Published Research - General Sleep and RLS (WED)

For everything and anything else not covered in the other RLS/WED sections.
mh380
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Re: Published Research - General Sleep and RLS (WED)

Postby mh380 » Wed Mar 16, 2016 6:58 pm

http://journals.plos.org/plosone/articl ... ne.0140632

"Conclusions"

"RLS patients suffer a greater humanistic and economic burden than those without RLS. Moreover as severity increases so does the burden of RLS."

The findings definitely jibe with my experience, so I'm inclined to believe them, but the peer review process at PLOS ONE is very uneven, and 2 of the 3 authors are from the company that makes the Neupro patch, so this isn't a study to hang our hats on.

ViewsAskew
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Re: Published Research - General Sleep and RLS (WED)

Postby ViewsAskew » Thu Mar 17, 2016 3:32 am

One of the many issues with RLS and PLMD - low populations in the research, few reviewers, and few studies in general!
Ann - Take what you need, leave the rest

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Rustsmith
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Re: Published Research - General Sleep and RLS (WED)

Postby Rustsmith » Thu Mar 17, 2016 9:09 am

This sounds a lot like one of the new Foundation funded research programs where they want to monetize the cost of RLS to society in the US. The idea is to get a good cost number to use in funding requests made to federal agencies and the Department of Defense.
Steve

Augmentation Evaluation http://bb.rls.org/viewtopic.php?f=4&t=9005

Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

badnights
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Re: Published Research - General Sleep and RLS (WED)

Postby badnights » Wed Mar 23, 2016 3:52 am

Using near infrared light to manage symptoms associated with restless legs syndrome. http://www.ncbi.nlm.nih.gov/pubmed/26756803. A quote from the article,"A significant improvement in IRLSRS scores was observed."

Small study - and since I only have the abstract, who knows how it was designed or what symptoms and how severe. But, really fascinating. And, it appears to have replicated similar results from another small study in 2011.
They suggest a mechanism - the IR light somehow encourages production and/or liberation of nitric oxide (perhaps by unbinding it from hemoglobin) which leads to a cascade of effects that culminate in dilation of the peripheral blood vessels. Dilation means more blood and more oxygen reaching the tissues.

This brings to mind the hypoxia theory, that low oxygen in the tissues somehow causes WED sensations. One possible mechanism mentioned in this paper is that impaired circulation might lead to a build-up of toxic metabolites or other such damage to the veins, and this results in abnormal sensory signals.

All this also reminds me of the case studies in which varicose vein surgery eliminated WED symptoms.

In the paper they mention that nitric oxide can also act as a neurotransmitter and affects nerve conduction properties, so it may exert a beneficial influence on WED/RLS somehow via that route.

I find all these benefits of NO kind of bizarre, since NO is a free radical and I've been brainwashed that free radicals are all bad. Not so.

The device they used to administer near-infrared light across the skin is a simple-looking hand-held device made by Dynatronics Corporation, Salt Lake City, UT. EDITED to add link and price: http://www.dynatronics.com/CatalogResul ... fault.aspx $2000, sold by prescription only.

Just to summarize the paper a bit more: they had 21 subjects, there was no control group, instead they compared pre-treatment and post-treatment values of a number of parameters, including some subjective ones which could have been influenced by the placebo effect (eg. the IRLSRS scale) and some that couldn't (eg. testing for protective sensation in the soles of the feet - whether the subject could detect the pressure needed to bend a thin filament whose end was placed against the sole of the foot - going to thinner and thinner filaments until the subject could not detect it anymore).
The IRLSRS score dropped by an average of 10 which is enough to take you from the moderate to mild category, and two of seven subjects who lacked protective sensation in the soles of their feet regained it (actually, 18 locations on the soles of each subject were tested, for 378 total locations, of which 63 locations in 7 subjects lacked protective sensation before the study and only 51 locations in 5 subjects after the study).
Beth - Wishing you all restful sleep tonight
WED/RLS AUGMENTATION:
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ViewsAskew
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Re: Published Research - General Sleep and RLS (WED)

Postby ViewsAskew » Thu Apr 07, 2016 7:12 am

Single blind and I didn't read it all to see how it was done. And, it's from Dove Press - not necessarily the worst thing, but comes with some issues.

https://www.dovepress.com/restless-legs ... icle-JPRLS

Here is the abstract - go to the link to download the whole paper.

Franco Gemignani,1 Andrea Melpignano,1,2 Giulia Milioli,1,2 Silvia Riccardi,1,2 Liborio Parrino1,2

1Neurology Unit, Department of Neurosciences, University of Parma, Parma, Italy; 2Sleep Disorders Center, Department of Neurosciences, University of Parma, Parma, Italy

Abstract: Restless legs syndrome (RLS) is a disorder of sensorimotor integration characterized by an urge to move the legs when at rest, especially at night or in the evening, which is relieved by movement. Sensory symptoms may be prominent, often exhibiting features consistent with neuropathic pain. Iron deficiency and genetic factors are implicated in RLS causation in most patients. The pathogenetic model of impaired circadian dopaminergic modulation of sensorimotor integration circuitry at the spinal level is fitting with the co-occurrence of movement disorders, sensory symptoms, and sleep disruption in RLS. Accordingly, levodopa and dopamine agonists are effective for RLS symptoms, which compensate for the impaired descending control by diencephalo-spinal dopa(min)ergic pathway. Dopamine agonists are usually indicated as the first-line therapy, but their use in long-term treatment is often complicated by augmentation and impulse control disorder, thus alpha-2-delta ligands also are now considered the first line of treatment. It has been recognized that endogenous opioid system is also involved in the mechanisms generating RLS, possibly through an impaired modulation of pain pathways. Opioids can be considered as an alternative therapy, particularly in patients with augmentation and/or refractory to other treatments. Recently introduced prolonged-release oxycodone–naloxone was efficacious for short-term treatment of patients with severe RLS inadequately controlled with previous treatment. It will be important to assess whether opioids, as well as other drugs, are especially effective in definite RLS subtypes such as the painful phenotype.
Ann - Take what you need, leave the rest



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Rustsmith
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Re: Published Research - General Sleep and RLS (WED)

Postby Rustsmith » Thu Apr 07, 2016 10:25 am

I read through the paper. It is basically an opinion piece that takes information from other studies, so there is no new data.

