Prevalence, severity and associated factors of restless leg syndrome in inflammatory bowel disease patients
Othman R AlHarbi1, Ahmad Bahammam2, Awad H Olaish2, Nahla A Azzam1, Abdulrahman A Aljebreen1, Majid A Almadi3, Suhail A Alsaleh4
1 Department of Medicine, Division of Gastroenterology, College of Medicine, King Khalid University Hospital, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
2 The University Sleep Disorders Center, College of Medicine, King Saud University Medical City, Riyadh, Saudi Arabia
3 Department of Medicine, Division of Gastroenterology, College of Medicine, King Khalid University Hospital, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia; Division of Gastroenterology, the McGill University Health Center, Montréal General Hospital, McGill University, Montréal, Canada
4 Department of Pediatrics, Division of Pediatric Respiratory Medicine, The Hospital for Sick Children, University of Toronto, Canada
Dr. Othman R AlHarbi
Department of Medicine, Division of Gastroenterology, King Khalid University Hospital, King Saud University Medical City, Riyadh - 12372
Source of Support: None, Conflict of Interest: None
Background: The association between restless leg syndrome (RLS) and inflammatory bowel disease (IBD) has often been an under-investigated and clinically misdiagnosed entity. An emphasis should be made on the severity and associated factors, as the prevalence of both entities is on the rise globally. In this study we aimed to investigate the prevalence, severity and associated risk factors of RLS in patients with IBD.
Methods: A multi-center, prospective cross-sectional study was conducted with age and gender matched controls in the ratio of 1:3. Cases of IBD were confirmed according to European Crohns and Colitis Organization guidelines. The study recruited 377 cases and 1131 age and gender-matched controls. RLS severity and prevalence was determined using a validated International Restless Legs Syndrome Study Group questionnaire. The anthropometric and blood biochemical measurements were retrieved from the patient's medical records. Associated factors were analyzed by regression analysis.
Results: The prevalence of RLS in patients with IBD and non-IBD control groups was 21.5% and 9.7%, respectively (P = 0.001). The severity index of RLS symptoms in all the three categories of mild, moderate and severe RLS was higher in the IBD group (P = 0.001). Obesity (BMI >30 Kg/m2) was more prevalent in patients with IBD with RLS than without RLS (21.9%: 10.3%, P = 0.009). Ages between 46 and 59 years (OR = 18.7 [2.6–29.4], P = 0.008), obesity (OR = 22 [2.6–29.4], P = 0.005), higher TSH levels (OR = 1.7 [1.0–3.0], P = 0.033), and lower hemoglobin levels (P = 0.028) showed a greater risk associated with RLS.
Conclusion: Prevalence and severity of RLS was higher in patients with IBD. The risk factors for RLS in IBD include increasing age, obesity, higher TSH, and lower hemoglobin.