THE PREVALENCE AND SEVERITY OF RESTLESS LEG SYNDROMES AND ITS IMPACT ON YOUNG PREGNANT FEMALES
Main Article Content
Keywords
Restless Legs Syndrome, pregnancy, maternal morbidity, physiotherapy, paresthesia, prevalence
Abstract
OBJECTIVE: This study examines the prevalence of Restless Legs Syndrome (RLS) among pregnant women and evaluates its effects on maternal health. It emphasizes the importance of physiotherapy in addressing the challenges posed by this condition.
INTRODUCTION: Pregnancy represents a unique physiological state that increases susceptibility to RLS, a condition that significantly disrupts sleep, mental well-being, and physical functionality. The interplay between RLS symptoms and maternal health highlights the need for comprehensive investigations. This study seeks to quantify the prevalence of RLS among pregnant women and examine its implications for maternal health, contributing to the body of knowledge on this underrecognized condition.
METHOD AND MATERIAL: A cross-sectional study was conducted with 258 pregnant women aged 18–35 years, recruited from obstetric care facilities. Diagnosis of RLS was established using the Cambridge-Hopkins Restless Legs Syndrome Questionnaire and symptom severity evaluated via the International Restless Legs Syndrome Rating Scale. Statistical analyses were performed using SPSS software to identify prevalence rates, symptom severity, and associated sociodemographic and clinical factors.
RESULT: In a study of 258 pregnant participants, 65.5% were diagnosed with Restless Legs Syndrome (RLS). Symptoms were reported in various contexts: 7% felt them only while sitting, 28.7% only while lying, and 29.8% in both positions. Symptom severity varied, with 20.5% experiencing extreme distress, 26.7% moderate distress, 6.6% mild distress, and 11.6% no distress. Frequency over the past year included daily (22.9%), 4-5 times weekly (30.2%), and 2-3 times weekly (12.4%), highlighting RLS as a pervasive and distressing issue during pregnancy.
CONCLUSION: RLS represents a substantial, yet underrecognized, contributor to maternal morbidity during pregnancy. This study underscores the imperative for heightened clinical awareness and systematic screening protocols to mitigate its deleterious effects on maternal health outcomes. Further investigation into non-pharmacological management strategies, including physiotherapeutic interventions, is warranted to enhance care delivery for affected populations.
References
2. Mendes A, Silva V. Possible etiologies of restless legs syndrome in pregnancy: a narrative review. Sleep Sci. 2022 Oct-Dec;15(4):471-479. doi: 10.5935/1984-0063.20220080. PMID: 36419819; PMCID: PMC9670777.
3. Mubeen SM, Ahsan MD. Prevalence and associated factors of restless leg syndrome (RLS) in Pakistani women during pregnancy. J Obstet Gynaecol. 2022 Aug;42(6):1829-1834. doi: 10.1080/01443615.2022.2040963. Epub 2022 Apr 27. PMID: 35476609.
4. Mahmood, K., Farhan, R., Surani, A., Surani, A. A., & Surani, S. (2015). Restless Legs Syndrome among Pakistani Population: A Cross-Sectional Study. International Scholarly Research Notices, 2015, 762045. https://doi.org/10.1155/2015/762045. PMID: 27347546; PMCID: PMC4897127.
5. Broström A, Alimoradi Z, Lind J, Ulander M, Lundin F, Pakpour A. Worldwide estimation of restless legs syndrome: a systematic review and meta‐analysis of prevalence in the general adult population. Journal of Sleep Research. 2023 Jan 4:e13783.
6. 6 Picchietti DL, Hensley JG, Bainbridge JL, Lee KA, Manconi M, McGregor JA, Silver RM, Trenkwalder C, Walters AS; International Restless Legs Syndrome Study Group (IRLSSG). Consensus clinical practice guidelines for the diagnosis and treatment of restless legs syndrome/Willis-Ekbom disease during pregnancy and lactation. Sleep Med Rev. 2015 Aug; 22:64-77. DOI: 10.1016/j.smrv.2014.10.009. PMID: 25553600.
7. Restless legs syndrome [Internet]. U.S. Department of Health and Human Services; [cited 2024 Jan 21].
8. Maria Masters CW. Restless legs syndrome (RLS) during pregnancy [Internet]. WhattoExpect; 2023 [cited 2024 Jan 22].
9. Gupta R, Dhyani M, Kendzerska T, Pandi-Perumal SR, BaHammam AS, Srivanitchapoom P, Pandey S, Hallett M. Restless legs syndrome and pregnancy: prevalence, possible pathophysiological mechanisms and treatment. Acta Neurol Scand. 2016 May;133(5):320-9. doi: 10.1111/ane.12520. Epub 2015 Oct 19. PMID: 26482928; PMCID: PMC5562408.
10. Batool-Anwar S, Li Y, De Vito K, Malhotra A, Winkelman J, Gao X. Lifestyle Factors and Risk of Restless Legs Syndrome: Prospective Cohort Study. J Clin Sleep Med. 2016 Feb;12(2):187-94. Doi: 10.5664/jcsm.5482. PMID: 26446243; PMCID: PMC4751426.
11. Na M, Wu J, Li M, Hinkle SN, Zhang C, Gao X. New onset of restless legs syndrome in pregnancy in a prospective multiracial cohort: Incidence and risk factors. Neurology. 2020 Dec 15;95(24): e3438-e3447. Doi: 10.1212/WNL.0000000000011082. Epub 2020 Nov 11. PMID: 33177224; PMCID: PMC7836662.
