Contributing Factors to Persistent Insomnia in Patients With Restless Legs Syndrome
Background and Objective Insomnia is common in restless legs syndrome (RLS) but can persist despite leg discomfort improvement. We investigated factors contributing to persistent insomnia in these patients. Methods We retrospectively analyzed the medical records of RLS patients treated for at least...
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Korean Society of Sleep Medicine
2025-06-01
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| Series: | Sleep Medicine Research |
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| Online Access: | http://sleepmedres.org/upload/pdf/smr-2025-02838.pdf |
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| author | Wankiun Lee Ki-Young Jung |
| author_facet | Wankiun Lee Ki-Young Jung |
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| description | Background and Objective Insomnia is common in restless legs syndrome (RLS) but can persist despite leg discomfort improvement. We investigated factors contributing to persistent insomnia in these patients. Methods We retrospectively analyzed the medical records of RLS patients treated for at least six months in our hospital from March 2022 to June 2024. Patients with a ≥6-point decrease in the International Restless Legs Syndrome Study Group Rating Scale (IRLS) and a ≥50% reduction in the Visual Analogue Scale for insomnia severity from baseline after RLS treatment (improved insomnia group) were compared to those with a <50% reduction (persistent insomnia group). Clinical characteristics and polysomnographic findings were compared. We also compared changes in sleep questionnaire results before and after controlling for leg discomfort within each group. Results There were no differences in clinical characteristics and polysomnographic findings between the two groups. The improved insomnia group had significant reductions in IRLS (31.8±3.6 to 13.6±5.9, p<0.001), Pittsburgh Sleep Quality Index (14.2±4.3 to 8.7±3.3, p<0.001), Insomnia Severity Index (ISI) (18.3±6.7 to 8.1±4.6, p<0.001), and the proportion with Hospital Anxiety and Depression Scale-Depression ≥8 (42.1% to 21.1%, p=0.018). The persistent insomnia group showed significant reductions in IRLS (27.3±3.5 to 15.7±2.1, p=0.027) and ISI (16.0±5.4 to 11.2±6.1, p=0.043) without significant improvement of sleep quality and depression score after controlling for leg discomfort. Conclusions Patients with RLS may continue to experience insomnia even after leg discomfort is alleviated through medical treatment. Depression may be one of contributing factors to persistent insomnia and should be carefully considered in the comprehensive management of RLS patients. |
| format | Article |
| id | doaj-art-e53f04c2f8264d2b9b63f12b0f792750 |
| institution | Kabale University |
| issn | 2093-9175 2233-8853 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Korean Society of Sleep Medicine |
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| series | Sleep Medicine Research |
| spelling | doaj-art-e53f04c2f8264d2b9b63f12b0f7927502025-08-20T03:32:11ZengKorean Society of Sleep MedicineSleep Medicine Research2093-91752233-88532025-06-0116211512010.17241/smr.2025.02838323Contributing Factors to Persistent Insomnia in Patients With Restless Legs SyndromeWankiun Lee0Ki-Young Jung1 Department of Neurology, Chungnam National University Hospital, Daejeon, Korea Department of Neurology, Seoul National University Hospital, Seoul, KoreaBackground and Objective Insomnia is common in restless legs syndrome (RLS) but can persist despite leg discomfort improvement. We investigated factors contributing to persistent insomnia in these patients. Methods We retrospectively analyzed the medical records of RLS patients treated for at least six months in our hospital from March 2022 to June 2024. Patients with a ≥6-point decrease in the International Restless Legs Syndrome Study Group Rating Scale (IRLS) and a ≥50% reduction in the Visual Analogue Scale for insomnia severity from baseline after RLS treatment (improved insomnia group) were compared to those with a <50% reduction (persistent insomnia group). Clinical characteristics and polysomnographic findings were compared. We also compared changes in sleep questionnaire results before and after controlling for leg discomfort within each group. Results There were no differences in clinical characteristics and polysomnographic findings between the two groups. The improved insomnia group had significant reductions in IRLS (31.8±3.6 to 13.6±5.9, p<0.001), Pittsburgh Sleep Quality Index (14.2±4.3 to 8.7±3.3, p<0.001), Insomnia Severity Index (ISI) (18.3±6.7 to 8.1±4.6, p<0.001), and the proportion with Hospital Anxiety and Depression Scale-Depression ≥8 (42.1% to 21.1%, p=0.018). The persistent insomnia group showed significant reductions in IRLS (27.3±3.5 to 15.7±2.1, p=0.027) and ISI (16.0±5.4 to 11.2±6.1, p=0.043) without significant improvement of sleep quality and depression score after controlling for leg discomfort. Conclusions Patients with RLS may continue to experience insomnia even after leg discomfort is alleviated through medical treatment. Depression may be one of contributing factors to persistent insomnia and should be carefully considered in the comprehensive management of RLS patients.http://sleepmedres.org/upload/pdf/smr-2025-02838.pdfrestless legs syndromeinsomniapolysomnography |
| spellingShingle | Wankiun Lee Ki-Young Jung Contributing Factors to Persistent Insomnia in Patients With Restless Legs Syndrome Sleep Medicine Research restless legs syndrome insomnia polysomnography |
| title | Contributing Factors to Persistent Insomnia in Patients With Restless Legs Syndrome |
| title_full | Contributing Factors to Persistent Insomnia in Patients With Restless Legs Syndrome |
| title_fullStr | Contributing Factors to Persistent Insomnia in Patients With Restless Legs Syndrome |
| title_full_unstemmed | Contributing Factors to Persistent Insomnia in Patients With Restless Legs Syndrome |
| title_short | Contributing Factors to Persistent Insomnia in Patients With Restless Legs Syndrome |
| title_sort | contributing factors to persistent insomnia in patients with restless legs syndrome |
| topic | restless legs syndrome insomnia polysomnography |
| url | http://sleepmedres.org/upload/pdf/smr-2025-02838.pdf |
| work_keys_str_mv | AT wankiunlee contributingfactorstopersistentinsomniainpatientswithrestlesslegssyndrome AT kiyoungjung contributingfactorstopersistentinsomniainpatientswithrestlesslegssyndrome |