Published Research - General Sleep and RLS (WED)

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

Post by rthom »

My wife thought this was a great fathers day post--lol Well that's life, but it makes sense to me--I think the "machine" can be just wore out and starts to break down. Death ensues. I've been brought back to life several times. I believe the exhaustion had a lot to do with it.

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

Post by Chipmunk »

I'm not surprised to hear that WED patients have a higher death rate. Lack of sleep means a lack of time for one's body to repair itself.
Tracy

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

Post by ViewsAskew »

Chipmunk wrote:I'm not surprised to hear that WED patients have a higher death rate. Lack of sleep means a lack of time for one's body to repair itself.


Along with one of the newer findings that there is a higher level of inflammation - also not good for the body.
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Re: Published Research - General Sleep and WED (RLS)

Post by ViewsAskew »

http://www.dailyrx.com/restless-legs-sy ... c-patients

Interesting - research from Saskatchewan, Canada about why RA (and other autoimmune disorders) may have increased incidence of WED/RLS.

Here is the content in case the link breaks in the future.

Why Your Arthritic Legs Can’t Stop Moving

Restless legs syndrome is common among arthritic patients
October 6, 2013

(dailyRx News) Do you think that the urge to keep your legs moving has nothing to do with your rheumatoid arthritis? Better think again. A recent review explained a possible link between these two conditions.

A constant urge to move your legs even at night, called restless legs syndrome (RLS), can disturb your sleep and affect your quality of life. Patients with rheumatoid arthritis (RA), an immune disease characterized by inflammation of the joints, are more likely to develop RLS.

Since almost everyone at some time or another may experience sleep problems, many RA patients may not give importance to their RLS symptoms, and RLS remains mostly underdiagnosed.

With the right treatment you can have both, a good night's sleep and your RA under control.
"Talk to your doctor about any trouble sleeping."

This recent review, which examined the causes of why restless legs syndrome is frequent among RA patients, was conducted by John A. Gjevre, MD, and Regina Taylor Gjevre, MD, from the Department of Medicine, University of Saskatchewan in Canada.

It is estimated that between 5 and 15 percent of the population has RLS, and women are twice as likely to have it. However, patients with RA are more likely to develop RLS than the general population, and this review reported that about 30 percent of the patients with RA have RLS.

It is important to assess RLS in patients with RA. Research has shown that poor sleep is associated with pain, mood, fatigability, stress, and disease activity in patients with rheumatologic disease.

When patients were asked whether they could distinguish between RLS and RA sensations, 91 percent of the patients were able to differentiate.

One link between RLS and RA conditions is that patients with either of these conditions usually display low levels of iron or iron stores in their blood. This review mentioned that clinical studies have shown benefit in RLS patients when they were treated with iron versus placebo (control). However, there have been no studies that have proven that specifically for RA patients who have RLS, the authors informed.

While RLS is generally considered a neurodegenerative disease, and RA a disease of the immune system, the researchers explained that there is a bidirectional communication between the brain and the immune system. The study reported that RLS has also been associated to other connective tissue disorders (Sjogren’s syndrome, scleroderma, and lupus), which are also classified as autoimmune diseases.

Furthermore, the same signaling molecules (cytokines) that are produced during inflammation by the immune system are involved in sleep physiology. Therefore there is a strong connection between the immune system and sleep, and this may explain why sleep disorders, including RLS, are common among people with RA.

Clinical trials on RA patients have reported sleep improvement when the TNF cytokines (tumor necrosis factor, a specific type of cytokine) were blocked, and when drugs (methotrexate, adalimumab, abatacept) to weaken the immune system were prescribed. This study suggested further investigations on the efficacy of blocking other types of cytokines, specifically IL-6.

The review recommended that treatment for RLS, both in RA or non-RA patients should start on normalizing the iron stores and iron levels in the blood. The second step should be the use of FDA-approved drugs that affect dopamine levels such as ropinirole, pramipexole, rotigotine, and gabapentin. However, this study advised on the proper evaluation of the risks, benefits, and dosage of drugs. The authors also discussed the potential benefits of anti-TNF therapy, since blocking TNF can alleviate pain in the joints for RA patients, and also appears to regulate sleep.

