Restless legs syndrome and periodic limb movements of sleep: Fact, fad, and fiction

Current Opinion in Pulmonary Medicine

Volumn 8, Issue 6, 2002, Pages 498-501

  Patel, Sanjiv ^a  

^a NONE   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

DOPAMINE RECEPTOR STIMULATING AGENT; GABAPENTIN; IRON; MELATONIN; OPIATE DERIVATIVE; RECOMBINANT ERYTHROPOIETIN;

AROUSAL; BREATHING DISORDER; DISEASE ASSOCIATION; HEMATOCRIT; HUMAN; IRON DEFICIENCY ANEMIA; KIDNEY FAILURE; LIMB MOVEMENT; MORTALITY; PERIODIC LIMB MOVEMENTS OF SLEEP; RESTLESS LEGS SYNDROME; REVIEW; SLEEP; SLEEP DISORDER; SOMNOLENCE; SYMPTOMATOLOGY;

ANEMIA, IRON-DEFICIENCY; ANTICONVULSANTS; HUMANS; KIDNEY FAILURE; MELATONIN; NOCTURNAL MYOCLONUS SYNDROME; RESTLESS LEGS SYNDROME; RISK FACTORS;

EID: 0036838255     PISSN: 10705287     EISSN: None     Source Type: Journal    
DOI: 10.1097/00063198-200211000-00002     Document Type: Review

References (17)

1. Benz RL, Pressman MR, Hovick ET, et al.: Potential novel predictors of mortality in end-stage renal disease patients with sleep disorders. Am J Kidney Dis 2000, 6:1052-1060. This is an interesting article using PLMS as a marker of mortality in patients with ESRD. The authors found a significant correlation with earlier mortality in those patients with high PLMSI and those associated with arousals (P = 0.01). When the data was analyzed, there appeared to be a break point at a PLMSI of 20. Those greater than 20 had a 50% 20-month survival versus those less than 20 with a 90% 20-month survival (P = 0.0008).
2. Coleman RM, Pollak CP, Weitzman ED: Periodic movements in sleep (nocturnal myoclonus): Relation to sleep disorders. Ann Neurol 1980, 8:416-421.
3. Benz RL, Pressman MR, Hovick ET, et al.: A preliminary study of the effects of correction of anemia with recombinant human erythropoietin therapy on sleep, sleep disorders, and daytime sleepiness in hemodialysis patients (The SLEEPO Study). Am J Kidney Dis 1999, 6:1089-1095. This article indicates that improving hematocrit in patients with ESRD improves morbidity. By "normalizing" their subjects with hematocrit, they showed a decrease in PLMSI (P < 0.03) and APLMSI (P < 0.002). For this subset of patients, this could prove important, given the findings from the previous cited article.
4. Thorpy ML, Morris CD, Bagby SP: A crossover study of gabapentin in treatment of restless legs syndrome among hemodialysis patients. Am J Kidney Dis 2001, 1:104-108. This paper shows good use of pharmacokinetics, using the long half-life of gabapentin in renal failure to treat patients with RLS and ESRD after each dialysis.
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14. Allen RP, Barker PB, Wehrl F, et al.: MRI measurement of brain iron in patients with restless leg syndrome. Neurology 2001, 2:263-265. This was an interesting article using an imaging test to evaluate patients with RLS. The hypothesis was that iron is a co-factor needed for dopamine production; thus, it should be decreased in the nigrostriatal areas of the brain in patients with RLS. The investigators used new MRI methods to show that patients with RLS did have decreased stores in certain areas of the brain compared with controls.
15. Bartzoki G, Aravagiri M, Oldendorf WH, et al.: Field dependent transverse relaxation rate increase may be specific measure of tissue iron stores. Magn Reason Med 1993, 29:459-464.
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17. Kunz d, Bes F: Exogenous melatonin in periodic limb movement disorder: An open clinical trial and a hypothesis. Sleep 2001, 24:183-187. Giving 3 mg of melatonin to these subjects reduced PLMSI (P = 0.004) and improved subjective well being. As stated in the paper, melatonin must be used with caution because it is considered a food supplement by the FDA and has no standards for purity and quality.