Restless Legs Syndrome Tied to Earlier Death Risk

Older men with condition have 39 percent increase in mortality, study suggests

By Serena Gordon

HealthDay Reporter

WEDNESDAY, June 12 (HealthDay News) -- Men with restless legs syndrome now have another health concern: New research has just linked the condition to an increased risk of dying early.

In a study of nearly 20,000 men, Harvard researchers found that men with restless legs syndrome had a 39 percent higher risk of an early death than did men without the condition.

"This study suggests that individuals with restless legs syndrome are more likely to die early than other people," said study author Dr. Xiang Gao, an assistant professor at Harvard Medical School and an associate epidemiologist at Brigham and Women's Hospital in Boston. "This association was independent of other known risk factors."

"[However], this is an observational study," Gao said of the findings, which were published online June 12 in the journal Neurology. "We can only see an association that suggests a possible causal relationship."

Restless legs syndrome is a common condition that causes people to feel an uncomfortable sensation in their legs when lying down, according to the U.S. National Institute of Neurological Disorders and Stroke (NINDS). The feeling may be a throbbing, pulling or creeping sensation. Restless legs syndrome makes it hard to fall asleep and stay asleep.

The exact cause of restless legs syndrome is unknown. It does seem to run in families, suggesting a genetic component to the condition, according to the NINDS. Restless legs syndrome has also been linked to some medical conditions, such as kidney disease and the nerve disorder peripheral neuropathy. It's also associated with the use of certain medications, and may occur during pregnancy.

Gao said many people with restless legs syndrome have low iron levels, and taking iron supplements often can alleviate the symptoms of restless legs syndrome. But, he cautioned, too much iron can be dangerous, so be sure to have your doctor check your iron levels before taking any supplements.

The current study included nearly 18,500 American men who were followed for eight years. At the start of the study, none of the men had diabetes, arthritis or kidney failure. The average age at the start of the study was 67.

Almost 4 percent (690 men) of the study group was diagnosed with restless legs syndrome. Men with restless legs syndrome were more likely to take antidepressant drugs and have high blood pressure, cardiovascular disease or Parkinson's disease. Not surprisingly, men with restless legs syndrome had more frequent complaints of insomnia.

During the study follow-up, nearly 2,800 men died.

When the researchers compared those with restless legs syndrome to those without, they found that men who had the condition were 39 percent more likely to die during the study period than men without the condition. When they controlled for factors such as body mass, lifestyle factors, chronic conditions and sleep duration, the mortality risk for men with restless legs syndrome dropped to 30 percent.

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Drugs May Help Relieve Restless Legs Syndrome

By Steven Reinberg

HealthDay Reporter

MONDAY, March 4 (HealthDay News) -- People suffering from restless legs syndrome may find some relief by taking one of several drugs approved to treat the condition, a new review confirms.

The medications, which include Requip (ropinirole), levodopa, Neurontin (gabapentin) and Lyrica (pregabalin), appear to reduce symptoms of the syndrome in more than 60 percent of patients, researchers report. The first two drugs raise dopamine levels in the body, and the last two drugs reduce the amount of calcium reaching brain cells and trigger the production of other chemicals that help reduce pain. Dopamine is a brain chemical that regulates movement and mood.

"Physicians and patients now have better information on the effectiveness and harms of two types of drug treatments for patients with at least moderately severe restless legs symptoms in which to guide treatment choices," said review author Dr. Timothy Wilt, core investigator at the Minneapolis VA Health Care System.

Restless legs syndrome causes a person to feel a powerful urge to move his or her legs. The legs become uncomfortable when lying down or sitting, and the condition can disrupt sleep and take a toll on the quality of life, the researchers said.

One expert, Dr. Martin Niethammer, a neurologist at the Movement Disorders Center of North Shore-LIJ's Cushing Neuroscience Institute in Manhasset, N.Y., said this study is merely a review of the current treatments for restless legs syndrome.

"There is nothing new here at all," he said. "It doesn't add anything to the field."

This is just a compilation of evidence that follows guidelines that have been long established in both Europe and the United States, Niethammer said.

"These are the only treatments approved by the [U.S. Food and Drug Administration]," he added.

The report was published in the March 4 online issue of JAMA Internal Medicine.

For the analysis, Wilt's team reviewed 29 clinical trials. The researchers found that 61 percent of those taking dopamine agonists showed at least a 50 percent improvement in their symptoms, compared with 41 percent of those taking an inactive placebo.

In addition, those taking dopamine agonists slept better and scored higher on measures of quality of life. Dopamine agonists were originally developed to treat Parkinson's disease.

Side effects of dopamine agonists can include euphoria, hallucinations, weight loss, nausea, insomnia, tiredness or weakness, dizziness and drowsiness.

There are generic versions of Requip that cost far less, running between $11 and $22 a month. Insurance covers the treatment in most cases, so actual out-of-pocket costs will vary by insurance plan. The same is true for levodopa, Wilt said.

Neurontin and Lyrica also helped relieve symptoms in 61 percent of patients, compared with 37 percent of those taking a placebo, the researchers found.

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