The epidemiology of cardiovascular disease in the restless legs syndrome and periodic limb movements during sleep

The restless legs syndrome (RLS) and periodic limb movements during sleep (PLMS) are two common sleep disorders, affecting approximately 5–10% of the general population. We reviewed evidence regarding the association of RLS and PLMS with CVD risk and cardiovascular disease (CVD) risk factors obtained from population-based studies. Several, but not all, epidemiologic studies reported positive associations between RLS/PLMS and CVD risk. Treating RLS was also shown to be associated with lower future CVD risk. However, most of these studies are cross-sectional and thus the direction of causation cannot be determined. A limited number of prospective studies aimed at determining a link between RLS and incident CVD have generated inconsistent results, which may be related to different methodological assessments of RLS across studies and a lack of quantification of RLS symptom severity. In conclusion, previous epidemiologic studies showed an association between RLS/PLMS and CVD, largely in cross sectional studies. These observations need confirmation by future large-scale prospective studies, using standardized approaches for RLS and PLMS assessment.