RLS in primary care in Holland

Clinical bottom line

About 7% of adults aged 50 years or older in primary care in Holland have symptoms of restless leg syndrome. Incidence increases with age.

Reference

R Rijsman et al. Epidemiology of restless legs in the Netherlands. European Journal of Neurology 2004 11: 607-611.

Study

This was a population based survey in a small town in Holland in the early 1990s. Every adult aged 50 years or older was sent a questionnaire about sleep, with two reminders at four-week intervals. Though primarily designed to investigate sleep apnoea, questions about RLS were included. They did not use the current diagnostic questions about RLS because they were not available in 1994.

Based on a question on sleep disturbance by leg movements, those who responded often or always were thought to suffer RLS. Other questions asked about sleep patterns and daytime tiredness.

Results

Of 1,683 adults (92% of the total registered with a single practice) 88% returned the questionnaire, but 42 did not complete the question about restless legs. Therefore the total who responded and answered the RLS question was 1,437.

Of these, 102 had sleep disturbed often or always by leg movements, or 7.1%. The proportion who had RLS so defined increased with age (Figure 1), and also more frequently reported poor sleep and daytime tiredness (Table 1).

Figure 1: RLS by decade of age

Table 1: Sleep disturbance and daytime tiredness in adults with or without RLS symptoms

Problem	No RLS	RLS
	% of 1318	% of 102
Poor sleep	26	55
Getting to sleep	17	39
Tired during the day	14	33
Naps during the day	17	31
Sleepy during the day	14	28
Waking in the night	7	22

Comment

The overall prevalence of adults with RLS symptoms in this Dutch primary care study accords well with other studies on RLS prevalence.