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Background: Restless Legs Syndrome (RLS) has a substantial impact on normal daily activities. Because of the high prevalence it is necessary to evaluate the impact on the health-related quality of life (HRQoL). Objective: To assess health-related quality of life in patients with RLS. Methods: A total of 519 patients (327 female patients; mean age: 64.2 y) were recruited in five different German centers according to the diagnostic criteria of the International RLS Study Group. Patients were either interviewed or completed a mailed questionnaire. The questionnaire consisted of an evaluation of the sociodemographic, clinical and health-related status. HRQoL was evaluated with the EuroQoL (EQ-5D). In addition, the IRLS scale, the MOS Sleep Scale, the Epworth Sleepiness Scale, and the BDI were applied as clinical rating scales. Results: HRQoL is substantially affected by RLS. The mean EQ-5D-VAS was 55.6 and considerably lower compared to the general population. It was found to be as low as in other chronic neurological disorders such as Parkinson’s disease and stroke. From different factors investigated by uni- and multivariate analyses, severity of RLS and depressive symptoms had the most significant impact on HRQoL. Additionally, sleep deficits, the duration of the disease and net household income were identified as predictors for different EQ-5D outcome scores. Conclusions: RLS considerably affects HRQoL. Further comparative studies are necessary to evaluate the effect of disease symptoms on HRQoL and their change due to medication. [Copyright &y& Elsevier]