This review concludes highlighting the importance of screening rheumatic disease patients for sleep abnormalities including RLS. Presently, different treatments exist to improve RLS, and RA symptoms. RA patients should not have to suffer with additional complications caused by the lack of sleep and RLS symptoms.

This study was published on June 12 in The Journal of Autoimmune Diseases. The authors had no disclosures to make.
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cornelia

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

Post by cornelia »

Good article for patients with RA en RLS, thanks for sending it.

Is it true though that RLS is considered a neuro degeneratieve disease?

Corrie

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

Post by ViewsAskew »

cornelia wrote:Good article for patients with RA en RLS, thanks for sending it.

Is it true though that RLS is considered a neuro degeneratieve disease?

Corrie


I saw that, too, and wondered about it. This really isn't the medical journal's article - so my hope is that the original article in the medical journal did not say that.
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Polar Bear
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Re: Published Research - General Sleep and WED (RLS)

Post by Polar Bear »

Yes, the 'degenerative' flashed at me also.
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Re: Published Research - General Sleep and WED (RLS)

Post by badnights »

It's not degenerative. The neurons don't die. The reporter did a fairly good job, but that was probably his/her mistake.

(There was a study that found damage to the myelin sheath in WED/RLS - maybe just to its functioning; even if it was physical degeneration of the myelin, that is not cell death, therefore not "neurodegenerative")
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cornelia

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

Post by cornelia »

I thought it was a mistake, but thanks for posting this

Corrie

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

Post by Rustsmith »

(There was a study that found damage to the myelin sheath in WED/RLS - maybe just to its functioning; even if it was physical degeneration of the myelin, that is not cell death, therefore not "neurodegenerative")


Beth, could you provide more information about this study on myelin damage and WED? Myelin damage sounds more like MS, a topic that I am much more familiar with thanks to serving as caretaker on my wife's case for 40 yrs.

Steve
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Ellephant
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Re:

Post by Ellephant »

ViewsAskew wrote:Wow, this was fascinating. I seem to recall that we have talked about this in the past (awhile ago).

http://www.websciences.org/cftemplate/N ... D=20066131

Auditory startle reaction is disinhibited in idiopathic restless legs syndrome.
FRAUSCHER B, LOSCHER WN, HOGL B, POEWE W, KOFLER M.
Sleep 2007;30(4):489-93.
Department of Neurology, Innsbruck Medical University, Innsbruck, Austria

STUDY OBJECTIVES: Because the auditory startle reaction is abnormal in disorders with substantia nigra pathology, we hypothesized that auditory startle responses (ASRs) might also be altered in restless legs syndrome (RLS). DESIGN: Neurophysiologic study of the auditory startle reaction. SETTING: Neurology departments of a university hospital and an affiliated local hospital. PATIENTS AND PARTICIPANTS: Fifteen patients with idiopathic RLS (6 de novo, 9 untreated after a 7-day wash-out period of levodopa, mean duration of IRLS symptoms 21.2 +/- 17.9 years, mean RLS severity score 23.5 +/- 6.7) and 15 sex- and age-matched healthy controls were investigated. INTERVENTIONS: Not applicable. MEASUREMENTS AND RESULTS: ASRs were elicited by 8 high-intensity auditory stimuli differing randomly in tonal frequency and intensity. Reflex electromyographic activity was simultaneously recorded with surface electrodes from 8 facial, neck, arm, and leg muscles. In RLS patients, ASRs were significantly more frequent (541 of 960 possible responses; controls, 430 of 960), and ASR area under the curve was significantly larger (3812 +/- 450 microVms; controls, 1756 +/- 226 microVms). Analysis per body region revealed that ASRs were significantly more frequent in RLS patients than in controls in leg muscles (138/360 vs 55/360); ASR latencies to leg muscles were significantly shorter in RLS patients (129 +/- 6 ms vs 160 +/- 11 ms); ASR area under the curve was significantly larger in RLS patients in facial (7547 +/- 1326 mmicroVms vs 2982 +/- 448 microVms) and leg muscles (1373 +/- 308 microVms vs 541 +/- 193 microVms). CONCLUSIONS: Our data demonstrate disinhibition of reticulospinal pathways in RLS patients as compared to normal controls, likely originating from dysfunction rostral to the lower brainstem.


