Objective: To determine if patient characteristics differ among Native Hawaiians/Pacific Islanders (NHPI), Asian American (AA) subgroups, and Whites who were hospitalized with Restless Leg Syndrome (RLS) in the state of Hawaiʻi.

Background: RLS is a treatable chronic condition affecting many. RLS can be primary or secondary, resulting from underlying medical diagnoses. RLS is common in patients with renal disease and pregnant patients. Characteristics of RLS patients by racial/ethnic groups have not been adequately studied, particularly for NHPI and AA.

Method: We conducted a retrospective cross-sectional study using hospital discharge records (2016 to 2023) from the Hawaiʻi statewide registry. Patients with RLS were identified by the ICD-10 code G25.81. Their first discharge records were analyzed to examine patient characteristics, including race/ethnicity (White, Japanese, Filipino, NHPI, and Other), age group (< or equal to 40, 41-60, 61-80, > or equal to 81), and comorbidities (diabetes, renal disease, pregnancy, Parkinson’s disease, and anemia). Bivariate analyses were performed using Kruskal-Wallis rank sum tests, Pearson’s chi-square tests, and Fisher’s exact tests to examine differences in patient characteristics by race/ethnicity groups. A p-value less than 0.05 was considered statistically significant.

Results: The study identified 1624 patients with RLS. About half were White (48%), followed by Japanese (15%), NHPI (15%), Other (14%), and Filipino (8%). Bivariate analysis found differences in age groups (p<.001), pregnancy (p=0.015), and diabetes (p<.001). NHPI had a higher proportion of RLS presenting at a younger age (age up to 40 years, p-valve <0.001). RLS and pregnancy was more prevalent in NHPI (p<0.015). There were no significant differences in anemia or renal disease comorbidities among subgroups. Presence of comorbid diabetes was significantly higher in the White subgroup (p<0.001).

Conclusion: Our data suggests that demographic presentation and comorbidities can vary among racial/ethnic groups. Pregnant NHPI patients should likely be screened for RLS. It is unknown if genetic factors play a role in NHPI RLS presentation. Further research, ideally prospective studies, are needed to understand these racial health disparities.

References: 1. Mansur A, Castillo PR, Rocha Cabrero F, et al. Restless Legs Syndrome. [Updated 2023 Feb 27]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK430878
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3. Takaki J, Nishi T, Nangaku M, Shimoyama H, Inada T, Matsuyama N, Kumano H, Kuboki T. Clinical and psychological aspects of restless legs syndrome in uremic patients on hemodialysis. Am J Kidney Dis. 2003 Apr;41(4):833-9.
4. Suzuki K, Ohida T, Sone T, Takemura S, Yokoyama E, Miyake T, Harano S, Motojima S, Suga M, Ibuka E. The prevalence of restless legs syndrome among pregnant women in Japan and the relationship between restless legs syndrome and sleep problems. Sleep. 2003 Sep;26(6):673-7. doi: 10.1093/sleep/26.6.673. PMID: 14572119.
5. Na M, Wu J, Li M, Hinkle SN, Zhang C, Gao X. New onset of restless legs syndrome in pregnancy in a prospective multiracial cohort: Incidence and risk factors. Neurology. 2020 Dec 15;95(24):e3438-e3447. doi: 10.1212/WNL.0000000000011082. Epub 2020 Nov 11. PMID: 33177224; PMCID: PMC78

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MDS Abstracts - https://www.mdsabstracts.org/abstract/racial-disparities-in-hospitalization-characteristics-among-native-hawaiians-pacific-islanders-and-asian-american-subgroups-with-restless-legs-syndrome/