Restless Legs Syndrome and Mental Health Disturbances: Clinical Implications and Current Treatment Options

Allen RP, Picchietti DL, Garcia-Borreguero D, Ondo WG, Walters AS, Winkelman JW, et al. Restless legs syndrome/Willis-Ekbom disease diagnostic criteria: Updated International Restless Legs Syndrome Study Group (IRLSSG) consensus criteria - history, rationale, description, and significance. Sleep Med Elsevier B V. 2014;15:860–73. https://doi.org/10.1016/j.sleep.2014.03.025.

Article  Google Scholar 

Fulda S, Allen RP, Earley CJ, Högl B, Garcia-Borreguero D, Inoue Y, et al. We need to do better: A systematic review and meta-analysis of diagnostic test accuracy of restless legs syndrome screening instruments. Sleep Med Rev. 2021;58:101461. https://doi.org/10.1016/j.smrv.2021.101461.

Article  PubMed  Google Scholar 

Ferré S, García-Borreguero D, Allen RP, Earley CJ. New Insights into the Neurobiology of Restless Legs Syndrome. Neuroscientist. 2019;25:113–25. https://doi.org/10.1177/1073858418791763.

Article  CAS  PubMed  Google Scholar 

Walters AS, Frauscher B, Allen R, Benes H, Chaudhuri KR, Garcia-Borreguero D, et al. Review of Severity Rating Scales for Restless Legs Syndrome: Critique and Recommendations. Mov Disord Clin Pract. 2014;1:317–24. https://doi.org/10.1002/mdc3.12088.

Article  PubMed  PubMed Central  Google Scholar 

Winkelman JW, Berkowski JA, DelRosso LM, Koo BB, Scharf MT, Sharon D, et al. Treatment of restless legs syndrome and periodic limb movement disorder: an American Academy of Sleep Medicine clinical practice guideline. J Clin Sleep Med Am Acad Sleep Med. 2025;21:137–52. https://doi.org/10.5664/jcsm.11390.

Article  Google Scholar 

Aneja J, Singh J, Udey B. Prevalence and clinical correlates of restless legs syndrome in psychiatric patients: A cross-sectional study from North India. Indian J Psychiatry Wolters Kluwer Medknow Publications. 2024;66:58–66. https://doi.org/10.4103/indianjpsychiatry.indianjpsychiatry_223_23.

Article  Google Scholar 

Auvinen P, Koponen H, Kautiainen H, Korniloff K, Ahonen T, Vanhala M, et al. A longitudinal study of restless legs symptoms among patients with depression. Nord J Psychiatry Taylor Francis Ltd. 2022;76:584–90. https://doi.org/10.1080/08039488.2022.2038265.

Article  Google Scholar 

Chenini S, Barateau L, Guiraud L, Denis C, Rassu AL, Lopez R, et al. Depressive Symptoms and Suicidal Thoughts in Restless Legs Syndrome. Mov Disorders John Wiley Sons Inc. 2022;37:812–25. https://doi.org/10.1002/mds.28903.

Article  Google Scholar 

AlShareef SM. The prevalence of and risk factors for restless legs syndrome: a nationwide study. Front Psychiatry Front Media S A. 2023;13. https://doi.org/10.3389/fpsyt.2022.987689.

Partinen E, Inoue Y, Sieminski M, Merikanto I, Bjorvatn B, Bolstad CJ, et al. Restless legs symptoms increased during COVID-19 pandemic. International ICOSS-survey. Sleep Med Elsevier B V. 2024;119:389–98. https://doi.org/10.1016/j.sleep.2024.04.016.

Article  Google Scholar 

Tully PJ, Kurth T, Elbaz A, Tzourio C. Convergence of psychiatric symptoms and restless legs syndrome: a cross-sectional study in an elderly French population. J Psychosom Res Elsevier Inc. 2020;128. https://doi.org/10.1016/j.jpsychores.2019.109884.

Kocakaya H, Say B. Evaluation of emotional dysregulation in patients with restless legs syndrome. Sleep Biol Rhythms Springer. 2023;21:447–54. https://doi.org/10.1007/s41105-023-00467-z.

Article  Google Scholar 

Kılınçarslan MG, Ocak Ö, Şahin EM. The impact of neuropsychiatric burden on Restless Legs Syndrome (RLS) disease severity. Sleep Med Elsevier B V. 2025;126:82–7. https://doi.org/10.1016/j.sleep.2024.12.004.

