TY - JOUR
T1 - Restless Legs Syndrome and Depression
T2 - Effect Mediation by Disturbed Sleep and Periodic Limb Movements
AU - Osteoporotic Fractures in Men (MrOS) Study Group
AU - Koo, Brian B.
AU - Blackwell, Terri
AU - Lee, Hochang B.
AU - Stone, Katie L.
AU - Louis, Elan D.
AU - Redline, Susan
N1 - Funding Information:
Dr. Koo serves on the medical advisory board for the Restless Legs Syndrome Foundation. Dr. Lee is funded by NIH grant R01 MH085740 . Dr. Stone is funded by NIH grants R01 2803205 , R01 AG026720 , and R01 HL071194 . Dr. Louis is funded by NIH grants R01 NS073872 and R01 NS039422 . Dr. Redline has received a grant from the Resmed Foundation; her institution has received equipment for use in NIH-funded studies and is supported by NIH grants R01 HL098433 and R01 HL113338 . All other authors report no disclosures.
Funding Information:
The MrOS Study is supported by National Institutes of Health (NIH) funding. The following institutes provided support: the National Institute on Aging ( U01 AG027810 , U01 AG042124 , U01 AG042139 , U01 AG042140 , U01 AG042143 , U01AG042145 , U01 AG042168 ), the National Heart, Lung, and Blood Institute (R01 HL070848, R01 HL070847, R01 HL070842, R01 HL070841, R01 HL070837, R01 HL070838, and R01 HL070839), and the National Center for Advancing Translational Sciences ( UL1 TR000128 ), and NIH Roadmap for Medical Research under the following grant numbers: U01 AG027810 , U01 AG042124 , U01 AG042139 , U01 AG042140 , U01 AG042143 , U01 AG042145 , U01 AG042168 , U01 AR066160 , and UL1 TR000128 . The National Heart, Lung, and Blood Institute provided funding for the MrOS Sleep ancillary study “Outcomes of Sleep Disorders in Older Men” under the following grant numbers: R01 HL070848 , R01 HL070847 , R01 HL070842 , R01 HL070841 , R01 HL070837 , R01 HL070838 , and R01 HL070839 .
Publisher Copyright:
© 2016
PY - 2016/11/1
Y1 - 2016/11/1
N2 - Objective To investigate an association between restless legs syndrome (RLS) and depression and to what extent sleep disturbance, periodic limb movements during sleep (PLMS), and antidepressant medication mediate this relationship. Methods A cross-sectional analysis was conducted of the Osteoporotic Fractures in Older Men Study data in 982 men assessed for RLS (International RLS Study Group scale [IRLSS]) and depression (Geriatric Depression Scale [GDS]), who underwent actigraphy (for sleep latency/efficiency) and polysomnography (for PLMS). Men were split into three groups: no RLS (N = 815), mild RLS (IRLSS ≤ 12, N = 85), moderate-to-severe RLS (IRLSS > 12, N = 82). Depression was defined as GDS score ≥ 6. Logistic and linear regression assessed associations of RLS and depression or number depressive symptoms, respectively. Models were adjusted for age, site, race, education, body mass index, personal habits, benzodiazepine/dopaminergic medication, physical activity, cardiovascular risk factors, and apnea-hypopnea index. Results Of 982 men, 167 (17.0%) had RLS. Depression was significantly associated with moderate-to-severe RLS after adjustment (versus no RLS: OR [95% CI] 2.85 [1.23, 6.64]). Further adjustment for potential mediators attenuated effect size modestly, most for sleep efficiency (OR: 2.85–2.55). Compared with no RLS, moderate-to-severe RLS was associated with the number of depressive symptoms after adjustment (adjusted means [95% CI]; no RLS: 1.14 [1.05, 1.24] versus IRLSS > 12: 1.69 [1.32, 2.11]). Further adjustment for potential mediators did not alter effect size. For men with PLMS index at least median, number of depressive symptoms significantly increased as RLS category became more severe. Conclusion Depression is more common as RLS severity worsens. The RLS–depression relationship is modestly explained by sleep disturbance and PLMS.
AB - Objective To investigate an association between restless legs syndrome (RLS) and depression and to what extent sleep disturbance, periodic limb movements during sleep (PLMS), and antidepressant medication mediate this relationship. Methods A cross-sectional analysis was conducted of the Osteoporotic Fractures in Older Men Study data in 982 men assessed for RLS (International RLS Study Group scale [IRLSS]) and depression (Geriatric Depression Scale [GDS]), who underwent actigraphy (for sleep latency/efficiency) and polysomnography (for PLMS). Men were split into three groups: no RLS (N = 815), mild RLS (IRLSS ≤ 12, N = 85), moderate-to-severe RLS (IRLSS > 12, N = 82). Depression was defined as GDS score ≥ 6. Logistic and linear regression assessed associations of RLS and depression or number depressive symptoms, respectively. Models were adjusted for age, site, race, education, body mass index, personal habits, benzodiazepine/dopaminergic medication, physical activity, cardiovascular risk factors, and apnea-hypopnea index. Results Of 982 men, 167 (17.0%) had RLS. Depression was significantly associated with moderate-to-severe RLS after adjustment (versus no RLS: OR [95% CI] 2.85 [1.23, 6.64]). Further adjustment for potential mediators attenuated effect size modestly, most for sleep efficiency (OR: 2.85–2.55). Compared with no RLS, moderate-to-severe RLS was associated with the number of depressive symptoms after adjustment (adjusted means [95% CI]; no RLS: 1.14 [1.05, 1.24] versus IRLSS > 12: 1.69 [1.32, 2.11]). Further adjustment for potential mediators did not alter effect size. For men with PLMS index at least median, number of depressive symptoms significantly increased as RLS category became more severe. Conclusion Depression is more common as RLS severity worsens. The RLS–depression relationship is modestly explained by sleep disturbance and PLMS.
KW - depression
KW - periodic limb movement during sleep
KW - restless legs syndrome
KW - sleep
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U2 - 10.1016/j.jagp.2016.04.003
DO - 10.1016/j.jagp.2016.04.003
M3 - Article
C2 - 27526989
AN - SCOPUS:84992170311
SN - 1064-7481
VL - 24
SP - 1105
EP - 1116
JO - American Journal of Geriatric Psychiatry
JF - American Journal of Geriatric Psychiatry
IS - 11
ER -