McCrink L, Allen RP, Wolowacz SE, Sherrill B, Connolly M, Kirsch J. Predictors of health-related quality of life in sufferers with restless legs syndrome: a multi-national study. Sleep Med. 2007 Jan 1;8(1):73-83.

Background and purpose: To explore aspects of restless legs syndrome (RLS) associated with detrimental impact on health-related quality of life (HRQoL). Patients and methods: The RLS epidemiology, symptoms, and treatment (REST) survey included SF-36 data on adults with RLS symptoms in the USA and five
European countries. Linear regression models on each SF-36 dimension score explored factors influencing HRQoL in this population.

Results: Of 16,202 people surveyed, 7% screened positively for RLS. Severity of RLS symptoms was strongly associated with impaired physical and mental HRQoL in both the cohorts from
the USA and Europe. Distress and symptom frequency also had predictive capability. In addition, significantly diminished HRQoL was associated with the use of prescription medication for RLS symptoms. Age, number of comorbidities, and number of physician visits were statistically associated with lower HRQoL in
respondents with RLS.

Conclusions: Diminished HRQoL was partly accounted for by a number of RLS-related factors, including frequency, severity, and distress from symptoms. The negative impact of prescription medications on HRQoL, in contrast to demonstrated improvements with dopamine agonists, suggests inappropriate or ineffective medications are being used in this population. Our results strongly support the need for better physician education, both to diagnose
the condition and importantly provide appropriate treatment with dopamine agonists, the only class of medication, that has been shown to improve the HRQoL of patients with RLS.

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