Article  Google Scholar 

Shi X, Zhu Y, Wang S, Wang A, Chen X, Li Y, et al. The prospective associations between different types of sleep disturbance and suicidal behavior in a large sample of chinese college students. J Affect Disord Elsevier B V. 2021;279:380–7. https://doi.org/10.1016/j.jad.2020.10.019.

Article  Google Scholar 

Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16:606–13. https://doi.org/10.1046/j.1525-1497.2001.016009606.x.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Beck AT, Steer RA, Brown G. Beck Depression Inventory–II. PsycTESTS Dataset. 2011. https://doi.org/10.1037/t00742-000.

Article  Google Scholar 

Beck AT, Weissman A, Lester D, Trexler L. The measurement of pessimism: The Hopelessness Scale. J Consult Clin Psychol. 1974;42:861–5. https://doi.org/10.1037/h0037562.

Article  CAS  PubMed  Google Scholar 

Eich AL, Ottersbach J, Geisler P, Hajak G, Wetter TC, Popp RFJ. Daytime sleepiness in patients with untreated restless legs syndrome. Somnologie Springer Medizin. 2024;28:149–55. https://doi.org/10.1007/s11818-024-00455-6.

Article  Google Scholar 

Ozer IS, Bayram E, Herdi O, Sener HO. Daytime impulsiveness, attention, and learning in the restless legs syndrome. Neurological Sciences. Springer-Verlag Italia s r l. 2024;45:639–45. https://doi.org/10.1007/s10072-023-07020-3.

Article  Google Scholar 

Mail Gurkan Z, Tantik Pak A, Parlakkaya FB, Kilicarslan T, Yilmaz O, Sengul Y. Recognition of emotional face expressions in patients with restless legs syndrome. Appl Neuropsychology:Adult Routledge. 2024;31:554–9. https://doi.org/10.1080/23279095.2022.2043326.

Article  Google Scholar 

Ellmerer P, Heim B, Stefani A, Peball M, Werkmann M, Holzknecht E, et al. Augmentation in restless legs syndrome: an eye tracking study on emotion processing. Ann Clin Transl Neurol Wiley-Blackwell. 2020;7:1620–7. https://doi.org/10.1002/acn3.51144.

Article  CAS  Google Scholar 

Gothi D, Kumar R, Anand S, Patro M, Malhotra N, Vaidya S. A study on the prevalence of RLS in OSA and the consequences of co-occurrence. Lung India. Wolters Kluwer Medknow Publications. 2023;40:321–6. https://doi.org/10.4103/lungindia.lungindia_28_23.

Article  Google Scholar 

Kim KY, Kim EH, Lee M, Ha J, Jung I, Kim E. Restless leg syndrome and risk of all-cause dementia: a nationwide retrospective cohort study. Alzheimers Res Ther BioMed Cent Ltd. 2023;15. https://doi.org/10.1186/s13195-023-01191-z.

Kiraz S, Çipil A, Ergün N. The relationship between disease symptoms and restless legs syndrome in adult attention-deficit hyperactivity disorder without iron deficiency. Middle East Curr Psychiatry Springer Sci Bus Media Deutschland GmbH. 2022;29. https://doi.org/10.1186/s43045-022-00226-9.

van der Ham M, Bijlenga D, Böhmer M, Beekman ATF, Kooij S. Sleep Problems in Adults With ADHD: Prevalences and Their Relationship With Psychiatric Comorbidity. J Atten Disord SAGE Publications Inc. 2024;28:1642–52. https://doi.org/10.1177/10870547241284477.

Article  Google Scholar 

Erdal Y, Perk S, Alnak A, Liman E, Dereci H, Emre U. Obsessive–compulsive disorder in restless legs syndrome. Sleep Biol Rhythms Springer Japan. 2021;19:393–8. https://doi.org/10.1007/s41105-021-00329-6.

Article  Google Scholar 

Mazurie Z, Mayo W, Ghorayeb I. Attention-deficit/hyperactivity and obsessive-compulsive symptoms in adult patients with primary restless legs syndrome. Appl Neuropsychology:Adult Routledge. 2024;31:639–46. https://doi.org/10.1080/23279095.2022.2057857.

Article  Google Scholar 

Deveci Ş, Kabeloğlu V, Atay Ö. The Interplay of Restless Legs Syndrome with Obsessive-Compulsive Disorder, Attention Deficit Hyperactivity Disorder, and Iron Levels: A Comprehensive Exploration. Neuropsychiatric Invest Istanbul Universitesi. 2024;62:9–14. https://doi.org/10.5152/NeuropsychiatricInvest.2024.23030.

