Cho Yong Won, Song Mei Ling, Earley Christopher J, Allen Richard P
Department of Neurology, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, South Korea.
Graduate School of Nursing, Keimyung University, Daegu, South Korea.
Sleep Med. 2015 Jun;16(6):775-8. doi: 10.1016/j.sleep.2014.12.024. Epub 2015 Mar 18.
The complaint of pain has largely been ignored in the diagnostic criteria for restless legs syndrome (RLS). The purpose of this study was to investigate the prevalence of painful symptoms in RLS, and to compare sleep-related characteristics between the patients who experienced the painful symptoms and those who did not.
The patients with RLS were retrospectively screened from July 2011 to December 2013 at a tertiary-care sleep center. For classifying those with pain and those without pain, more than three specialists separately observed the patients' reports and complaints of symptoms, and the final decision was made through consensus. The demographics and clinical characteristics, including sleep, psychiatric-related scales, and polysomnographic data were reviewed for the study.
One hundred and sixty patients with RLS were selected, and 23.8% of them reported painful symptoms of RLS. Patients with RLS who experienced painful sensations were found to have lower ferritin levels, more severe RLS symptoms, anxiety and depressive symptoms, and a lower quality of life. The polysomnography data found that patients with RLS who experienced painful sensations had a longer latency to sleep onset and a lower periodic limb movement index (PLMI) (p <0.05).
Patients who experienced painful sensations had more severe RLS symptoms and a trend toward lower PLMI during sleep. According to these results, an inference can be made that painful sensations may be one important point in determining the severity of RLS.
不安腿综合征(RLS)的诊断标准很大程度上忽视了疼痛主诉。本研究旨在调查RLS中疼痛症状的患病率,并比较有疼痛症状的患者与无疼痛症状的患者之间与睡眠相关的特征。
2011年7月至2013年12月在一家三级医疗睡眠中心对RLS患者进行回顾性筛查。为了区分有疼痛和无疼痛的患者,由三名以上专家分别观察患者的症状报告和主诉,最终通过共识做出决定。对研究对象的人口统计学和临床特征进行了回顾,包括睡眠、精神相关量表和多导睡眠图数据。
选取了160例RLS患者,其中23.8%报告有RLS疼痛症状。发现有疼痛感觉的RLS患者铁蛋白水平较低、RLS症状更严重、有焦虑和抑郁症状,且生活质量较低。多导睡眠图数据显示,有疼痛感觉的RLS患者入睡潜伏期更长,周期性肢体运动指数(PLMI)更低(p<0.05)。
有疼痛感觉的患者RLS症状更严重,睡眠期间PLMI有降低趋势。根据这些结果,可以推断疼痛感觉可能是确定RLS严重程度的一个重要因素。