Restless legs syndrome in patients with obstructive sleep apnea: Association between apnea severity and symptoms of depression, insomnia, and daytime sleepiness

To determine if the prevalence and severity of restless legs syndrome (RLS) varies with apnea severity and analyze differences between the sexes in terms of comorbid RLS with symptoms of depression, insomnia, and daytime sleepiness in patients with obstructive sleep apnea (OSA). Symptoms of depressi...

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Bibliographic Details
Published in:	Sleep medicine 2024-05, Vol.117, p.40-45
Main Authors:	Kim, Boyoung, Kim, Tae-Young, Choi, Eun-Ju, Lee, Myeongwoo, Kim, Wontae, Lee, Sang-Ahm
Format:	Article
Language:	eng
Subjects:	Adult Apnea-hypopnea index Daytime sleepiness Depression Depression - epidemiology Disorders of Excessive Somnolence - complications Disorders of Excessive Somnolence - epidemiology Female Humans Insomnia Male Obstructive sleep apnea Restless legs syndrome Restless Legs Syndrome - complications Restless Legs Syndrome - epidemiology Sleep Apnea, Obstructive - complications Sleep Apnea, Obstructive - diagnosis Sleep Apnea, Obstructive - epidemiology Sleep Initiation and Maintenance Disorders - complications Sleep Initiation and Maintenance Disorders - epidemiology
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Summary:	To determine if the prevalence and severity of restless legs syndrome (RLS) varies with apnea severity and analyze differences between the sexes in terms of comorbid RLS with symptoms of depression, insomnia, and daytime sleepiness in patients with obstructive sleep apnea (OSA). Symptoms of depression, insomnia, and daytime sleepiness were defined as Patient Health Questionnaire–9 score ≥10, Insomnia Severity Index score ≥15, and Epworth Sleepiness Scale score ≥11. Multivariate logistic and linear regression analyses were conducted. In 707 adults with OSA (85.1% males), 16.1% (n = 114) had comorbid RLS. The prevalence of RLS was markedly lower in those with moderate and severe OSA than in those with mild OSA. Similarly, the odds of RLS significantly decreased with increasing apnea-hypopnea index. After controlling for age and sex, in patients with comorbid RLS, the International RLS Study Group Rating Scale scores were negatively correlated with apnea-hypopnea index and a nadir peripheral oxygen saturation during sleep. The presence of RLS was more likely to be associated with symptoms of depression, insomnia, and daytime sleepiness after controlling for confounding variables, but only in men. RLS is frequently noted in combination with OSA, with a female preponderance. The severities of OSA and RLS may be negatively associated. In patients with OSA, sex-related differences in terms of comorbid RLS with symptoms of depression, insomnia, and daytime sleepiness warrant further investigations. •The RLS prevalence was 16.1% of patients with OSA, with female preponderance.•OSA severity was negatively correlated with the prevalence and severity of RLS.•RLS was more likely to be associated with symptoms of depression, insomnia, and daytime sleepiness.•However, these associations were observed only in males and not in females.
ISSN:	1389-9457 1878-5506