Impact of Sleep-Related Complaints on Depressive Symptoms in Patients With Restless Legs Syndrome
J Clin Psychiatry 2005;66(9):1139-1145
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Objective: Restless legs syndrome (RLS) is
a distressing sensorimotor disorder with a 5% to 10% prevalence in the United States and
Western Europe. The nocturnal occurrence of
symptoms often leads to severe sleep disturbances. RLS
has been reported to be associated with depression and anxiety. The aim of the present study was
to investigate the relationship between RLS symptom severity, sleep disturbances, and
Method: Questionnaire data from 100
consecutive patients with idiopathic RLS who had been investigated in our Sleep Disorders
Unit from April 1999 to December 2004 were evaluated. Patients were untreated regarding RLS,
depression, or sleep disturbances. Severity of RLS was assessed with the International RLS
Study Group rating scale (IRLS). Depressive
symptoms and subjective sleep quality were determined
using the Beck Depression Inventory (BDI) and the Pittsburgh Sleep Quality Index (PSQI),
Results: IRLS scores indicated
moderate-to-severe RLS symptoms in the population
studied (mean ± SD IRLS score = 23.6 ± 6.7).
The mean ± SD BDI score was 9.3 ± 5.6, with
highest values on the "reduced sleep," "loss of
energy," and "work difficulties" items, indicating
predominating somatic symptoms of depression.
Fourteen patients had a BDI score of 15 to 20 ("mild
depression"), and 3 patients had a BDI score of
20 to 30 ("mild to moderate depression").
Overall, patients estimated their sleep quality as
moderately impaired (mean ± SD PSQI score = 10.9 ± 3.7). Severity of RLS
correlated with the impairment of subjective sleep
quality (r = 0.281, p = .007) but not with self-rated
depressive symptoms (r = 0.119, p = .237).
Conclusion: RLS patients scored high on
the somatic items of the BDI, particularly on
those related to sleep disturbance, but not on the
other items that mostly address cognitive
symptoms. Our results indicate that RLS might be
associated with some features of depression but not with
the full spectrum of a depressive disorder. The
relationship between the 2 disorders should be
investigated in further studies.