Objective: To quantify the prevalence of insomnia, sleep architecture disruption, and their cascading impacts on emotional well-being and overall quality of life in patients with Restless Legs Syndrome (RLS).

Background: RLS is a sensorimotor neurological disorder characterized by an irresistible urge to move the lower extremities, typically peaking during evening rest. This circadian symptom manifestation severely disrupts sleep initiation and maintenance. Chronic sleep deprivation in RLS frequently exacerbates secondary neuropsychiatric comorbidities, including depression and anxiety, significantly degrading the patient’s overall quality of life.

Method: An observational cross-sectional study evaluated 130 individuals (average age: 65.3 ± 0.7 years; average disease duration: 6.5 ± 3.4 years) diagnosed with idiopathic RLS. The cohort comprised 70 men and 60  women. Disease severity was quantified using the International RLS Rating Scale (IRLS). Sleep architecture, daytime somnolence, and psychiatric morbidities were assessed utilizing the Epworth Sleepiness Scale (ESS), the Beck Depression Inventory (BDI), the Spielberger State-Trait Anxiety Inventory (STAI), and the RLS Quality of Life Questionnaire (RLS-QoL).

Results: Insomnia was highly prevalent, affecting 39% of the cohort, with a striking 87% experiencing severe sleep fragmentation and frequent nocturnal awakenings. Early morning awakenings were documented in 45% of patients. A distinct sex disparity was observed, with women reporting significantly higher rates of sleep disruption and distressing dreams compared to men. Insomnia severity strongly correlated with both disease duration and IRLS severity scores. Patients experiencing early-onset sleep disturbances reported profoundly degraded sleep architecture, nocturia, severe morning somnolence, and highly erratic daily symptom fluctuations compared to those with later-onset disruptions (p < 0.001).

Conclusion: Sleep disruption in RLS is a severe, multifactorial burden intrinsically linked to disease severity, biological sex, and subsequent neuropsychiatric decline. Because insomnia cascades into profound anxiety and depressive symptoms, standard dopaminergic or alpha-2-delta therapies must be paired with targeted behavioral and pharmacological sleep interventions to comprehensively restore patient quality of life.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/the-impact-of-insomnia-and-sleep-fragmentation-on-quality-of-life-and-neuropsychiatric-outcomes-in-restless-legs-syndrome/