Neurology. 2013 Jul 2;81(1):52-9.

Prospectivestudy of restlesslegssyndromeandmortalityamong men.

Li Y, Wang W, Winkelman JW, Malhotra A, Ma J, Gao X.

Source

FromTheChanningLaboratory (Y.L., J.M., X.G.) andtheDivision of SleepMedicine (J.W.W., A.M.), Department of Medicine, BrighamandWomen'sHospitaland Harvard Medical School, Boston, MA; Department of Otolaryngology (W.W.), Tianjin First Central Hospital, Tianjin, China; andDepartment of Nutrition (W.W., X.G.), Harvard School of PublicHealth, Boston, MA.

Abstract

OBJECTIVE:

Toprospectivelyexaminewhether men withrestlesslegssyndrome (RLS) had an increased risk of mortality.

METHOD:

Thiswas a prospectivecohortstudy of 18,425 US men free of diabetes, arthritis, andrenalfailure in theHealthProfessionalsFollow-upStudy (HPFS). In 2002, RLS wasassessedusing a set of standardizedquestions. Deathswereidentifiedfromstatevitalstatisticsrecords, theNationalDeath Index, familyreports, andthe postal system.

RESULTS:

During 8 years of follow-up (2002-2010), wedocumented 2,765 deaths. In an age-adjusted model, RLS wasassociatedwith a 39% increased risk of mortality (hazardratio [HR] = 1.39; 95% confidenceinterval [CI] 1.19-1.62; p < 0.0001). Theassociationbetween RLS andmortalitywasslightlyattenuatedafterfurtheradjustmentfor body massindex, lifestylefactors, chronicconditions, sleepduration, andothersleep-relateddisorders (adjusted HR = 1.30; 95% CI 1.11-1.52; p = 0.003). Whenwefurtherexcludedthosewithmajorchronicconditions (e.g.,cancer, highbloodpressure, cardiovasculardisease, andothercomorbidities), theadjusted HR was 1.92 (95% CI 1.03-3.56; p = 0.04). Theinteractionsbetween RLS andother risk factors (olderage, overweight, shortsleepduration, smoking, lowphysicalactivity, andunhealthydiet) in relationto total mortality risk were not significant (p forinteraction0.2forall).

CONCLUSION:

Weobservedthat men with RLS had a higheroverallmortalityandthisassociationwasindependent of known risk factors. Theincreasedmortality in RLS wasmorefrequentlyassociatedwithrespiratorydisease, endocrinedisease, nutritional/metabolicdisease, andimmunologicdisorders. Futureresearchexploringthepathophysiologicrelationshipbetweenthesedisordersand RLS is warranted.