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Gender differences in the prevalence of restless legs syndrome/Willis-Ekbom disease

Geschlechtsunterschiede bei der Prävalenz des Restless-Legs-Syndroms/ Willis-Ekbom-Erkrankung

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Abstract

The restless legs syndrome (RLS) also known as Willis-Ekbom disease (WED) is one of the most frequent neurological sleep disorders. Epidemiological studies have shown consistently that it is more frequent in females than in males with male-to-female ratios mostly in the range of 1:1.5–1:2.0 in adult populations. One of the main candidates involved in this gender gap is pregnancy and specifically the transient form of RLS during pregnancy that affects around 20 % of females. Not only does the risk for RLS increase with increasing numbers of pregnancies, but RLS symptoms during that period are also a significant gender-specific risk factor for the development of chronic, idiopathic RLS later in life. Iron deficiency anemia is a further risk factor that is gender-specific inasmuch as it is more prevalent in females although the probability to develop RLS with iron deficiency anemia does not differ between men and women. While it is unknown whether and how these two gender-specific risk factors, i.e., pregnancy and iron deficiency anemia, interact and to what extent their effects are mediated by an individual genetic predisposition, they can at least explain part of the observed prevalence differences between males and females.

Zusammenfassung

Das Syndrom der unruhigen Beine („restless legs syndrome“, RLS) oder Willis-Ekbom-Erkrankung („Willis-Ekbom disease“, WED) ist eine der häufigsten neurologischen Schlafstörungen. Einer der konsistentesten Befunde aus epidemiologischen Studien ist die größere Häufigkeit von RLS bei Frauen mit einer Geschlechtsverteilung von Männern zu Frauen zwischen 1:1,5 und 1:2,0 im Erwachsenenalter. Einen der einflussreichsten Faktoren bezüglich dieses Geschlechtsunterschieds stellt die Schwangerschaft und insbesondere die transiente Form des RLS in der Schwangerschaft dar, die bei etwa 20 % der Frauen auftritt. Bei Frauen steigt das Risiko für ein RLS mit der Anzahl der Schwangerschaften, und neuere Befunde haben gezeigt, dass insbesondere das Auftreten des RLS in der Schwangerschaft das Risiko für ein späteres, chronisches RLS deutlich erhöht. Daneben ist die Eisenmangelanämie ein geschlechtsspezifischer Risikofaktor für das RLS, denn obwohl das Risiko dafür, ein RLS beim Vorliegen einer Eisenmangelanämie zu entwickeln, sich nicht zwischen Männern und Frauen unterscheidet, ist die Eisenmangelanämie deutlich häufiger bei Frauen zu finden. In welcher Art diese beiden geschlechtsspezifischen Risikofaktoren interagieren und ob ihr Effekt auf die Wahrscheinlichkeit des Auftretens eines RLS durch individuelle, möglicherweise genetische Faktoren vermittelt wird, ist derzeit unklar. Gemeinsam könnten sie jedoch zumindest zum Teil die beobachteten Geschlechtsunterschiede in der Häufigkeit des Auftretens eines RLS erklären.

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Conflict of interest. S. Fulda states that there are no conflicts of interest.

The accompanying manuscript does not include studies on humans or animals.

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  1. Sleep & Epilepsy Center, Neurocenter of Southern Switzerland, Civic Hospital (EOC) of Lugano, Via Tesserete 46, 6903, Lugano, Switzerland

    S. Fulda PhD

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Fulda, S. Gender differences in the prevalence of restless legs syndrome/Willis-Ekbom disease. Somnologie 17, 246–251 (2013). https://doi.org/10.1007/s11818-013-0636-7

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  • DOI: https://doi.org/10.1007/s11818-013-0636-7

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