Symptoms of restless legs syndrome in older adults: Outcomes on sleep quality, sleepiness, fatigue, depression, and quality of life

OBJECTIVES: To compare differences in sleep quality, sleepiness, fatigue, depression, and quality of life according to severity of symptoms of restless legs syndrome (RLS) in older adults. DESIGN: Descriptive, comparative study; cross-sectional design. SETTING: Penn Sleep Center at the University of Pennsylvania and RLS support groups in Philadelphia. PARTICIPANTS: Thirty-nine adults, aged 65 and older, diagnosed with RLS with symptoms at least 3 nights per week. Participants were stratified according to symptom severity based on scores from the RLS Symptom Severity Scale. Exclusion criteria were dementia, cognitive impairments, and sleep disorders other than RLS. MEASUREMENTS: Sleep quality, measured using the Pittsburgh Sleep Quality Index (PSQI), was the primary outcome. Secondary outcomes were sleepiness, fatigue, depression, and quality of life measured using the Epworth Sleepiness Scale (ESS), Fatigue Severity Scale (FSS), Center for Epidemiological Studies-Depression Scale (CES-D), and RLS Quality of Life Instrument (RLS-QLI), respectively. RESULTS: Significant differences were found in subjective sleep quality (P=.007) and sleep duration (P=.04), as well as in PSQI global score (P=.007). RLS-QLI sleep quality (beta=-0.12, 95% confidence interval (CI)=-0.18 to -0.06, P <.001) and sleepiness (beta=0.35, 95% CI=0.09-0.61, P=.01) were significantly related to PSQI global score. Subjects with severe symptoms were five times as likely to use medication to treat RLS (OR=5.3, 95% CI=1.2-22.2). CONCLUSION: The severity of RLS symptoms in older adults affects not only sleep quality but also many aspects of quality of life, including social functioning, daily functioning, and emotional well-being.