So sorry for the gigantic quote, but I did multiple forum searches and couldn't find where this article had previously been discussed and even after reading the full article on pubmed, I wanted to ask some questions about the results.
...
...
What do they mean? haha

I'm specifically curious if the disinhibited physiological startle response implies that RLS patients are more sensitive and perceptive to sounds in general, or if it's just that the sounds are perceived the same as non-RLS patients, but the body physically responds much quicker and more intensely. Would an RLS patient be significantly more bothered by a television that was constantly playing too loudly than an non-RLS patient, or is the increased sensitivity only seen in response to sudden, startling sounds and in the form of the physical reaction?

I'm also very curious to know if this implies that RLS patients are more sensitive to background noise when sleeping. Are RLS patients lighter sleepers when it comes to external noise?I know that's a difficult question to ask because RLS patients are obviously light and inconsistent sleepers to begin with for lots of reasons, but I'm wondering if, entirely hypothetically, there were a way to control for all other factors, would the RLS patient be woken up more easily and quickly by a moderate volume noise than the average person? Are RLS patients predisposed to be light sleepers in terms of noise?

Do you guys personally find that you can sleep through the same level of noise that you could before your RLS symptoms became significant? What level of noise would you say you could sleep through? Are all RLS patients light sleepers, or are there still some who can sleep through any kind of noise IF they're actually sleeping in the first place?

I clearly have some questions haha, and I know they're a bit tangential to the actual study but I would be very interested in getting some of them answered.

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Re: Re:

Post by ViewsAskew »

Ellephant wrote:
ViewsAskew wrote:Wow, this was fascinating. I seem to recall that we have talked about this in the past (awhile ago).



So sorry for the gigantic quote, but I did multiple forum searches and couldn't find where this article had previously been discussed and even after reading the full article on pubmed, I wanted to ask some questions about the results.
...
...
What do they mean? haha

I'm specifically curious if the disinhibited physiological startle response implies that RLS patients are more sensitive and perceptive to sounds in general, or if it's just that the sounds are perceived the same as non-RLS patients, but the body physically responds much quicker and more intensely. Would an RLS patient be significantly more bothered by a television that was constantly playing too loudly than an non-RLS patient, or is the increased sensitivity only seen in response to sudden, startling sounds and in the form of the physical reaction?

I'm also very curious to know if this implies that RLS patients are more sensitive to background noise when sleeping. Are RLS patients lighter sleepers when it comes to external noise?I know that's a difficult question to ask because RLS patients are obviously light and inconsistent sleepers to begin with for lots of reasons, but I'm wondering if, entirely hypothetically, there were a way to control for all other factors, would the RLS patient be woken up more easily and quickly by a moderate volume noise than the average person? Are RLS patients predisposed to be light sleepers in terms of noise?

Do you guys personally find that you can sleep through the same level of noise that you could before your RLS symptoms became significant? What level of noise would you say you could sleep through? Are all RLS patients light sleepers, or are there still some who can sleep through any kind of noise IF they're actually sleeping in the first place?

I clearly have some questions haha, and I know they're a bit tangential to the actual study but I would be very interested in getting some of them answered.


