Restless in Idaho

Chicago, IL, June 8, 2001

With its cool, clear nights, crisp mountain air and leisurely pace of life, Moscow, Idaho (population 22,000) would seem the perfect place to get a good night's sleep. Yet, according to research presented at the annual scientific sessions of the Associated Professional Sleep Societies Meeting, nearly one in five primary care patients participating in a sleep study in Moscow, Idaho, suffers from a common, though frequently undiagnosed, condition called restless legs syndrome (RLS).

According to the National Institutes of Health, RLS affects five to ten percent of the U.S. population, or as many as 12 million adults.

The finding emerged as part of a study conducted in a primary care setting in Moscow, Idaho, to substantiate the previously found high prevalence of RLS and also to evaluate a newly developed questionnaire to assist physicians in identifying patients with the mostly unknown, but easily treated, disorder.

"Restless legs syndrome is a very common disorder yet most people have not heard of it. I would estimate that only about ten percent of people with RLS have actually been diagnosed," said Richard Allen, Ph.D., Chair, Medical Advisory Board, Restless Legs Syndrome Foundation. "As a result, it is woefully undertreated because primary care physicians lack the knowledge or awareness needed to identify sufferers."

It's obvious why restless legs aren't compatible with a good night's sleep. People describe the disturbing sensations as crawling, wormy, prickly, even painful, and often the only relief is to move their legs. In addition, these sensations may cause people to jerk their legs throughout the night. Although restless legs are thought to disrupt the sleep of a significant number of Americans, the condition is rarely diagnosed and even more rarely treated.

Researchers first identified a high prevalence (29.3%) of symptoms suggesting RLS during an earlier project initiated to increase awareness of sleep disorders and to determine their prevalence. Based on these findings, they set out to determine the prevalence of RLS in that patient population using a validated screening questionnaire.

The study investigators found that general practitioners, using a simple 10-item questionnaire, were able to reliably and accurately diagnose RLS. Their diagnosis was compared to a subsequent diagnosis made by an independent sleep expert and in more than 90 percent of the cases, the experts concurred with the physician/questionnaire diagnosis. Once a diagnosis of RLS is made, treatment in most cases is straightforward and effective.

"It is a major step forward to now have a simple tool for use by primary care physicians that is sensitive enough to accurately diagnose RLS," said Dr. William C. Dement, lead study author and Director, Stanford Sleep Clinic and Research Center, Palo Alto, Calif. "This is important as most of the people with restless legs are living with an undiagnosed condition and therefore are suffering unnecessarily. Most never make it to a sleep expert and we need to provide physicians with the tools to correctly identify and treat people with RLS."

While the diagnosis of RLS was found to affect nearly one-fifth of the Moscow patients (417 of 2099), the researchers caution that these findings from one town cannot be extrapolated to the entire U.S. population. Additional studies in more diverse populations will be needed to provide a definitive national prevalence.

Treatments for RLS can range from behavioral changes to medication. Patients are best advised to discuss their symptoms and a strategy for relief with their physician.

Three authors of the Moscow, Idaho Restless Legs Syndrome study are shown in front of the poster presentation of the study. (From left to right) Dr. William C. Dement, Stanford University; Debee Nichols, Stanford University; Dr. Clete Kushida, Stanford University.

The Restless Legs Syndrome Foundation, headquartered in Rochester, Minn., is a nonprofit 501(C)(3) agency that provides information about RLS, publishes a quarterly newsletter known as NightWalkers, develops support groups and funds research to find better treatments and, eventually, a definitive cure. For a free copy of "Living with Restless Legs," please call the toll-free 1-877-INFO RLS or visit the foundation's website at www.rls.org.