Sudden onset of sleep and dopaminergic therapy in patients with restless legs syndrome

Möller, Jens Carsten; Körner, Yvonne; Cassel, Werner; Meindorfner, Charlotte; Krüger, Hans-Peter; Oertel, Wolfgang H.; Stiasny-Kolster, Karin

doi:10.1016/j.sleep.2005.08.009

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Volume 7, Issue 4 , Pages 333-339, June 2006

Sudden onset of sleep and dopaminergic therapy in patients with restless legs syndrome

Jens Carsten Möller
- Department of Neurology, Philipps-University, 35033 Marburg, Germany
- Corresponding author. Address: Klinik für Neurologie, Philipps-Universität, Rudolf-Bultmann-Str. 8, 35039 Marburg, Germany. Tel.: +49 6421 28 65372; fax: +49 6421 28 67055.
Yvonne Körner
- Department of Psychology, Center for Traffic Sciences, Julius-Maximilians University, 97070 Würzburg, Germany
Werner Cassel
- Department of Internal Medicine, Philipps-University, 35033 Marburg, Germany
Charlotte Meindorfner
- Department of Psychology, Center for Traffic Sciences, Julius-Maximilians University, 97070 Würzburg, Germany
Hans-Peter Krüger
- Department of Psychology, Center for Traffic Sciences, Julius-Maximilians University, 97070 Würzburg, Germany
Wolfgang H. Oertel
- Department of Neurology, Philipps-University, 35033 Marburg, Germany
Karin Stiasny-Kolster
- Department of Neurology, Philipps-University, 35033 Marburg, Germany

Received 29 March 2005; received in revised form 29 July 2005; accepted 7 August 2005.

Abstract

Background and purpose

Sudden onset of sleep (SOS) was recently reported in patients with Parkinson's disease (PD) under dopaminergic treatment. Here, we investigated as to what extent SOS is found in patients with restless legs syndrome (RLS), who are frequently treated with dopaminergic drugs, and controls.

Patients and methods

A questionnaire survey on SOS was administered to 156 RLS patients and 126 controls.

Results

While no significant difference between RLS patients and controls was detected in Epworth sleepiness scale (ESS) scores (P=0.76), the prevalence of SOS was higher in RLS patients (32.7%) than in controls (19.8%) (P=0.02). Significant predictors of SOS in RLS were ESS score (odds ratio (OR) 16.4), male sex (OR 4.6), duration of night-time sleep (OR 3.0), and age (OR 2.9), while no association was observed for duration or severity of the disease. Patients on dopaminergic therapy usually featured a lower risk of SOS than untreated patients. Falling asleep while driving was reported by 14.6% of all RLS patients with a driver's license and associated with increased risk of accident (OR 7.1).

Conclusions

RLS patients who are untreated, male, and elderly should be assessed for the presence of SOS. In contrast to PD, dopaminergic drugs may reduce the risk of SOS in RLS. The possible benefit of the drugs should be investigated particularly in male patients.

Keywords: Sleep attack, Accident risk, Daytime sleepiness, Dopamine agonists, Epworth sleepiness scale, Driving ban