Restless Legs Syndrome Affects 35%, Often in Third Trimester


From the annual meeting of the Associated Professional Sleep Societies

SAN ANTONIO — Restless legs syndrome is extremely common in pregnancy, and one-third of affected women experience severe symptoms on four or more nights per week, according to a large prospective study.

Moreover, the presence of restless legs syndrome (RLS) doubles a pregnant woman's odds of experiencing poor sleep quality or poor daytime functioning, Dr. Qurratul Shamim-Uzzaman reported at the meeting.

These findings suggest targeting RLS offers potential opportunities to improve women's sleep during pregnancy, according to Dr. Shamim-Uzzaman, a sleep medicine fellow in the department of neurology at the University of Michigan, Ann Arbor.

She presented a study of 1,489 women who were surveyed in their third trimester about their sleep. The validated screening questionnaires utilized in the study included a four-item Brief Restless Legs Scale, the Epworth Sleepiness Scale, and the General Sleep Disturbance Scale.

Thirty-five percent of the pregnant women reported having symptoms of RLS, typically peaking in the third trimester. Seventy percent of affected women had symptoms 2 or more nights per week, and 16% experienced symptoms 6-7 nights per week. The prevalence of RLS in the general population of nonpregnant women has been pegged at 14%-16% in prior studies, suggesting that the rate more than doubles in pregnancy.

One of the questions the Michigan study set out to answer is whether the prevalence of RLS in pregnancy varies by race. This indeed proved to be the case. The prevalence was highest in whites at 38%, compared with 27% in blacks and 33% in Asian-Indian women.

A score of 10 or more on the Epworth Sleepiness Scale, indicative of excessive daytime sleepiness, was achieved by 48% of women with RLS, compared with 38% without RLS. The presence of RLS resulted in impaired daytime functioning. Poor daytime functioning was experienced by 67% of pregnant women without RLS, 69% with RLS symptoms less than 2 nights per week, and 87% of those with RLS at least 4 nights weekly.

In a multivariate regression model that controlled for age, race, snoring, and body mass index (BMI), RLS was an independent predictor of poor sleep quality, with an associated twofold increase in the odds of experiencing poor sleep. Similarly, in an analysis that controlledv for age, race, and BMI, RLS was an independent predictor of poor daytime function, with an odds ratio of 1.8.

Disclosures: Dr. Shamim-Uzzamam reported having no financial conflicts in connection with the study, which was funded by the University of Michigan Institute for Research on Women and Gender; the National Heart, Lung, and Blood Institute; and the Gilmore Fund.

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