Daytime symptoms in restless legs syndrome - An underestimated problem?

摘要

Restless legs syndrome (RLS) is typically characterized by unpleasant sensations in the limbs, often the lower limbs, and associated with an urge to move them. Since the historic description by Ekbom in the 1940s it has been widely assumed that these paraesthesias are "...mostly felt during the night..." and "...are either entirely absent or are of a mild degree..." during the daytime [1]. Ekbom's observation was later confirmed by a few studies that systematically investigated RLS symptoms during the course of the day and found that the severity of subjective leg discomfort measured with (modified) suggested immobilization tests in untreated patients increases during the late evening and peaks in the middle of the night, with a minimum of symptoms in the morning [2-4]. Although Ekbom already found that daytime symptoms occur, the obvious and frequent problem of patients' difficulties falling and staying asleep identified Restless-Legs-Syndrome as a sleep disorder. This might explain why previous questionnaire surveys reported an impact on daytime functioning in around 50% of patients [5,6], but did not differentiate if this resulted from daytime symptoms or from impaired sleep. Furthermore, a previous epide-miological study reported that 10% of the patients had daytime symptoms, but defined daytime only as before 6 p.m. [7].