Clinical Study Of Chronic Insomnia With Restless Legs Syndrome In Outpatients

Objective:To analyze etiological composition and Symptomatic characteristics of chronic insomnia disorder with restless legs syndrome(CID+RLS),and further understand clinical characteristics of RLS.Methods: A consecutive case series CID were enrolled into the study.the patient's general information,etiological composition(insomnia subtype),insomnia symptom,the Epworth Sleeping Scale,Insomnia Severity Index,restless legs syndrome(RLS)symptoms investigation and IRLSS symptom severity scale were recorded.All patients were divided into two groups:CID with RLS group(CID+RLS)and CID without RLS group(CID-RLS),and the distribution of etiological composition(insomnia subtype),,insomnia symptom,the Epworth Sleeping Scale and Insomnia Severity Index was compared between two groups.Results: 1.117 cases of CID were enrolled from 122 consecutive cases,5 cases were eliminated because of unable cooperation.30 cases(25.6%)for restless leg syndrome,3 cases were mild,13 cases were moderate,13 cases were severe,1 cases were extremely severe,and 87 cases were CID-RLS.2.there was no significant difference in gender,age,nationality,BMI,education level,marital status,life history,past medical history,medication history between CID+RLS group and CID-RLS group(P>0.05).3.50 cases(42.7%)comorbid 2or more etiological subtypes.the incidences of insomnia due to mental disorders,insomnia due to medical disorders,psychological physiology insomnia were 50(42.7%),41(35.0%)and 32(27.4%).Insomnia due to other sleep disorder were 33(28.2%),30 cases(25.6%)for restless leg syndrome.Compared with the CID-RLS group,CID + RLS group have insomnia more due to medical disorders(40.0% VS 12.6%,P =0.001),the ratio of CID+RLS comorbiding other sleep disorder is higher(23.3% VS 3.4%,P=0.003).CID +RLS group have insomnia less due to physiologic insomnia,unspecified(0.0%VS 16.1%,P=0.044).4.27cases(90%)in CID+RLS group had significant difficulty falling asleep,compared with 62 cases(71.3%)in CID-RLS group(P=0.038).there was a significant difference in waking up early 20 cases(66.7%)in CID+RLS group compared with 38 cases(43.7%)in CID-RLS group(P=0.030).Compared with CID-RLS group,CID+RLS group had no significant daytime sleepiness(P=0.28),CID+RLS group had higher ISI score(P=0.025),which manifests difficulty falling asleep(P=0.002),not satisfied with sleep(P=0.003),the fear and pain about sleep condition(P=0.028).Conclusion: 1.There is a prevalence of 25.6% comorbiding RLS in outpatient CID patients in our study.2.In the Neurological outpatients,nearly half of the patients combord two or more than two kinds of subtypes.It is more common to have insomnia due to mental disorders,medical disorders and psychological physiology insomnia among CID outpatients.the etiological composition(insomnia subtype)of two groups are significantly different.3.CID often comorbids RLS in Outpatients.Compared with CID-RLS,CID+RLS are prone to fall asleep and wake up early.their sleep quality is poor,which manifests difficulty in sleeping,not satisfied with sleep,the fear and pain about sleep condition.