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Restless legs syndrome among women: prevalence, co-morbidity and possible relationship to menopause
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. (Klinisk och experimentell reproduktionsbiologi/Olovsson)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. (Obstetrisk forskning/Axelsson)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. (Klinisk och experimentell reproduktionsbiologi/Olvosson)
Center for Clinical Research Dalarna Falun, Sweden.
2008 (English)In: Climacteric, ISSN 1369-7137, Vol. 11, no 5, 422-428 p.Article in journal (Refereed) Published
Abstract [en]

Objectives Restless legs syndrome (RLS) is a common neurological movement disorder with a female preponderance and an increasing prevalence with age. During the menopausal transition, sleep is affected. Prior studies suggest that female hormones are associated with the clinical manifestation of RLS. Methods A random sample of 5000 women aged 18-64 years was selected from the general Swedish population. They were sent questions on RLS, general health, sleep problems, reproductive health and menopausal state. Results The response rate was 70.3%; 15.7% of the women were diagnosed with RLS. Prevalence increased with age. RLS subjects more often had symptoms of affected sleep and depressed mood. Co-morbidity with heart disease was more common among RLS subjects, whereas hypertension and diabetes mellitus were not. There was a strong association between vasomotor symptoms and RLS but no statistical relationship between use of hormone replacement therapy, postmenopausal state and RLS. Conclusion The prevalence of RLS among Swedish women is high. RLS sufferers more often suffered from depression and heart disease, whereas no such associations were noted for diabetes or hypertension. We found an increased prevalence of RLS among women with vasomotor symptoms (night sweats) during the menopausal transition but not among women using hormone replacement therapy.

Place, publisher, year, edition, pages
2008. Vol. 11, no 5, 422-428 p.
Keyword [en]
Restless legs syndrome, Women, Prevalence, Co-morbidity, Menopause, Estrogen
National Category
Medical and Health Sciences
URN: urn:nbn:se:uu:diva-85685DOI: 10.1080/13697130802359683ISI: 000259086500011OAI: oai:DiVA.org:uu-85685DiVA: diva2:113861
Available from: 2008-12-03 Created: 2008-10-30 Last updated: 2014-01-07Bibliographically approved
In thesis
1. Sleep Related Movement Disorders: Association with Menopause and Pregnancy
Open this publication in new window or tab >>Sleep Related Movement Disorders: Association with Menopause and Pregnancy
2013 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

It is known that sleep problems affect people’s wellbeing and has great consequences for public health.

Restless legs syndrome (RLS) gives uncomfortable sensations in the legs at rest, leading to an irresistible need for activity. It aggravates in evening and at night. Therefore, RLS provides poorer sleep and can affect quality of life through fatigue, family life and social activities, work, and comorbidity. It is demonstrated a dysfunction of the dopaminergic system in the brain with low levels of dopamine and / or less sensitive dopamine receptors. RLS is more common in women and the prevalence increases with age and during pregnancy.

Periodic limb movements are characterized by uncontrolled stretching movements of the legs, especially the toes, ankles, knees and hips during sleep. They last between 0.5 and 5 seconds, and can cause brief awakenings leading to daytime sleepiness. The clinical significance of PLM is rather controversial and PLM is sometimes seen in healthy people with no daytime symptoms.

RLS is a subjective diagnosis and translated with the help of questionnaires. PLM however, can objectively be evaluated by polysomnography.

Depression is common during and after pregnancy. It is not known whether women with RLS during pregnancy have a higher risk of prenatal or postpartum depression.

The aims of this thesis was to  to examine the prevalence, associated symptoms and comorbidities, in particular, vasomotor symptoms, menopause, and hormone replacement therapy (HRT) use, among women who suffer from RLS and PLMs. We also evaluated the impact of RLS and PLMs on health related quality of life (HRQoL), and if RLS before and during pregnancy increases the risk of antenatal or postpartum depressive symptoms.

Three different poulations were used.  Paper 1-3 were cross-sectional and included 5000 resp. 10000 randomly selected women from the general populations of Dalarna and Uppsala County. Questionnaires, polysomnographic recordings, blodtests etc. were used. Paper 4 was a longitudinal cohort study where 1428 pregnant women in Uppsala County were followed.

In summary, data included in this thesis points out that RLS and PLMs are more common in women with estrogendeficiency-related symptoms of menopause. RLS-positive women had an impaired mental HRQoL compared to RLS-negative women and more often suffered from comorbidities. Data also revealed that women with RLS before and during pregnancy are at increased risk for depression during and after pregnancy.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2013. 74 p.
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 915
Sleep, Restless Legs Syndrome, Women, Menopause, Pregnancy, Depression
National Category
Other Clinical Medicine
Research subject
urn:nbn:se:uu:diva-204149 (URN)978-91-554-8703-4 (ISBN)
Public defence
2013-09-06, Gustavianum, Akademigatan 3, Uppsala, 09:15 (English)
Available from: 2013-08-16 Created: 2013-07-22 Last updated: 2014-01-07Bibliographically approved

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