NDT Advance Access originally published online on January 25, 2005
Nephrology Dialysis Transplantation 2005 20(3):571-577; doi:10.1093/ndt/gfh654
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Restless legs syndrome, insomnia and quality of life in patients on maintenance dialysis
Zoller11 Institute of Behavioral Sciences, Semmelweis University, Budapest, Hungary, 2 First Department of Internal Medicine, Semmelweis University, Budapest, Hungary, 3 Division of Nephrology, Faculty of Medicine, University of Toronto, Toronto, Canada, 4 Semmelweis University – Fresenius Medical Care Dialysis Center, Budapest, Hungary, 5 Department of Transplantation and Surgery, Semmelweis University, Budapest, Hungary and6 Sleep Research Laboratory, Department of Psychiatry, University of Toronto, Toronto, Canada
Correspondence and offprint requests to: Marta Novak, MD, Toronto Western Hospital, UHN, 399 Bathurst St, Toronto, ON M5T 2S8, Canada. E-mail: novis{at}hu.inter.net
Background. In a cross-sectional study, we analysed the complex relationship between restless legs syndrome (RLS), insomnia and specific insomnia symptoms and health-related quality of life (QoL) in patients on maintenance dialysis.
Methods. Data were obtained from 333 patients on chronic maintenance dialysis. To assess the prevalence of RLS, we used the RLS Questionnaire (RLSQ). The Athens Insomnia Scale (AIS) was used to assess insomnia and QoL was measured with the Kidney Disease Quality-of-Life Questionnaire.
Results. The prevalence of RLS was 14%. The number of comorbid conditions was significantly higher in patients with vs without RLS (median: three vs two; P<0.05). RLS patients were twice as likely to have significant insomnia as patients without RLS (35% vs 16%; P<0.05). Furthermore, RLS was associated with impaired overall sleep quality (median AIS score: 8 vs 4; P<0.01) and poorer QoL. RLS was a significant and independent predictor of several of the QoL domains after statistical adjustment for clinical and socio-demographic covariables. Importantly, this association remained significant even after adjusting for sleep quality.
Conclusions. RLS is associated with poor sleep, increased odds for insomnia and impaired QoL in patients on maintenance dialysis. Based on the present results, we suggest that both sleep-related and sleep-independent factors may confer the effect of RLS on QoL.
Keywords: insomnia; maintenance dialysis; quality of life; restless legs syndrome
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