG severity scale score: 20.5 +/- 2.8 for COPD, and 18 +/- 3.5 for controls; p = 0.016) and more pronounced daytime somnolence (mean ESS score: 11.8 +/- 1.1 for COPD, and 8.6 +/- 3.6 for controls; p = 0.009). Moreover, compared to those without RLS, COPD patients with RLS showed increased daytime sleepiness (mean ESS score: 11.8 +/- 1.1 for COPD/RLS, and 7.3 +/- 4 for COPD/non-RLS; p < 0.001) and longer disease duration (11.9 +/- 7 years for COPD/RLS, and 8.7 +/- 6.9 years for COPD/non-RLS; p = 0.045). Multivariate analysis showed that ESS score was the only factor significantly associated with RLS in COPD patients.
RLS is a frequent cause of disabling sleep disturbance in patients with COPD and should be specifically investigated in these patients.
尽管慢性阻塞性肺疾病（COPD）患者中睡眠不佳的抱怨非常常见，但不安腿综合征（RLS）症状在这些患者中尚未得到广泛研究。
评估COPD患者中RLS的患病率和严重程度，并调查与RLS潜在相关的因素。
总共87例COPD患者和110例年龄和性别匹配的对照者，就RLS症状的存在和严重程度进行评估。根据国际RLS研究组（IRSLSSG）的标准进行RLS诊断，并通过IRLSSG严重程度量表评估严重程度。使用Epworth嗜睡量表（ESS）评估日间过度嗜睡情况。
COPD患者中RLS的发生率显著高于对照组（36.8%对11%；p<0.001）。与对照组相比，患有RLS的COPD患者疾病严重程度更高（平均IRLSSG严重程度量表评分：COPD组为20.5±2.8，对照组为18±3.5；p = 0.016），日间嗜睡更明显（平均ESS评分：COPD组为11.8±1.1，对照组为8.6±3.6；p = 0.009）。此外，与无RLS的患者相比，患有RLS的COPD患者日间嗜睡增加（平均ESS评分：COPD/RLS组为11.8±1.1，COPD/非RLS组为7.3±4；p<0.001），病程更长（COPD/RLS组为11.9±7年，COPD/非RLS组为8.7±6.9年；p = 0.045）。多变量分析显示，ESS评分是COPD患者中与RLS显著相关的唯一因素。
RLS是COPD患者致残性睡眠障碍的常见原因，应对这些患者进行专门调查。