About the only thing that I saw that was useful was that the found from the data that the addition of ER naloxone to ER oxycodone helps to address the issue of opiod induced constipation.
Steve

Augmentation Evaluation http://bb.rls.org/viewtopic.php?f=4&t=9005

Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

ViewsAskew
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Re: Published Research - General Sleep and RLS (WED)

Postby ViewsAskew » Fri Apr 08, 2016 2:24 am

I seem to recall that Trenkwalder already noted that in the Germany study. But could be misremembering.
Ann - Take what you need, leave the rest



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stjohnh
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Re: Published Research - General Sleep and RLS (WED)

Postby stjohnh » Tue Aug 02, 2016 2:00 pm

This is an interesting article from Sweden on consequences of fragmented sleep. It is fairly technical, so probably of interest only to those with scientific backgrounds. It discusses dopamine effects, antioxidant effects, aging neuroprotective mechanisms and epigenetics.

http://journal.frontiersin.org/article/ ... 00180/full
Blessings,
Holland

ViewsAskew
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Re: Published Research - General Sleep and RLS (WED)

Postby ViewsAskew » Thu Aug 18, 2016 9:45 pm

Study of PLMS by Mass Gen and Harvard.

https://www.dovepress.com/periodic-limb ... rticle-NSS

Conclusion: "Although elevated PLMI values were commonly observed, routinely acquired clinical information had only weak predictive utility. As the clinical importance of elevated PLMI continues to evolve, it is likely that objective measures such as PSG or at-home PLMS monitors will prove increasingly important for clinical and research endeavors."
Ann - Take what you need, leave the rest



Managing Your RLS



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67java89
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Re: Published Research - General Sleep and WED (RLS)

Postby 67java89 » Fri Aug 19, 2016 10:55 pm

ViewsAskew wrote:Sleep and Blood Pressure

http://www.eurekalert.org/pub_releases/ ... 031315.php

Quote: "People exposed to prolonged periods of shortened sleep have significant increases in blood pressure during nighttime hours, Mayo Clinic researchers report in a small study of eight participants."

It's a small study, but it is consistent with the WED findings - we seem to have higher blood pressure at night.

Not surprised. The summer my RLS started my blood pressure shot up.
Sleep is a basic need.

67java89
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Re: Published Research - General Sleep and RLS

Postby 67java89 » Sat Aug 20, 2016 12:29 am

badnights wrote:This is a beauty, found by a friend of mine doing a google search. It is buried without links on the RLSF website. It's a slide show by Arthur Walters, an RLS/WED specialist, in which he summarizes many unconventional treatments for RLS/WED. He gives references for many of them too. The latest reference cited is 2008, so the presentation probably dates from 2008 or 2009. I had no idea so much was being done!

Access it through this link http://www.rls.org/Document.Doc?id=1710
or by downloading this:
Walters_2008Q_Less_conventional_forms_of_treatment_for_RLS.pdf

I would get botox injections if it it helped. I would stand on my head before bedtime if that helped. I am so desperate for a good night's sleep.
Sleep is a basic need.

Polar Bear
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Re: Published Research - General Sleep and RLS (WED)

Postby Polar Bear » Sat Aug 20, 2016 5:38 pm

I would have ablation on my veins, I would try botox. No doubt about that.
Betty
http://www.willis-ekbom.org/about-rls-wed/publications
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badnights
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Re: Published Research - General Sleep and RLS (WED)

Postby badnights » Sun Aug 21, 2016 9:20 pm

http://www.tremorjournal.org/index.php/ ... w/401/html

This is a good summary of the state of knowledge on what causes WED/RLS. I especially like their last sentence :)
Beth - Wishing you all restful sleep tonight
WED/RLS AUGMENTATION:
viewtopic.php?f=5&t=6532&p=61601#p61601
Discussion Board Moderator's posts don't reflect the RLS Foundation's opinion & are not medical advice

ViewsAskew
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Re: Published Research - General Sleep and RLS (WED)

Postby ViewsAskew » Sun Aug 21, 2016 9:33 pm

The last two paragraphs are excellent. And, I, too, like that last sentence!
Ann - Take what you need, leave the rest



Managing Your RLS



Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

Rustsmith
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Re: Published Research - General Sleep and RLS (WED)

Postby Rustsmith » Mon Aug 22, 2016 12:52 am

Excellent summary paper. They did a great job of illustrating how there is so much about RLS that is now known because a lot of the past "known" information may very well be an effect rather than a cause. Dopamine disfunction being the best example where what we thought that we knew may not really be a cause after all.

The other thing that the paper did was emphasize my lack of depth of understanding when it comes to RLS neurology and neurochemistry. I understood the majority of what was written, but often found myself asking "so what" because I don't have the depth of knowledge to understand how our results are abnormal.

But the best part for me was the obvious finding that there are a number of tools and areas of investigation that have a high likelihood of bearing fruit. I don't believe that I have ever seen a summary paper in my field of research that had so many different high quality directions for a new researcher to choose from.
Steve

Augmentation Evaluation http://bb.rls.org/viewtopic.php?f=4&t=9005

Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.


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