Restless Legs Linked to Higher Mortality in US Veterans

Miklos Z Molnar, MD, PhD, FEBTM, FERA, FASN Associate Professor of Medicine Division of Nephrology, Department of Medicine University of Tennessee Health Science Center Memphis, TN, 38163

MedicalResearch.com Interview with:
Miklos Z Molnar, MD, PhD, FEBTM, FERA, FASN
Associate Professor of Medicine
Division of Nephrology, Department of Medicine
University of Tennessee Health Science Center
Memphis, TN, 38163

Medical Research: What is the background for this study? What are the main findings?

Response: Restless legs syndrome is a common sleep disorder, but there is a paucity of large cohort studies examining the association of restless legs syndrome with clinical outcomes, including all-cause mortality, incident coronary heart disease, stroke and chronic kidney disease.

From a nationally representative prospective cohort of over 3 million US veterans [93% male, median follow-up time of 8.1 years (interquartile range: 7.0–8.5years)] with baseline estimated glomerular filtration rate ≥60 mL/min/1.73 m2, a propensity-matched cohort of 7392 patients was created, and the association between incident restless legs syndrome and the following was examined:

  • (1) all-cause mortality;
  • (2) incident coronary heart disease;
  • (3) incident strokes; and
  • (4) incident chronic kidney disease defined as estimated glomerular filtration rate <60 mL/min/1.73 m2.

Compared with restless legs syndrome-negative patients, incident restless legs syndrome was associated with 88% higher mortality risk [hazard ratio and 95% confidence interval: 1.88 (1.70–2.08)], and almost four times higher risk of coronary heart disease and stroke [hazard ratio: 3.97 (3.26–4.84) and 3.89 (3.07–4.94), respectively]. The risk of incident chronic kidney disease was also significantly higher in incident restless legs syndrome patients [hazard ratio: 3.17 (2.74–3.66)] compared with restless legs syndrome-negative counterparts. These associations was independent from other confounders such as demographic data, comorbidities and other sleep disorders (sleep apnea and periodic limb movements in sleep).

Medical Research: What should clinicians and patients take away from your report?

Response: In this large and contemporary cohort of US veterans, incident restless legs syndrome was associated with higher risk of mortality, incident coronary heart disease, stroke and chronic kidney disease. The association between restless legs syndrome and chronic kidney disease is new, it was never observed before.

Medical Research: What recommendations do you have for future research as a result of this study?

Response: Improvement of the diagnostics and early detection as well the effect of proper therapy of restless legs syndrome on preventing these clinical events needs to be tested in clinical trials.

Citation:

Association of incident restless legs syndrome with outcomes in a large cohort of US veterans.

Molnar MZ, Lu JL, Kalantar-Zadeh K, Kovesdy CP.

J Sleep Res. 2015 Sep 17. doi: 10.1111/jsr.12335. [Epub ahead of print]
PMID: 26377112

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Miklos Z Molnar, MD, PhD (2015). Restless Legs Linked to Higher Mortality in US Veterans

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