Restless legs syndrome frequency in patients with rheumatoid arthritis

Rheumatoid arthritis is one of the most common rheumatologic diseases. Clinical conditions, which are often associated with disease-specific findings, also reduce the comfort of many patients in their daily lives. It is known that sleep disorders and related diseases are more common in RA patients than in the normal population. However, specific sleep disorders have not been studied extensively in the rheumatological population. Restless legs syndrome (RLS) is a disorder characterized by sleep disorders; is a chronic sensorimotor disease characterized by abnormal sensations that occur with the need to move the legs or to move the legs. This syndrome can be found either as a primer or as a secondary symptom complex associated with various clinical conditions such as rheumatologic diseases. In this study; patients who are followed up with RA diagnosis in our polyclinic; We aimed to determine the frequency of RLS and to investigate its relation with quality of life, disease activity, demographic characteristics of the patient, treatment, serology and comorbidities. Between November 2017 and February 2018, 149 patients aged 18 years or older, who had RA diagnosed according to the 2010 ACR/EULAR RA classification criteria and who agreed to participate in the study, had no cognitive deficits that prevented them from completing the clinical evaluation forms and 100 control subjects were included who were similar in age and gender to the RA group, without known inflammatory disease. A cross-sectional / analytical / controlled study methodology was used. Throughout the study, the Helsinki Declaration stuck to its principles. Demographics, habits, drugs used, duration of illness, and laboratory findings were recorded for each person employed. Subjects who were taken into the study were evaluated for RLS, and those who were diagnosed as RLS were filled with the IRLSSG RLS severity scale. In addition, RA was evaluated in terms of disease duration, antirheumatic drug use, laboratory results, modified charlson comorbidity index (MCCI), HAQ and DAS-28 score. Statistical analysis of the study found a p <0.05 significance, p <0.001 very significant. In our study, the incidence of RLS in RA patients was 22.8% and the frequency of RLS in the control group was 4% (p <0.001). In RA patients; there was no statistically significant difference in terms of disease duration, serology, DAS-28 and HAQ scores of patients with and without RLS. The mean age of the group with RLS was found to be higher than those without RLS, and this difference was statistically significant. Compared with the groups in terms of comorbidities; the mean MCCI score of the group with RLS was 3.59 (± 1.76) and the mean MCCI score of the non-RLS group was 2.84 (± 1.76) (p<0.05). There were 16 (47.1%) patients with hypertension in the RLS group and 33 (28.7%) patients with hypertension in the non-RLS group. There were 7 (20.6%) patients with depression in the RLS group and 8 (7%) patients with depression in the non-RLS group. The use of antidepressant and antihypertensive drugs in the RLS group was significantly higher than the non-RLS group. As a result of examining the laboratory values of the patients by logistic regression analysis; serum glucose, vitamin B12, folate and thrombocyte levels increased the likelihood of RLS and TSH, alkaline phosphatase, calcium and phosphorus levels decreased the likelihood of RLS. The IRLSSG RLS severity scale scores of 34 patients with RLS in RA were found not to correlate with CRP and ESH levels, HAQ and DAS-28 scores, biological DMARD exposures, disease duration and serology. RA, like in neuropathy, is also a risk for the development of RLS. Patients with RA should also be questioned for sleep disorders, including RLS. It should not be forgotten that sleep disorders RA and RA have the potential to trigger sleep disorders.