Restless legs syndrome (RLS) is a troublesome condition manifested by sensory and motor symptoms that disrupt sleep onset or sleep maintenance. RLS is common, occuring with a estimated population prevalence of 10%. There are no consistently reliable treatment alternatives and pharmacological treatments are often associated with unacceptable side effects. An effective nonpharmacological treatment would be a highly attractive option.
A convenience sample of patients reliably diagnosed with RLS was asked to wear pneumatic compression devices for at least one hour each evening for at least 30 days. Symptoms of RLS severity and related quality of life measures were evaluated before and after treatment. RLS severity was measured using a validated 10-item questionnaire. Quality of life indices were scored using the RLS Foundaton Quality of Life Instrument. Daytime sleepiness was gauged using the Epworth Sleepiness Scale (ESS). Patients were asked to track compliance using logs.
Of eight patients enrolled (mean age 55 years, range 37 to 81, 6 women), one man withdrew due to inability to comply. Of the other seven patients, all improved regarding RLS severity with three patients (43%) experiencing complete resolution. Mean severity decreased from 24/40 to 7/40 (p=0.003). Social functioning improved from 87% to 98% (p=0.05), daily functioning improved from 76% to 94% (p=0.06), sleep quality improved from 30% to 54% (p=0.01), and emotional well-being improved from 61% to 88% (p=0.05). ESS did not change significantly, decreasing from 9.9 to 8.6 (p=0.14). Compliance averaged 87% of nights (range 58% to 100%). One patient was able to discontinue previously prescribed gabapentin and pramipexole while experiencing improvement in RLS symptoms.
Pneumatic compression devices worn for one hour per day over days to weeks improve RLS symptom severity and quality of life measures. A proportion of patients experience complete resolution of RLS symptoms.
Pneumatic compression devices are an effective treatment alternative for patients with RLS. This nonpharmacological therapy may preclude resorting to medications which may be ineffective or have unacceptable side effects.
Arn Eliasson, Other Aircast Industries of New Providence NJ supplied six pneumatic compression devices for use in this study. No other financial incentive or support was received.