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Byline: Jan. Ulfberg Restless legs Syndrome (RLS) is a disorder that hardly receives the attention it should deserve. A study conducted in Europe and United States suggests that RLS is [...]

Aim The aim of this study was to examine possible signs of impairment of the microcirculation in the lower extremities of female patients suffering from primary restless legs syndrome ( RLS)/ Willis- Ekbom disease. Methods This study was performed in eight female patients, mean age 48 years (range 21-65), diagnosed with primary RLS but otherwise healthy. Eight healthy female control subjects, mean age 47 years (range 27-64), were also included in the study. Laser Doppler flowmetry was used to determine intramuscular blood flow by placing an optical single fiber in the tibialis anterior muscle belly. The studies were performed between 08.00 and 10.00 hours and 20.00 and 22.00 hours. Blood flow was expressed in perfusion units. Results The median intramuscular blood flow in the RLS patients' tibialis anterior muscles, recorded from both legs, was significantly higher in the morning, at 17.9 perfusion units, than in the evening, at 12.1 perfusion units ( P = 0.004). Corresponding values for the healthy controls were 13.1 perfusion units and 12.0 perfusion units, a non-significant difference. The relative fold changes of microcirculation in the RLS group compared to healthy age-matched controls were 0.7 ± 0.3 and 1.1 ± 0.6, respectively ( P = 0.04). Conclusion Our results suggest that in female patients with primary RLS, the microcirculation in the tibialis anterior muscle is higher in the morning compared with in the evening. [ABSTRACT FROM AUTHOR]

Ulfberg J, Micic S, Strøm J (Sleep Laboratory, Department of Internal Medicine, Avesta Hospital, Sweden, Department of Biotechnology, Statens Seruminstitut, Copenhagen, Denmark and the Department of Anaesthesiology, Glostrup University Hospital, Copenhagen, Denmark). Afternoon serum-melatonin in sleep disordered breathing. J Intern Med 1998; 244: 163–8. Objectives To study afternoon serum-melatonin values in patients with sleep disordered breathing. Melatonin has a strong circadian rhythm with high values during the night-time and low values in the afternoon. Sleep disordered breathing may change the circadian rhythm of melatonin which may have diagnostic implications. Setting The Sleep Laboratory, The Department of Internal Medicine, Avesta Hospital, Sweden, and the Department of Anaesthesiology, Glostrup University Hospital, Copenhagen, Denmark. Subjects We examined 60 consecutive patients admitted for sleep disordered breathing and 10 healthy non snoring controls. The patients underwent a sleep apnoea screening test having a specificity of 100% for the obstructive sleep apnoea syndrome (OSAS) using a combination of static charge sensitive bed and oximetry. Obstructive sleep apnoea syndrome was found in 49 patients, eight patients had borderline sleep disordered breathing (BSDB) and three patients were excluded due to interfering disease. Main outcome measures Patients and controls had an afternoon determination of serum-melatonin. The Epworth Sleepiness Scale was used to score daytime sleepiness. Results In comparison with normal controls patients suffering from OSAS had significantly higher serum-melatonin levels in the afternoon. However, as a diagnostic test for OSAS in patients with sleep disordered breathing serum-melatonin showed a low sensitivity but a high specificity. The results indicate that breathing disorders during sleep in general affect pineal function. Conclusions Sleep disordered breathing seems to disturb pineal function. Determination of afternoon serum-melatonin alone or together with a scoring of daytime sleepiness does not identify OSAS-patients in a heterogeneous population of patients complaining of heavy snoring and excessive daytime sleepiness. [ABSTRACT FROM AUTHOR]

The article presents case studies of three female patients, aged 25-60 years, who were all suffering from severe to very severe Restless legs syndrome/Willis-Ekbom disease (RLS/WED) and mentioned the side effects of selenium drug used for treatment.

Background: Restless legs syndrome is a common cause of sleep problems; the condition is often associated with periodic limb movement during sleep. The syndrome is probably under-diagnosed and under-treated., Material and Methods: The article is based on literature identified through a search in PubMed, a review of international recommendations and our own clinical experience., Results: The restless leg syndrome is common, with a prevalence of about 10 %. Many of these patients are affected by sleep disturbances and have periodic limb movement during sleep (PLMS). Restless legs and the associated sleep disturbances can be effectively treated with dopaminagonists. Because of the augmentation risk, the lowest necessary dose should be maintained. PLMS also occurs in other sleep disorders. Periodic limb movement disorder (PLMD) is defined as PLMS combined with sleep disturbances and/or sleepiness during daytime without a known cause. The clinical relevance of PLMD for sleep disturbances is not clear., Interpretation: The restless legs syndrome is a common cause of sleep disturbance; good treatment options are available.