Urges to move and struggles to breathe: restless legs syndrome/WillisEkbom disease in adult patients with obstructive sleep apnea

Recent evidences pointed out that the prevalence of comorbidity of restless legs syndrome/Willis-Ekbom disease (RLS/WED) and obstructive sleep apnea (OSA) is around 20%. Nonetheless its association factors have not been extensively evaluated after the recent modification in diagnostic criteria. We aimed to estimate the prevalence of RLS/WED and its association factors with OSA in an adult sample.

This was a prospective, cross-sectional study including 490 adult patients with OSA diagnosis (apnea–hypopnea index ≥ 5 obstructive events/hour associated to clinical picture). RLS/WED diagnosis was established by the 2014 International Restless Legs Syndrome Study Group (IRLSSG) criteria established by face-to-face interview with a neurologist.

The prevalence of RLS/WED was 18.6% (n = 91) and its diagnosis was previously established in 13.2% (n = 12/91). The mean IRLSSG severity score was 17.0 (standard deviation 6.8). RLS/WED was associated with female sex, chronic insomnia symptoms, greater anxiety, and depression severity scores, and with mild obstructive sleep apnea severity. On the other hand, severe obstructive sleep apnea was negatively associated to RLS/WED.

Despite being relatively prevalent among patients with OSA, RLS/WED is previously underrecognized in our sample. RLS/WED severity correlated with higher scores on anxiety and depression scales. Chronic insomnia symptoms were the main RLS/WED association factor.