Not related to sleeping in this study - it was conducted during waking hours and they were told to stay awake, though they were in a resting position. I don't know if anyone has studied if we're lighter sleepers related to this, however. Since over 80% of us have PLMs, I'd guess most of us are always light sleepers. The PLMs keep us from being in deep sleep all that often. With medication, I do not awaken any more often than people without sleep issues.
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Mouse Model - Brain cleans itself during sleep

Post by ViewsAskew »

http://www.nlm.nih.gov/medlineplus/news ... 41650.html
Sleep May Be Brain's 'Cleaning' Time, Mouse Study Suggests
Is waste-removal system at work during slumber?

By Mary Elizabeth Dallas
Thursday, October 17, 2013
HealthDay news image

Related MedlinePlus Pages

Brain Diseases
Sleep Disorders

THURSDAY, Oct. 17 (HealthDay News) -- Why do humans need sleep? That age-old question may have an answer, with scientists finding that slumber seems to help the brain clear away potentially harmful waste that builds up during the day.

The new study of mice found that by "taking out the trash" during sleep, the brain clears away toxins thought to be responsible for brain disorders such as Alzheimer's disease.

"This study shows that the brain has different functional states when asleep and when awake," the study's lead author, Dr. Maiken Nedergaard, co-director of the University of Rochester Medical Center for Translational Neuromedicine, said in a university news release. "In fact, the restorative nature of sleep appears to be the result of the active clearance of the by-products of neural activity that accumulate during wakefulness."

The lymphatic system disposes cellular waste throughout the rest of the body, but this waste removal system does not include the brain, Nedergaard's team found in earlier research.

With the help of new imaging technologies, the researchers were able to examine a living mouse brain to determine exactly how the brain gets rid of waste. They discovered the brain has its own unique process, known as the glymphatic system, that is guarded by a complex gateway known as the blood-brain barrier.

Using the brain's blood vessels, the glymphatic system pumps cerebral spinal fluid through the brain's tissue, flushing waste into the circulatory system until it eventually reaches the liver.

Noting that the amount of energy used by the brain increases during sleep, the researchers suggested this is when the brain's waste-removal system becomes more active. The brains of the mice studied were 10 times more active during sleep, the investigators found.

The researchers explained that pumping cerebral spinal fluid requires a lot of energy and this process may only be possible at night when the brain is not actively processing information. They also pointed out the sleeping brains were able to remove much more amyloid-beta, the plaque-building protein associated with Alzheimer's disease.

"The brain only has limited energy at its disposal and it appears that it must choose between two different functional states -- awake and aware or asleep and cleaning up," explained Nedergaard. "You can think of it like having a house party. You can either entertain the guests or clean up the house, but you can't really do both at the same time."

The study, published Oct. 17 in Science, also showed that during sleep, cells in the brain "shrink" or reduce in size by 60 percent. This creates more space between cells so that waste can be removed more effectively. The researchers speculated that noradrenaline, a hormone that is less active during sleep, could help control this process.

Without the brain's waste-removal system, toxic proteins, such as amyloid-beta, would accumulate in the brain. The researchers pointed out that nearly every degenerative brain disorder is linked to the buildup of cellular waste products.

"These findings have significant implications for treating 'dirty brain' disease like Alzheimer's," concluded Nedergaard. "Understanding precisely how and when the brain activates the glymphatic system and clears waste is a critical first step in efforts to potentially modulate this system and make it work more efficiently."

Scientists note, however, that results obtained in animal experiments do not necessarily apply to humans.

SOURCE: University of Rochester Medical Center, news release, Oct. 17, 2013
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aveerik
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Re: Published Research - General Sleep and WED (RLS)

Post by aveerik »

Do people with wed/rls have a higher incident in Alzheimers?

As far as noise issues with sleeping I wake up with any slight sound. I didn't used to do that but I do now. I sleep with a fan in my window every night and that helps drown out some sounds but I still hear every little noise.

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

Post by ViewsAskew »

aveerik wrote:Do people with wed/rls have a higher incident in Alzheimers?

As far as noise issues with sleeping I wake up with any slight sound. I didn't used to do that but I do now. I sleep with a fan in my window every night and that helps drown out some sounds but I still hear every little noise.


Not that I know of.
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