12. Kaplan O, Başer M. A Neglected Area: Restless Leg Syndrome in Pregnancy and The Role of the Obstetrics and Gynecology Nurse. İzmir Kâtip Çelebi Üniversitesi Sağlık Bilimleri Fakültesi Dergisi. 2023;8(3):1073-1080. DOI: 10.61399/ikcusbfd.1161636.
13. 13-Jahani Kondori M, Kolla BP, Moore KM, Mansukhani MP. Management of Restless Legs Syndrome in Pregnancy and Lactation. J Prim Care Community Health. 2020 Jan-Dec; 11:2150132720905950. Doi: 10.1177/2150132720905950. PMID: 32054396; PMCID: PMC7025421.
14. Mayer BA. Restless leg syndrome happens in pregnancy-here’s what to do about it. Parents. Available at: https://www.parents.com/how-to-stop-restless-legs-immediately-while-pregnant-7484165. Accessed 08 June 2024.
15. NICHD [Internet]. U.S. Department of Health and Human Services.
16. Restless legs syndrome [Internet]. Mayo Foundation for Medical Education and Research; 2022
17. Maternal health; World Health Organization.
18. Tuna Oran N, Yuksel E, Ruzgar S. Prevalence of restless leg syndrome and effects on quality of life during pregnancy. Sleep and breathing. 2021 Dec 1:1-8.
19. Felimban O, Abdali S, Alsager N, Feayah T, Alkdede M, Almuhaysin A, Hussain B, AlEssa M, Alsefri S, Alobaidi Z, Azzah Z. Prevalence, Hormonal Factors, and Treatment of Restless Leg Syndrome in Pregnancy.
20. Shafiq H, Ahmed A, Afzal W, Hanif K, Tariq M. Prevalence of Restless Leg Syndrome among Pregnant Women in Lahore City. Asian Journal of Allied Health Sciences (AJAHS). 2018:39-43.
21. Manconi M, Garcia-Borreguero D, Schormair B, Videnovic A, Berger K, Ferri R, Dauvilliers Y. Restless legs syndrome. Nature reviews Disease primers. 2021 Nov 3;7(1):80.
22. Picchietti DL, Hensley JG, Bainbridge JL, Lee KA, Manconi M, McGregor JA, Silver RM, Trenkwalder C, Walters AS, International Restless Legs Syndrome Study Group. Consensus clinical practice guidelines for the diagnosis and treatment of restless legs syndrome/Willis-Ekbom disease during pregnancy and lactation. Sleep medicine reviews. 2015 Aug 1; 22:64-77.
23. Akbaş P, Yaman Sözbir Ş. non-pharmacological methods used in coping with restless leg syndrome (RLS): a systematic review. Sleep and Biological Rhythms. 2021 Jul;19(3):215-25
24. Kamble PA, Jadhav AS, Yadav T, Chotai K. Effect of Mulligan’s traction straight leg raise in nurses with restless leg syndrome. Int J Health Sci Res. 2019;9(9):296-300.
25. Lv Q, Wang X, Asakawa T, Wang XP. Pharmacologic treatment of restless legs syndrome. Current Neuropharmacology. 2021 Mar 1;19(3):372-82.
26. Shamekh AH, Hassan NZ, Rashwan ZI, Fathalla NF. Effect of stretching exercises versus thermotherapy on restless legs syndrome symptoms, pain, and quality of sleep among pregnant women. International Journal of Health Sciences. 2022;6(S6):11204
27. .Turan H, Turan SA, Butun Z, Kayapınar M. The Prevalence, Severity, and Predictive Factors of Restless Legs Syndrome in Pregnancy. Cureus. 2020;12(2): e44884. DOI: 10.7759/cureus.44884.
28. Allen RP, et al. Official CH-RLSq13 | Cambridge - Hopkins Restless Legs. [URL: https://eprovide.mapi-trust.org/instruments/cambridge-hopkins-restless-legs-syndrome-short-form-2-diagnostic-questionnaire]
29. Allen RP, Validation of the self-completed Cambridge-Hopkins questionnaire (CH-RLSq) for ascertainment of restless legs syndrome (RLS) in a population. Sleep. 2009.
30. Costa J, et al. Validation of an Arabic version of the Cambridge-Hopkins diagnostic questionnaire for restless legs syndrome (CH-RLSq13). 2022. [DOI: 10.1007/s00702-021-02410-1]
31. Walters AS, Brocq C, Dhar A, Hening W, Rosen R, Allen RP, Trenkwalder C; International Restless Legs Syndrome Study Group. Validation of the International Restless Legs Syndrome Study Group rating scale for restless legs syndrome. Sleep Med. 2003 Mar;4(2):121-32. DOI: 10.1016/s1389-9457(02)00258-7. PMID: 14592342.
32. Abetz L, Arbuckle R, Allen RP, Garcia-Borreguero D, Hening W, Walters AS, Mavraki E, Kirsch JM. The reliability, validity, and responsiveness of the International Restless Legs Syndrome Study Group rating scale and subscales in a clinical-trial setting. Sleep Medicine. 2006 Jun;7(4):340-9. Doi: 10.1016/j.sleep.2005.12.011. Epub 2006 May 19. PMID: 16713344