Article  Google Scholar 

Çoban Ö, Yaşa ME, Sonkaya AR, Yıldırım NÜ. The relationship of depression with fatigue, quality of life, and gastrointestinal symptoms in patients with restless legs syndrome. Gulhane Med J Galenos Publishing House. 2023;65:86–91. https://doi.org/10.4274/gulhane.galenos.2022.59389.

Article  Google Scholar 

Çiçekli E, Okuyan HM, Birimoğlu Okuyan C, Ayçiçek ŞÖ, Kotan D. Relationship of autophagic dysfunction with the quality of life and sleep, depression and disease severity in patients with restless legs syndrome. Brain Behav. John Wiley and Sons Ltd; 2025. p. 15. https://doi.org/10.1002/brb3.70172.

Szklarek M, Kostka T, Kostka J. Correlates of Restless Legs Syndrome in Older People. J Clin Med. Multidisciplinary Digital Publishing Institute (MDPI); 2024. p. 13. https://doi.org/10.3390/jcm13051364.

Barateau L, Chenini S, Rassu AL, Denis C, Lorber Q, Dhalluin C, et al. Changes in Sleep Pattern During the COVID-19 Lockdown in Patients With Narcolepsy, Idiopathic Hypersomnia, and Restless Legs Syndrome. Neurol Lippincott Williams Wilkins. 2022;99:E1475–85. https://doi.org/10.1212/WNL.0000000000200907.

Article  Google Scholar 

Geng C, Chen C. Association between inflammatory cytokines and disease severity in restless legs syndrome. Neurol Sci. Springer-Verlag Italia s.r.l.; 2024;45:5765–70. https://doi.org/10.1007/s10072-024-07736-w.

Im HJ, Kim JH, Yun CH, Kim DW, Oh J. Changes in hepcidin serum levels correlate with clinical improvement in idiopathic restless legs syndrome patients. J Clin Med. Multidisciplinary Digital Publishing Institute (MDPI); 2020;9. https://doi.org/10.3390/jcm9124115.

Avidan AY, Lee D, Park M, Jaros MJ, Shang G, Kim R. The Effect of Gabapentin Enacarbil on Quality of Life and Mood Outcomes in a Pooled Population of Adult Patients with Moderate-to-Severe Primary Restless Legs Syndrome. CNS Drugs Springer Int Publishing. 2016;30:305–16. https://doi.org/10.1007/s40263-016-0329-4.

Article  CAS  Google Scholar 

Bogan RK, Lee DO, Buchfuhrer MJ, Jaros MJ, Kim R, Shang G. Treatment response to sleep, pain, and mood disturbance and their correlation with sleep disturbance in adult patients with moderate-to-severe primary restless legs syndrome: Pooled analyses from 3 trials of gabapentin enacarbil. Ann Med Informa Healthc. 2015;47:269–77. https://doi.org/10.3109/07853890.2015.1025825.

Article  CAS  Google Scholar 

Benes H, Mattern W, Peglau I, Dreykluft T, Bergmann L, Hansen C et al. Ropinirole improves depressive symptoms and restless legs syndrome severity in RLS patients: a multicentre, randomized, placebo-controlled study. J Neurol. Dr. Dietrich Steinkopff Verlag GmbH and Co. KG; 2011;258:1046–54. https://doi.org/10.1007/s00415-010-5879-7.

Montagna P, Hornyak M, Ulfberg J, Hong SB, Koester J, Crespi G, et al. Randomized trial of pramipexole for patients with restless legs syndrome (RLS) and RLS-related impairment of mood. Sleep Med. 2011;12:34–40. https://doi.org/10.1016/j.sleep.2010.08.005.

Article  PubMed  Google Scholar 

Silber MH, Buchfuhrer MJ, Earley CJ, Koo BB, Manconi M, Winkelman JW et al. The management of restless legs syndrome: an updated algorithm. Mayo Clin Proc. 2021;96:1921–37. https://doi.org/10.1016/j.mayocp.2020.12.026.

Pourcher E, Rémillard S, Cohen H. Compulsive habits in restless legs syndrome patients under dopaminergic treatment. J Neurol Sci. 2010;290:52–6. https://doi.org/10.1016/j.jns.2009.11.010.

Article  CAS 

Comments (0)

No login
gif